Posted at April 27, 2020
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Bioethics

  1. Introduction

The Terry Shiavo case was legal case that divided the nation. After Terry lost consciousness in her home and developed hypoxic encephalopathy because of prolonged lack of oxygen. Terry would be in a persistent vegetative state, “a state of eyes-open unconsciousness with sleep–wake cycles in which patients are unaware of themselves or their environment” that would require artificial life support (Wejier; 2005; p. 2). After four years of Terry being in this state, her husband and guardian wished to take her off life support. However, her parents were opposed to this action which led to the right-to-die legal case.

Key stakeholders in this case were her husband Michael Shiavo, her parents Robert and Mary Schindler, and Terry Shiavo. The bioethics regarding this case is the ethical dilemma of end-of-life issues and whether it was ethical to have her feeding and breathing tube extracted.   Her husband Michael wanted to do what he believed she would have wanted after reciting her statement, “I don’t want to be kept alive on a machine” (Wejier; 2015; p. 5). He believed her quality of life was diminished to the point where she was only suffering. Her parents opposed this decision and did everything in their power to remove legal rights away from Michael. They believed their daughter should remain alive by all means necessary. Over the course of 15 years, they battled over this decision in the legal court. This case gained national attention even prompting Senator Jeb Bush to pass the “Terry’s Law” in attempts to block the feeding tube removal. However, it was stopped by the Florida Supreme Court. After years of court battles and appeals Terry’s feeding and breathing tube was finally removed March 2005, resulting in Terry’s death 14 days later.

2. Bioethical Analysis

There are several bioethical components involved in this case.  “Bioethics is concerned with questions about basic human values such as the rights to life and health, and the rightness or wrongness of certain developments in healthcare institutions, life technology, medicine, the health professions and about society’s responsibility for the life and health of its members” (Adelaide Centre for Bioethics and Culture, n.d., p. 2). Bioethics has four basic principles, they are: autonomy, justice, beneficence, non- maleficence.

“Autonomy requires that the patient have autonomy of thought, intention, and action when making decisions regarding health care procedures” (What are the Basic Principles, n.d., p. 2). Terry did not have a living will or any type of plan indicating what she wanted to do in case she became medically incapacitated. If Terry would have had a healthcare directive indicating her healthcare wishes it is possible the lengthy legal battle wouldn’t have ensued. “Justice is the idea that the burdens and benefits of new or experimental treatments must be distributed equally among all groups in society” (What are the Basic Principles, n.d., p3). “Beneficence requires that the procedure be provided with the intent of doing good for the patient involved” (What are the Basic Principles, n.d., p. 4). In Terry’s case the medical community remained silent about the possible course of action that should be taken in this case. “Non-maleficence requires that a procedure does not harm the patient involved or others in society” (What are the Basic Principles, n.d., p.5). This particular principle is vital because healthcare professionals live by the do no harm principle. They dedicate their life to helping patients not ending their life.

3. Conclusion

The majority of the country identifies with two types of advanced directives. The first is the living will which “allows you to make end-of-life health care decisions now” (The American Academy of Estate Planning Attorneys, 2017, p. 8). The second is appointing an ‘agent’ who will “make decisions for you if you cannot make them yourself because of your own incapacity” (The American Academy of Estate Planning Attorneys, 2017, p. 8). Both of these directives would have benefitted Terry Shiavo and her case as these directives are both legally binding and they would have no need for “financial and emotional toll of litigation” (The American Academy of Estate Planning Attorneys, 2017, p. 8).

The Terry Shiavo case opened the discussion regarding patients in vegetative states and their quality of life and what determines reduced consciousness. This case has also opened the discussion of who manages a patient who when the patient cannot. This case influenced healthcare professionals igniting physician suicide laws to be passed. They played a role in defining how Terry was in a vegetative state where she was incapable of thoughts or emotions and her only means of life were by artificial means. This was later confirmed in her autopsy where it was discovered “that she was in a persistent vegetative state and had irreversible brain damage” (Charatan, 2005, p. 1). More recently it has influenced the case relating to terminally ill Brittany Maynard, who died by ingesting barbiturates that were given to her by her physician. “Physician-assisted suicide is legal in nine US states and the District of Columbia. It is an option given to individuals by law in the District of Columbia, Hawaii, Maine, New Jersey, Oregon, Vermont and Washington. It is an option given to individuals in Montana and California via court decision” (Phycian-Assisted ; 2019; p.1). In order to go through this process a person must have a terminal illness and a diagnosis of six or less months to live.

 

 

 

 

Reference

Charatan. (2005, June 25). Autopsy supports claim that Schiavo was in a persistent vegetative state. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC558485/

Physician-Assisted Suicide Fast Facts. (2019, 1 August). Retrieved from: https://www.cnn.com/2014/11/26/us/physician-assisted-suicide-fast-facts/index.html

What are the Basic Principles of

Medical Ethics?. (n.d.) Retrieved from: https://web.stanford.edu/class/siw198q/websites/reprotech/New%20Ways%20of%20Making%20Babies/EthicVoc.htm

The American Academy of Estate Planning Attorneys. (2017, September 7). THE IMPORTANCE OF ADVANCED DIRECTIVES – THE TERRI SCHIAVO STORY. Retrieved from: https://www.schomerlawgroup.com/estate-planning/the-importance-of-advanced-directives-the-terri-schiavo-story/

Wejier, C. (2005, Apr 26). A death in the family: Reflections on the Terri Schiavo case. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC557072/ahoo

 

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