Terri Schiavo Case Summary

When a patient is unable to make decisions for himself or herself, their caregivers and those who know them are appointed to make the decisions based on what the patient would have wanted. This is called surrogate decision making. According to the article Terri Schiavo and End-of-Life Decisions “when surrogate decision makers and caregivers cannot agree upon what that choice would have been, they may turn to the courts to determine either what the now-incapacitated patient would have chosen or who is best suited to choose as the patient would have” (Mathes, 2005)

The appellant of the Cruzan v. Missouri case was the parents of Nancy Cruzan, Joe Cruzan and Joyce Cruzan. The Cruzans argued that when they made the decision to hook Nancy up to a feeding and hydration tube they were unaware that Nancy would be in the vegetative state permanently, they thought she would make it (Cruzan by Cruzan v. Director, Missouri Department of Health. (n.d.). Oyez. Retrieved December 8, 2015, from https://www.oyez.org/cases/1989/88-1503).

The process of deciding when a terminally ill patient should die lies within the patient, family members, and the

In the Schiavo case she had a cardiac arrest, triggered by extreme hypokalemia brought on by an eating disorder, this ended up causing her to be in a PVS. She had no say in her care or her dying. Unable to speak and leaving no written orders or thoughts on how she would want to deal with a situation like this it was left up to the family. Eventually it was decided to stop her tube feedings and hydration.

(TCO D) A patient's family may be actively involved in end-of-life decisions for patients who are incapacitated or incompetent. Compare and contrast two legal cases that address the rights

Does a written document such as a living will decide when someone should die or should the verbal wishes of the incapacitated person be followed if known? Such as the controversy over when life begins, we now face the ultimate question of when does life end. In 1990, Terri Schiavo, a young Florida woman suffered a heart attack caused by bulimia leaving her brain without oxygen for six minutes. According to medical opinions, she has limited involuntary physical movement. She has remained in a persistent vegetative state ever since. Terri did not have a living will or medical directive in place at the time of her heart attack.

Schiavo’s case spent years in the court systems. Her husband, Michael Schiavo, fought to have her feeding tubes removed, stating Terri would not want to live like that, while her parents, the Schindlers, fought back to keep her alive (Sanburn, 2015). In 1990, when Schiavo was 26 years old, she collapsed for an unknown reason and oxygen was cut off from her brain for several minutes. She was left brain damaged, visually impaired, and dependent on a feeding tube, however, she could still breath on her own, maintain a heartbeat and blood pressure, see, and move. Michael blamed the collapse on cardiac arrest because of Terri’s potassium imbalance associated with bulimia. Her parents found this hard to believe, blaming Michael, and accusing him of trying to strangle Terri causing her brain oxygen deprivation (Lynne, 2005). Multiple doctors diagnosed Terri with permanent vegetative state

Hampson, L. A., & Emanuel, E. J. (2005). The prognosis for changes in end-of-life care after the schiavo case. Health Affairs, 24(4), 972-5.

In the year of 1990 on February 25, a presumably healthy young women by the name of Theresa Marie Schiavo better known as Terri suffered a massive heart attack in her Florida home which left her with serve brain damage. At the age of 26 she found herself unable to speak, or move, and unfortunately without a living will in place. How can she have told them what she really wanted if unable to talk in a vegetative state? Terri, although able to breathe on her own, found herself unable to eat or use the bathroom without the aid of a machine or person she was literally a prisoner in her own body. By law her husband Michael Schiavo was in charge of making treatment decisions for her , and after two years of therapy he wanted to disconnect the feeding tubes that helped keep her alive.

Schiavo accepted the doctors diagnosis of persistent vegetative and decided he wanted to remove her from the ventilator (Quill, 2005). The article says he was recalling prior statements that his wife had made, such as “I don’t want to be kept alive on a machine” (Quill, 2005). This is the part where things get tricky. Terri’s parents (the Schindler family) disagreed and did not accept the diagnosis, they believed that Ms. Schiavo’s condition would improve if they continued to provide rehabilitative treatment (citation).

They were the subjects of public disputes with family members, court systems, medical professionals, the media, and society at large. Terri Schiavo, Nancy Cruzan and Karen Ann Quinlan; their names are synonymous with permanent vegetative state (PVS). The amazing technological advancements in modern medicine has been credited with keeping persons alive who in times past would have died, therefore this is remarkable for countless families. In the cases of the Quinlan’s, the Cruzan’s and many like them, families members find it unbearable to witness loved ones who linger indefinitely in PVS with little or no chance for recovery. There are many like Terri Schiavo’s parents, who value the lives of their love ones no matter how limited their

Ethical dilemma may also arise in cases where a patient may feel their right to DNR should be carried out when giving direct order. The DNR process, however, is required to be documented by a physician. Andrew Putnam (2003) presents a case where an eighty-eight year old patient’s code status was DNR; “However, the patient has never signed formal advance directive statement or assigned durable power of attorney for her health care to anyone.” (Putnam, 2003, 2025) Ethics can be simply stated as doing the right thing (Roberts, 2002, 242); but in this case ethics is questioned because the physician was faced with the decision to carry out the wishes of the patient or to make a decision based on legality. In this case, it may have been morally right to carry out the wishes of the patient who wanted DNR orders carried out, but it may have been the right choice to do the legal thing and not carried out due to lack of signed documentation.

As an administrator I would need to take into consideration the patient’s autonomy, autonomy is recognizing an individual’s right to make his/her own decisions about what is best for them regarding their health care (Pozgar, 2012). The patient’s rights always should be considered before any decisions are made by any other family members. In this scenario it is clear that the patient is unable to make any decisions, the patient has suffered a serious brain damage, and although it is not complete brain death, we must determine how to proceed.

The advance directive, or living will, is one way of circumventing the ethical dilemma of Quinlan, as it is essentially a set of choices by the competent patient if faced with different hypothetical circumstances. Patients can thus feel comfortable knowing that their competent wishes have been documented and can be easily interpreted in case of catastrophe. However, the authority of advance directives is a topic hotly debated amongst medical ethicists (see Advance Directive Authority). Arguments against directives state that not all factors are considered by the person creating the advance order. Also, in some cases of severe dementia, it is argued that the personal identity of the author is no longer intact and therefore has no authority over the treatment of the “new” person. The debate on this topic is extremely complex, but many of today’s cases are decided on an individual basis, with the directive often being upheld.

Such a controversial topic as euthanasia and physician assisted suicide obviously brings about both proponents and opponents. When it comes to the case of a terminally ill person who is fully competent, how can one say no to his desire in having