Free Essay About Terri Schiavo And Healthcare Ethics Name

Abstract

The case of Terri Schiavo may be tragic but provides a valuable insight into the ethical compliance of the healthcare industry. Not only this case provides a valuable lesson to students on healthcare ethics, but also gives them a perception regarding law and social morality. From the legal perspective, Terri’s case was a straightforward one. However, biased media coverage generated a public outrage, and the biased mass opinion formed on the basis of the biased media publications completely changed the color of the case. This media bias was further fuelled by the involvement of eminent politicians. However, Terri Schiavo’s case is a great example of how the legal system did not buckle under the pressure of the popular media, the Pope, the President of the United States and the Governor of Florida and stuck to fairness. The court proceedings involved the presentation of the maximum number of neurological evidences ever produced in a case in the history of the United States before the passing of the end of life judgment. However, the case shows us that greater clarity is required in the definition of the persistent vegetative state.

Introduction

Healthcare ethics is a broad spectrum. The ethics of medical profession may start at the hospital ground influenced by medical code and terms, but soon it encompasses the patients’ families, moral values, individual choice, political games and even media views. Over the years, we have witnessed several cases that changed the very perception of ours regarding healthcare ethics.
Terri Schiavo case is one of the most discussed cases in the spectrum of healthcare ethics that grabbed the attention of both national as well as the international media, the Pope of Rome and the President of the United States. This case brings to the fore the issues related to personal choice in the end of life decision versus the existing system opposing the end of life decision making. This case also highlights the importance of advance life directives, healthcare proxies and living wills. The events surrounding the case of Terri Schiavo’s death raises many legal, moral and ethical issues. In many cases, media portrayed only a partial picture of the whole story that created a huge public outrage and even elicited statements from the Pope John Paul II. Many groups tried to promote many agendas during the debate over the life and death decision of Terri Schiavo, often in order to promote their own agenda (Perry, Churchill and Kirshner, 2005). This paper will discuss the implications of family disagreement over life and death decision, role played by the media, politicians and the court in galvanizing the moral debate. It will also highlight legal, ethical and moral sides of the case in the discussion. However, the main focus will be on the ethical side of the case.

Background

On 25th February 1990, Terri Schiavo at the age of 26 collapsed in the hallway of her apartment and suffered a severe hypoxia for several minutes. She left no living will or gave anyone the power of attorney to reveal her desire for the end of life decisions at the time. However, a few months after the injury, Michael Schiavo, Terri’s husband, was appointed as the legal guardian with full support given by Terri’s parents, Robert and Mary Schindler. After the mishap that took place on 25th February, 1990, Terri was unable to swallow anything, and so a gastronomical tube was inserted into her body to feed her medically (Perry, Churchill and Kirshner, 2005). In the next few years, Michael Schiavo took Terri to many known medical institutions across the country for various treatments, including experimental nerve stimulation treatment at the University of California and the speech and occupational therapy at the Sabal Palms Skilled Care Facility, Florida. However, none of those was successful in restoring Terri to her earlier condition. In 1991, Dr. Garcia J. DeSousa and Dr. Victor Gambone were the first ones to declare Terri in a permanently vegetative state. By 1994, Michael also became convinced that there was no hope left for Terri’s recovery (Perry, Churchill and Kirshner, 2005). However, he tried other medical procedures till 1998 and finally in 1998, Michael filed a petition to remove Terri Schiavo’s food tube, but Terri’s parents challenged the petition in the court. After years of legal battle starting from Pinellas County court in 2000, involving an array of public offices and dignitaries, including the Second District Court, Florida, the Department of Law, Florida, the US Congress and the President of the USA, judge Greer passed the order to take out the feeding tube on March 31, 2005 (Fine, 2005).

Understanding Full Vegetative State

Ethical Framework for the Case and the Role of Media
There are several ethical angles to the case. The central ethical argument centers on the respect for autonomy of individual and respect towards the disabled community. However, many argue that the main moral argument is around the character of those empowered to decide on a patient’s behalf.
In 2000, Judge George Greer gave the go-ahead to take out the food tube of Terri for the first time. The logic provided for his decisions issued from a legal as well as a healthcare ethical perspective. Terri was declared in a persistent vegetative state with no chance of recovery by the court appointed neurological experts, 10 years after the incident happened (Fine, 2005). From legal perspective, her brain was dead, and hence, Judge Greer from a pure legal perspective gave the go-ahead. From pure ethical perspective, proponents, also known as social conservatives, who supported Judge Greer’s decision, argued that the dilemma was between the quality of life versus sanctity of life. If a life cannot generate any quality for itself or for others, then that life is as good as dead was the prime argument of the supporters (Perry, Churchill and Kirshner, 2005). However, the definition of sanctity and quality in this ethical argument was mostly kept at a superficial level. The quality and sanctity of whose life and who should decide was not well-defined by the social conservatives.
However, once the decision was made by the judge, Terri’s parents started campaigning against it. It was quite natural for parents to do so as nobody wants to lose their child. Even if Terri was in a purely vegetative state, still to Robert and Mary, their child was alive. They were unable to accept the fact that Terri would never get well in the future. Media, which should have published a balanced view or the right view, started a campaign pro-life campaign. The media only showcased interviews of those doctors who gave their opinion in favor of keeping life because they thought that Terri had a chance for improvement. However, none of them could provide any neurological evidence or research in support of their opinion (Fine, 2005). Media projected the story in such a way that people started believing that Terri actually had a chance to recover from her state, and this generated a mass movement against the legal decision. This type of media coverage also encouraged the politicians to gain leverage from the situation. George W. Bush, then the governor of Florida, not only stopped the local court order, but also passed a law called “Terri’s law” to stop any such court orders against vegetative patients (Fine, 2005). In this process, his popularity rating went high in the state for helping a cause not well understood not only by him, but also by the people because of biased media coverage.
Media also brought a religious and moral angle to the ethical dilemma. Terri and her family were devout Catholic Christians. As per catholic beliefs, euthanasia was a sin and this process of taking off the food pipe was nothing but “euthanasia by omission” (as termed by the Pope John Paul II) (Perry, Churchill and Kirshner, 2005). Media argued that as a devout catholic, Terri would have never allowed this to happen to her or anybody else. This argument received so much attention that in 2004 the Pope John Paul II announced that artificial nutrition and hydration must be maintained in cases of permanent vegetative state, and it is morally obligatory to all Catholics (Fine, 2005).
However, one argument produced by the media was well-balanced. The media first highlighted the point that discontinuing Terri’s life would create a cascading disregard for people who are disabled. However, even this argument has fundamental flaw of overgeneralization as persistently vegetative state person cannot be compared with a disabled person. In this case, the similarities between a dead person and Terri Schiavo are far more than between Terri and a disabled person.
Finally, the ethical question boils down to who should take the decision about the life of Terri. After 15 years, Michael started relationship with another woman, and therefore, it was argued by the mass media that Michael should not be allowed to take any decision regarding Terri’s life.

Conclusion

Terri Schiavo’s case will probably remain as one of the highly controversial cases in the medical history of the USA. This case has so many different aspects that some will continue to believe that the legal decision taken by the court was wrong and that Terri should have been kept alive. On the other hand, many others would argue that the case should have been closed a long time back as Terri from the very beginning was declared in a persistent vegetative state with no chance of improvement by all the neurologists that came to the court as an independent observer. They argue that because of biased media coverage and political pressure the case took unnecessary time to get solved.

References

Perry, J.; Churchill, L.R. and Kirshner, H. S. (2005). The Terri Schiavo Case: Legal, Ethical, and Medical Perspectives. Annals Of Internal Medicine, 143(10), 744. doi:10.7326/0003-4819-143-10-200511150-00012. Retrieved on 24th February, 2015 from <http://science.kennesaw.edu/~echen1/Bioethics/Readings%20and%20slides%20for%20Quarter%201/Quarter%201%20readings/Terri%20Schiavo-Perry%20et%20al.pdf>
Fine, R. L. (2005). From Quinlan to Schiavo: medical, ethical, and legal issues in severe brain injury. Proc (Bayl Univ Med Cent). 18(4): 303–310. Retrieved on 24th February, 2015 from <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1255938/>