IHP-420 Milestone Three
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Feb 20, 2024
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Milestone Three
Danelle Morgan
IHP-420 Ethical & Legal Considerations Southern New Hampshire University
Professor Johnathan Rhodes
October 8, 2023
Introduction
Terri Schiavo was 26 years old when she suffered cardiac arrest in her home on February 25, 1990. Although resuscitation efforts were successful, Terri went without oxygen for several hours, which resulted in severe brain damage. The extent of the brain damage resulted in her being in a persistent vegetative state. “A persistent vegetative state (PVS), also known as post-
coma unresponsiveness (PCU), is a chronic disorder in which an individual with severe brain damage appears to be awake but shows no evidence of awareness of their surroundings. (Guo, n.d.)” Terri’s family immediately explored potential treatment and rehab options while they continued to care for her over the next four years. At that time, the physician told Michael Schiavo (Terri’s husband) and Mary Schindler (Terri’s mother) that all options had been exhausted and Terri would not be able to function. Terri’s parents and Michael were friendly until the malpractice lawsuit was settled. Terri was awarded $1 million, and Michael was granted
control. In 1998, Michael filed a case to have Terri’s feeding tube removed, stating Terri had discussed with him prior to her accident that she would not want to live in that state. This decision led to a long battle with Terri’s parents. Bob and Mary insisted that Terri was not comatose and could smile, blink, and follow balloons in her room. Terri’s parents fought to keep her feeding tube and sought the help of the media. This became one of the longest legal battles involving end-of-life choices. The legal battle lasted seven years and ultimately ended with Michael being granted permission to remove the feeding tube. Terri peacefully passed away 13 days after the removal of her feeding tube. An autopsy was performed after her death which confirmed that she had suffered irreversible damage as a result of the accident.
Bioethical Analysis
Fremgen (2020) defines bioethics as the moral dilemmas and issues of advanced medicine and medical research. Terri’s case presented a bioethical issue concerning end-of-life care and a right to end her life according to her wishes. The conflict arose when her wishes had not been documented and were only verbally communicated to her husband. Patients have the right to refuse treatment, but when a patient is incapacitated, we refer to the patient's wishes. An advance directive documents the patient's wishes before the patient becomes incapacitated. This case does not mention if Terri’s wishes had been communicated to the family before her being awarded 1 million dollars, which Michael would gain from her death. This adds to the perception
that Michael chose to end her life to his benefit. Due to the different perceptions of Terri’s end-
of-life wishes and no advanced directive, her life was left in the hands of the courts. Conclusion
“Without advance directives, questions about decisions including guardianship, 'do not resuscitate', the use of artificial hydration and nutrition, and palliative sedation are suddenly important considerations. (Atari, 2008)” If Terri had an advance directive, her wishes would have been communicated and could have been upheld. Because the family members disagreed on
what was best for Terri, her care was left in limbo for several years until the court system agreed the removal of the feeding tube was in her best interest.
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References
Atari, S. (2008, April). The right to die: 'do not resuscitate': the Terri Schiavo case. How does hospice fit in?
PubMed. Retrieved October 8, 2023, from https://pubmed.ncbi.nlm.nih.gov/19397242/
Fremgen, B. (2019). Medical Law and Ethics
. Pearson Higher Education & Professional Group.
Guo, L. (n.d.). Persistent Vegetative State: What Is It, Causes, Diagnosis and More
. Osmosis. Retrieved October 8, 2023, from https://www.osmosis.org/answers/persistent-
vegetative-state