The case of Terri Schiavo dates back to 1990 when she was diagnosed with severe brain injury, commonly called a persistent vegetative state, after falling in the house and becoming unconscious. The condition worsened, prompting her husband, Michael, to apply for removal of feeding tubes in 1998 to stop her suffering. After several attempts, on March 18, 2005, doctors removed the feeding and hydration tube for the third time, leading to her demise on March 31 (Léon-Jimenez, 2017). The case attracted many stakeholders, including Terri’s husband and siblings, her parents, doctors and neurologists, the government, researchers, and the general public. The critical area confronting Terri Schiavo was the lack of understanding of her preferences concerning life in a persistent vegetative state that she could have addressed through advance directives.
At the time, assisted suicide in Florida had been addressed through previous cases and experiences. The decision was based on end-of-life support that doctors are allowed to accord patients to facilitate natural and painless death or legal euthanasia. According to Léon-Jimenez (2017), end-of-life is informed by a condition where the doctors assess a patient and establish that there is no possibility of recovering and the patient suffers from chronic pain. In the case of Terri, doctors performed medical procedures severally and the overall conclusion was that she could not recover. Based on the assessments, Michael Schiavo approved the procedure that was based on the parameters of the four-box method developed by the University of Washington in Seattle. Following the parameters, the doctors decided that removing tubes supplying nutrition and hydration would enable Terri to die naturally, as her condition was classified as terminal, where end-of-life procedures have been sanctioned legally.
On the other hand, the Schindler family (Terri’s parents) denied that their daughter was unresponsive to the surroundings and external stimuli. Their claim was fortified by two doctors who held that Terri’s condition had not reached a persistent vegetative state. They admitted that Terri’s condition was only “end-stage” and “terminal” when the tubes providing hydration and nutrition were withdrawn (Grishina et al., 2019). They argued that Terri would have continued to live for a more extended period; hence, pulling out the tubes supplying hydration and nutrition led to active euthanasia, which was considered inappropriate in medicine.
Simply put, they argued that termination of life support is not ethical and should not be permitted even when physical or cognitive limits have been outstretched. The case impacted the decision-making of the healthcare professionals involved in terms of requiring adequate neurological research in brain trauma cases. Léon-Jimenez (2017) emphasizes the need for healthcare professionals to conduct proper diagnostic procedures to set apart patients in a vegetative state based on the likelihood of recovering or not recovering from the condition. In such a way, the doctors can make objective diagnoses and prognoses without a difference of opinion as characterized by the specialists involved in Terri’s case.
The confrontation could well have been avoided if Terri had prepared advance directives. The directives could have spelled out her choices on the appropriate action to take in the event she faced looming death. Leaving such a crucial decision to other people exposes them to make their determinations on what “extraordinary measures,” “to alleviate further suffering,” and “if there is no hope of recovery” really mean (Léon-Jimenez, 2017). The advance directives would help to define the appropriate course of action in such an occurrence.
In conclusion, the case of Terri underlies the ethical dilemma in bioethics in determining the fate of an individual suffering from a terminal condition. The fact is that her condition significantly affected her ability to respond to her surroundings and external stimuli. The moment Terri’s husband made the decision for her life to be terminated, a debate emerged. It attracted a considerable family and political confrontation that could have been avoided had Terri prepared advance directives.
References
Grishina, E. P., Shiryaeva, S. V., Sherafetdinova, N. A., & Solovyev, A. A. (2019). Forensic medical examination of the quality of medical care: Legal, methodological and ethical issues. International Journal of Psychosocial Rehabilitation, 23(4), 668–679. Web.
Léon-Jimenez, F. (2017). Ethical and legal issues in brain injury rehabilitation. NeuroRehabilitation, 11(2), 119–127. Web.