...Running head: FIGHTING FOR DEAR LIFE: AN ETHICAL CASE STUDY ON Fighting for Dear Life: An Ethical Case Study on Terri Schiavo Catherine Grace Bautista Adventist University of Health Sciences Ethical and Legal Issues in Healthcare HTCA543 Dr. Stanley Dobias February 24, 2015 1 FIGHTING FOR DEAR LIFE: AN ETHICAL CASE STUDY ON 2 Introduction Death is inevitable. However, for some of us, we fail to express our final wishes to our loved ones and this more often than not ends in conflict. In the United States, it is necessary for an individual to have a living will since this provides answers to end of life issues that would be in question. The story of Terri Schiavo was a case study worthy of note given that concerns or conflicts about end of life care have never been a source of familial dispute in my native country, the Philippines. Her 15-year saga brought about several questions that correspond to moral, ethical, and legal issues. Terri Schiavo’s end of life issue has now set a treacherous precedent for all vulnerable Americans, especially those who are in the marginalized sector: the disabled, those who have terminal illnesses, those who can no longer speak for themselves, and perhaps one day even to those who are indigent and unable to pay for costly health care. These individuals may become gradually compelled to make the choice to die and “get out of the way” notwithstanding their true wishes. Early Years Therese Marie Schindler was born...
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...Terri Schiavo was a 27-year old who suffered cardiac arrest on February 25,1990. Terri was anorexic which caused her to suffer from extreme hypokalemia, which is an imbalance of potassium. The hypokalemia caused the cardiac arrest, which led to a coma due to anoxia, a lack of oxygen in her brain. Terri had brain damage and was in a vegetative state “ during the subsequent months, she exhibited no evidence of higher cortical function. Computed tomographic scans of her brain eventually showed severe atrophy of her cerebral hemispheres, and her electroencephalograms were flat, indicating no functional activity of the cerebral cortex. Her neurologic examinations were indicative of a persistent vegetative state, which includes periods of wakefulness alternating with sleep, some reflexive responses to light and noise, and some basic gag and swallowing responses, but no signs of emotion, willful activity, or cognition” (Quill, M.D., 2005) At the hospital to buy time and keep her alive doctors had inserted a feeding tube. Two months later, her husband Michael transferred Terri from the hospital to a rehabilitation center. The following month her husband with no objections from her parents became her legal guardian. Her parents tried taking her home and caring for her but later sent her back to the rehab center because it was too much work to take care of her at home. Terri needed round the clock care “For months 13-18 into her coma, three shift of workers worked 24 hours a day...
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...A recent case of euthanasia in the state of Florida was the Terri Schiavo case. Terri Schiavo collapsed at her home on February 1990, at the age of 26. She was admitted into the hospital in St.Petersburg, Florida. Terri had a brain injury due to oxygenation starvation to the brain, she was on a ventilator for a few weeks, and however, she was then taken off life support, since she started breathing on her own. Terri was married to Michael Schiavo, which was then appointed as her guardian by the courts, without notifying her family first ("Terri's Story," n.d.). Terri was provided with physical therapy by 1991. Terri’s husband initiated a medical malpractice lawsuit against her doctors, stating that Terri may have suffered of an eating disorder,...
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...On February 25th, 1990, paramedics arrived at a Florida apartment complex and found a woman by the name of Terri Schiavo laying face down in the hallway of her apartment. Upon arrival, the paramedic's medical analysis showed that Schiavo's breathing had ceased and a pulse could not be found. Several attempts at resuscitation were made on the way to the hospital and upon arrival Schiavo was intubated and hooked up to a mechanical ventilator to assist her with breathing and receiving proper nutrition. The official medical records contained notes with various revelations and remarks from doctors. The information that stood out the most from the files were notes shedding some insight on two severe issues that could very well explain why a young...
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...On February 25, 1990 began the life and death struggle between spouse and family to determine the fate Terri Schiavo’s life. Schiavo suffered from an episode of cardiac arrest which left her unconscious and without oxygen to her brain. Resuscitation efforts were a success but due to the lack of oxygen there was irreversible damage done to her brain. Once placed into the hospital, Schiavo needed an aggressive form of care and was ultimately intubated in order to help her breathe. It was later determined that she was would most likely spend the rest of her life as a vegetable, it was then that the struggle between her spouse and family would ensue. Once it was determined that there was no hope of a full recovery, Schiavo’s husband made it clear that his wife would not want to live on life support and wanted to have her feeding tube removed. “Schaivo’s husband and legal guardian argued that Schiavo would not have wanted prolonged artificial life support without the prospect of recovery, and elected to remove her feeding tube.” Once Michael, Schiavo’s husband, elected to have the feeding tube removed, her family began the process of trying to keep her alive. “Schiavo’s parents argued in favor of continuing...
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...Terri Schiavo was considered to be in a vegetative state which is a condition that is separate from being classified as “brain dead.” She was able to breathe without assistance but was thought to have no mental state. There was an increasingly petulant battle between her husband and her parents. Mr. Schiavo wanted to remove her feeding tubes and insisted that his wife would not want to be kept alive in her state. The parents wanted to keep her on the feeding tube because they believed it to be their daughter’s wishes. The Florida courts were sympathetic to both parties but sided with Mr. Schiavo lawfully. Florida legislators felt the decision was unconstitutional and created what they called “Terri’s law” to prevent Mr. Schiavo from removing her tubes. The law was later overturn by the Florida Supreme Court. Then, the president at the time, George W. Bush, got involved and made the issue a federal case, which in turn favored with Mr. Schiavo in the removal of the feeding tubes. Ms. Schiavo died soon after. This is an unfortunately sad case that involved multiple stakeholders. Both the husband and parents loved Ms. Schiavo. I can understand all parties in this case but I overtly sympathize with the parents and husband because it is difficult to let someone go that you love but it is also difficult to see them suffering. I also understand that in some cases there is need for the courts to intervene. Considering all factors, I firmly believe that decisions involving the life...
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...Ethical Principles Violated In 1990, Terri Schiavo suffered cardiac arrest leading to a persistent vegetative state. Over the next 15 years, her case received international attention as her husband and parents argued over how to fulfill Terri's end-of-life wishes. Although tragic, the plight of Terri Schiavo provides a valuable case study. The conflicts and misunderstandings surrounding her situation offer important lessons in medicine, law, and ethics. Despite media saturation and intense public interest, widespread confusion lingers regarding the diagnosis of persistent vegetative state, the judicial processes involved, and the appropriateness of the ethical framework used by those entrusted with Terri Schiavo's care (Fine, 2005) On March 31, 2005, Terri Schiavo (born December 3, 1963) died -- the final complication of a cardiac arrest on February 25, 1990. Her death was preceded by the withdrawal of artificially administered hydration and nutrition through a feeding tube. Prior to her death, Terri's saga was the focus of intense medical, ethical, and legal debates in the United States and elsewhere. These debates were characterized by confusion about the facts, ethical principles, and laws relevant to the case. Much of the confusion revolved around a number of ethical and legal questions including: Is it ethically and legally permissible to withhold or withdraw life-sustaining treatments from patients who do not want the treatments? Is withholding or withdrawing...
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...families make ethical decision making by the healthcare team virtually impossible. Hospital ethical committees and even the legal system in certain situations must oversee such cases. There have been many cases where patients’ lives have been sustained by artificial measures and the issue of right to die has been debated. These individuals are in hospitals and long term facilities where everyone from family to the healthcare providers have an opinion. One particular instance would be the Terri Schiavo case where a young woman’s life had been sustained by artificial means for 15 years. A public battle was waged between her family and her husband and the decision to end her life. The case lingered on and ultimately the US congress had to intervene. As Terri Quill (2005) stated in relation to the case, “how can it be that medicine, ethics, law, and family could work so poorly together in meeting the needs of this woman who was left in a persistent vegetative state?” Cases like Terry Schiavo are not encountered everyday in a healthcare organization but to a lesser extent there are ethical situations that are. Healthcare organizations must also address ethical issues in terms of the financial aspect of healthcare. There has been a significant increase in awareness of healthcare fraud. Some examples would be physicians billing for services that were not rendered to patients and ordering procedures not necessary in order to seek reimbursements (Price and Norris, 2009). This impacts...
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...The Moral Dilemma – Euthanasia I have chosen to evaluate the Terri Schiavo ‘right to die’ case. This case dealt with the decision whether or not to remove her life support (feeding tube). In Terri’s situation she was in a persistent vegetative state (PVS). Therefore, Terri could not make the decision to remove her feeding tube for herself. The decision, therefore, was left to her husband who decided it would be best to remove her life support (feeding tube) which was opposed by her parents. Thus, the moral dilemma to evaluate, should human beings have the choice to die (right to die)? Moreover, should others have the right to make the decision for you? In this case, the type of euthanasia in practice is non-voluntary. Her particular case involved a combination of euthanasia types, meaning, nonvoluntary and passive with no extraordinary measures. Nonvoluntary because Terri could not make the decision for herself and passive because the removal of her feeding tube would eventually allow her to die. Lastly, with no extraordinary means, meaning, no additional measures or treatments applied to her condition that has no way of helping her state. Therefore, the burden of her situation outweighs any benefit (Mackinnon & Fiala, 2015). To evaluate this ‘right to die’ issue, we must consider the consequentialist and nonconsequentialist considerations. ‘Rule utilitarianism (RU) is the primary factor since ‘act’ utilitarianism (AU) would not work as a consideration in this case...
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...EUTHANASIA- The “Right” to Die ABSTRACT Euthanasia is one of those Taboo topics that individuals try to distance themselves from due to the fact that it’s a sensitive issue. Most individuals try to take a politically correct stand without evaluating the impact it has on the aggrieved party’s life. Euthanasia in itself may seem a simple issue at the first instance, but by probing deep into the issue we are made to ponder a lot about not only its ethical aspects but also the stakes involved in exercising Euthanasia as a fundamental right of an individual. The dilemma in this issue is a lot more complicated if we were to compare it to other conventional ethical dilemmas because both the stands seem morally right, but there’s a legal perspective which opposes one school of thought and supports the other. Is an individual allowed to determine his death if survival is more of a formality? If so what is the basis of qualifying a case to be a suitable contender for euthanasia? Is the judiciary ignoring this since Euthanasia is an issue faced by a minority? SOME FAMOUS VOICES ON EUTHNASIA: 1. Mr. Ravi B Naik, former High Court Judge and Senior Advocate: (deccanherald.com) “When it is not possible for man to give life, who is he to take it away? We should leave death in the hands of God who gave life. There is no law that allows killing by force till a man dies naturally, nor should there be one. In a situation where it is ‘impossible to live’, people die naturally. When they don’t...
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...All of the evidence and things are from Clyde Haberman article “From Private Ordeal To National Fight:The Case Of Terri Schiavo” (2014).Should have Terri Schiavo’s feeding tube been removed.Yes,it should have been.I’m proving that her feeding tube getting removed was better for her and everyone who loved her. I’m against keeping her tube in because according to Clyde Haberman’s article (2014) she couldn’t speak,she couldn’t even eat without a machine doing it for her.I wouldn’t want to live like that and I don’t think anyone would.She most likely didn’t want to live like that for the rest of her life.Her husband has also said that she had actually gestured yes when he asked if she wanted to die.So if that’s true then he was just fulfilling...
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...[pic] Terri Schiavo Who Has the Right to Die? [pic] GM520 Legal, Political and Ethical Dimensions of Business June 10, 2009 Terri Schiavo’s death has become a key element in the right-to-die argument she plays a key role in the case of who should decide what the value of life is? Terri Schiavo’s case was front page news for advocates of both the pro-life and right-to-die organizations, and each side believed they had the winning argument to support their position. The case became so big that both Congress and President Bush weighed in on the issue. On February 25, 1990, at approximately 4:30 a.m. EST at the age of 26, Terri Schiavo collapsed in her home and suffered a heart attack which interrupted the flow of oxygen to her brain. Paramedics were called to the scene and administrated first aid until she arrived at Humana Northside Hospital. Physicians continued attempting to revive Terri until it was determined that she had been without oxygen for too long and was placed on a ventilator. This lack of oxygen caused a condition called hypoxic encephalopathy (a neurological injury caused by lack of oxygen to the brain). Many people wondered what caused a healthy 26 year old woman to have a heart attack and some thought that there was foul play involved, but her Husband Michael Schiavo claimed that his wife was battling bulimia and a chemical imbalance was the cause of the heart attack...
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...Legal Ramifications of the Schiavo Case This article discusses the importance of Advance Directives and the development of the patient self-determination act of 1990 demonstrates the importance that the government places on a person’s right to make their own health care decisions. In the act, congress decided consumers had the right to make their own health care choices or appoint someone who can make that decision for them if they can no longer speak for themselves. It was deemed important enough that CMS (Center for Medicare and Medicaid Services) mandated that all hospitals, home health and hospice agencies, skilled and long term facilities who receive their funds, are mandated to inform patients of their rights under state law to execute advance directives. The article discusses the legal mechanisms for consent or refusal of treatment including: living wills, durable power of attorney for health care and medical directives. The legal ramifications of the Terri Schiavo case was that there was no health care directive executed by her other than a conversation with her husband in which she stated she would not want to have her life prolonged if she was in a persistent vegetative state. Without a health care directive, after three years the decision to remove artificial nutrition and hydration was made by her husband (legal guardian). Terri’s parents and siblings disagreed and thus began a judicial, legal, ethical and media circus. The parents and siblings deemed the removal...
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...For example, philosophers define ethics as a study of morality, whereas health care providers might explain it in terms of meeting patient needs and owing a responsibility to the patient. We often examine ethical issues not with a specific approach, but rather with a “hybrid” approach, based on past experiences, our conscience, legal constraints, and social influences and pressures. Often, ethical issues touch on legal issues, or are regulated by laws and regulations. Laws or rules are usually established to set minimum standards for society to employ when dealing with others. The case of a woman battling for her life stirs controversy and becomes mainstream media worldwide. On February 25, 2009, 26 year-old Terry Schiavo was found by her husband, Michael Schiavo, after collapsing in their home (). She was believed to had an eating disorder known as bulimia, which can result in heart failure because of the lack of vitamins such as potassium(). Oxygen deprivation during the time of her collapse was believed to be the cause of brain damage, which doctors believed she was in a persistant vegetative state but not drain dead. However, the case sparks the medias attention eight years later when Terry’s husband Michael petitions to have his wife’s feeding tube removed whereas Terry’s parents contest Michaels petition to end her life (). The ethical concern is the right to die. Euthanasia is a sensitive and debatable topic. From an ethical point of view, Terry’s situation should be...
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...Study This study is about a 41 year old woman whose name is Terri Schiavo. She was in a persistent vegetative state for 15 years with a brain injury before she died on March 31, 2005. This paper discusses her 15 year ordeal, the effects of it on her husband and family, Terri’s right to die, and the importance of end of life choices. We discuss the ethical and legal issues involved in the decision making of this case. Her husband and family disagreed on how to handle her situation, whether or not to remove her feeding tube. Even though their Terri was in both of their best interest, they could not agree on, would removing the feeding tube be killing her or letting her die? Ethical Importance Terri had left no written instructions as to what her wishes might be if she were no longer able to make her own medical decisions. The only thing that the court and her family had to go on was what her husband and family remembered her saying in conversation over the years. The memories of her husband and family were very different. In the beginning of this ordeal they both agreed that everything should be done for Terri’s survival because at that time there was hope. After a while, when Terri did not appear to be changing, or getting better, her husband believed that the quality of life that Terri had was not the quality that she would have wanted had she been able to voice her opinion. “Michael Schiavo said his wife had said that she would never want to be kept alive in...
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