The Terri Schiavo Case Study

This is a prominent principle throughout the book, as patients typically appreciate having a say in their own fate. A patient’s control of their care varies from case to case, but the agents in the novel did their best to respect the patient’s decisions.

Throughout our lives, we face many situations that pose different ethical issues. Whether these situations are personal, or world wide, they are always here. A certain issue that has caught the public’s attention is The Death with Dignity Act. Death with Dignity involved a woman, named Brittany Maynard. Regarding all ethical issues, people may support things, while some people may not. Brittany’s decision was ethical and changed her life forever. From this, I determined that this decision was through rights - based ethics.

This ethical scenario presents an 86 year old female with numerous health issues and chronic illnesses. Mrs. Boswell’s advancing Alzheimer’s disease makes it extremely difficult to initiate dialysis, leading her physician to conclude a poor quality of life. The ethical dilemma portrayed in this case is between nonmaleficence and autonomy. Health care workers should focus on promoting the patient’s overall wellbeing and weigh the benefits and risks of the course of action, while also considering what the family declares they want done. Since the patient is deemed unable to make decisions, the goal is to collaborate with family, assess patient quality of life, address prognosis, and establish realistic care goals.

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)

Similar to Oregon’s Death with Dignity Act, I do believe there should be a policy with relevant criteria that best describes how to respond to patients needs and to protect vulnerable people in regards to PAS. To respect others’ autonomy or right to self-determination is to treat them as individuals having the abilities required to be rational decision makers, capable of identifying their own interests and making their own reflective choices. At the end of the day, patients should have the right to autonomous decision-making to determine for themselves what will be done to their bodies.

Compare the situations surrounding Diane and Debbie in terms of the physicians’ actions and morality surrounding those actions leading to their deaths. How are the cases similar? How are they different? What was the situation surrounding Terri Schiavo? How does her situation compare to the Diane and Debbie cases? What are the major ethical issues involved in each of these three cases? How are their cases similar? What are the ethically relevant, salient differences between them? What do you personally take away as the “moral of the story” for these three cases?

On February 28, 1990, twenty six-year old Terri Schiavo suffered severe brain damage when her heart stopped for five minutes. Terri's condition was the subject of intense debate and media scrutiny over the subject of euthanasia and guardianship. Given the circumstances of Terri's vegetated condition, and no physical proof of her wishes, the last word on whether or not Terri would stay alive was given to her husband Michael Schiavo, by the state of Florida. Michael's argument was that he was carrying out her wishes to not be kept alive in that state. Terri's family challenged Michael's claims saying she is responsive and in no discomfort, that her condition does not meet the medical definition of

I have chosen to discuss the case of Terri Shiavo which was a very big ethical case back in 2005. She had been left on a ventilator for 15 years. So let’s start from the beginning. On February 25, 1990 Terri Schiavo had a cardiac arrest that was causes by extreme hypokalemia (low potassium) brought on by an eating disorder (Quill, 2005). As a result of this cardiac arrest Terri developed severe hypoxic – ischemic encephalopathy which is another way of saying lack of oxygen to the brain (Quill, 2005). During this period she exhibited no evidence of brain function and eventually scans of her brain showed severe atrophy of her cerebral hemispheres (Quill, 2005). Her electroencephalograms were fat, indicating no functional activity of the

The ethical principles for nurses to practice with beneficence and no maleficence. This legal battle between Terri Schiavo’s husband and her family was an ethical debate between continuing artificial life or remove her feeding tube by the request of her husband. Using the theories of utilitarianism and deontology can be applied or considered in making the most ethically correct resolution. The cases are very complex and raise many moral and ethical issues. The cases have brought awareness to society of “the importance of discussing end-of-life issues with family members and underscores how an advance directive, a living will and/or durable power of attorney for health care, are a healthcare proxy clarifies and provides evidence of the wishes of an individual regarding end-of-life decisions. Terri Schiavo should impress upon laypersons and professionals alike the uncertainty of the context in which issues of continuation and termination are argued ethically. Nobody knows what Mrs. Schiavo would have wanted. She left no advance directive and in its absence her husband says one thing and her parents

Terri Schiavo had a cardiac arrest triggered by hypokalemia, which means that she had low levels of potassium in her blood. The cardiac arrest deprived oxygen of her brain and put her in a coma. Many doctors diagnosed her as a persistent vegetative state. Ever since she collapsed on February 25, 1990, she has been on a feeding tube until March 18, 2005.

Terri Schiavo was 26 years old when she collapsed in her home and suffered acute hypoxia for several minutes. Slightly shy of a year after her injury, it was clinically determined that she was in a persistent vegetative state (Perry, Churchill, & Kirshner, 2005). There were no legal documents, such as an advance directive or living will, specifying the wishes for care under such circumstances. Her husband, Michael Schiavo, was designated as her legal guardian. The Schiavo case caught the public’s attention when her husband elected to remove her feeding tube in the mid 1900’s. He understood that there has never been a case of recovery after a year of being in a persistent vegetative state. One of the moral issues surrounding the case centered on the appropriateness of removing the life-sustaining feeding tube or maintaining it. Throughout the case, there has

This is illustrated in Mrs. Smith’s case. Mrs. Smith is an 85 year old who has suffered from a large stroke that extends to both of her brain hemispheres which has left her unconscious and unable to make medical decisions for herself. She only has some brain stem reflexes and requires a ventilator for life support. Mrs. Smith did not set up an advanced directive, which is defined by Miracle (2011) “mechanism by which individuals make known how they want medical treatment decisions made when they can no longer make them for themselves” (p.229). Without an advanced directive, medical decisions will fall to Mrs. Smith’s children, Sara and Frank. Each of which have different views regarding their mother’s plan of care. The decision that needs to be made is whether to prolong Mrs. Smith’s life with continued medical intervention, as Sara would like to do, or stop all treatments and care, as Frank

29). The ethical dilemma regarding autonomy is what if the person is unresponsive and unable to voice their decision? Garrett, Baillie, and Garrett p. 30 answers this concern by saying that persons do not lose dignity because they are unconscious, in a coma, or out of contact with reality and that treating that person with dignity should still be in effect.

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.

Shouldn’t the parents have asked if what Andrea is experiencing is, in fact, absolutely terrible, before they decided that active euthanasia is best option for her (autonomy)? Just because she cannot be a moral agent that does not mean that her wishes and concerns are not important. With support from parents and health care team, the nine-year-old girl would definitely be able to express how she feels and what she would like to do. The two moral agents, the parents and the physician, seemed to have forgotten that the decision they are making was for Andrea.