Ethical implications of Terri Schiavo case

Terri Schiavo is a patient who lost consciousness in 1990 as a result of ventricular arrhythmia. Later, the diagnostic results revealed that she was in a persistent vegetative state (PVS). She used a feeding tube to remain alive. Her husband made a first application to court so that the feeding tube could be removed in 1998. The feeding tube was later removed in 2005 which was the third time and this resulted into her death after two weeks. The removal of the feeding tube from Terri brought about various ethical issues and implications and it was condemned and regarded as being illegal.

Medical ethics show that there are four main points of view from which the clinical issues get analyzed. They include what the patient prefers, the medical indication of the patient, the quality of life of the patient, and the socially related factors. All these issues are taken into consideration before any major decision is made (Atac, 2005).

First, medical indications are determined. After diagnosis of persistent vegetative status is confirmed, through the work of the expert neurologists, the physician discusses the likelihood of the patient recovering from the condition with the relatives. This includes the parents, spouse, children or sibling. It is important that the patient be accorded respect while undergoing treatment and care at home. It is therefore of ethical implication that Terri Schiavo’s case shows that she was not accorded the necessary respect since debate to remove her feeding tube was high between her husband and her parents concerning determination of care (Thompson, 2005).

Second, the patient’s preference is also taken into consideration. In Teri Schiavo’s case, there was no statement left behind as far as her wishes were concerned. The parents did not want the feeding tube removed since they were convinced that Terri wanted to live. It is also seen that her husband had two other children with another women after Terri became sick. The ethical implication that comes out here is that the husband lost his legal guardianship for Terri. Her parents therefore remained the legal guardians and as a matter of fact, their wishes for Terri should have taken preference over those of Michael Schiavo, her husband. The parents being the next of kin they were supposed to be given the legal right as the guardians of Terri. However, for the whole time, fifteen years, Terri Schiavo was sick; they were not involved in provision of any financial help. Therefore there is a contrast of ethical issues as expressed from the parents and the husband. The ones who want her to live are not giving any financial support whereas the one wants her to be freed in what is known as right-to-die is left to take control (The Ethical Issue, 1995).

Another issue is the quality of life. It is known that the survival period for the PVS patients ranges from two to five years, unlikely to exceed ten years. After Terri remained in a vegetative state for fifteen years, there were very little chances of recovering her consciousness. Normally, PVS patients are in need of around-the-clock care for hygiene and feeding. The PVS patients are termed as being unconscious and have their cerebral cortex destroyed thus characterized by inconsistent patterns of pain. Therefore their quality of life is not ideal. Activities done on them may have ethical implications since they may be assisted to die by withdrawal of care. This may raise conflicts especially where mercy killing or euthanasia is done, something against the code of conduct of the physicians. Therefore, the removal of the feeding tube in Terri Schiavo’s case is of ethical implication as it led to her death within two weeks (Dickman, 2000).

In the case of Terri Schiavo, the two parties involved are the husband and her parents. They both hold different opinions concerning the termination of the care being accorded to her. Whereas the husband wants the feeding tube be removed as a kind of liberation her parents are opposing the idea. It is established that, in 1992, Michael Schiavo was given one million dollars to surrender the guardianship of Terri but he did not. Therefore he still had the right to influence the termination of the care, something which most people condemned. Her parents, as the next of kin wanted the care to continue but they did not get their opinions preferred, accordingly showing that they had lesser rights than the husband.

From the discussion above of Terri Schiavo’s case, it is evident that the withdrawal of care from her led to her death resulting into different reactions from various people. It was of ethical implication to remove the feeding tube on the basis of liberating her from suffering terming it the right to die. Therefore, from this case, it was unjustifiable to terminate the care and thus it is necessary to promote care for the patient as much as possible.

References

Atac, A., (2005). A Study of the Opinions and Behaviors of Physicians with Regard to Informed Consent and Refusing Treatment, Military Medicine, 170(7), 566-71

Dickman, R. L., (2000), Bending the rules to get a medication, American Family Physician, 61(5), 1563

GAO Highlights, (2005), Un-compensated Care. Retrieved 5 September, 2009, from http://www.gao.gov/new.items/d05743t.pdf

Mossman, K. L., (1997). Medical testing: Issues and ethics. Forum for Applied Research and Public Policy 12 (3), 90

The Ethical Issue, (1995), Informed Consent.  Retrieved 5 September, 2009, from http://www-hsc.usc.edu/~mbernste/ethics.informed_consent.html

Thompson, R. E., (2005).  The Terri Schiavo Dilemma: An Ethics Report Card with a Few Surprises. Physician Executive, 31(5) pg. 60