Terri Schiavo

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Terri Schiavo
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Terri Schiavo Case Study

• On 25 February 1990, Terri Schiavo collapsed from
  heart failure as a result of her doctors
  misdiagnoses. Although she recovered from the
  heart attack, her brain was without oxygen for so
  long that she was severely brain damaged. She
  does not require artificial ventilation, but is
  unable to eat, so that she has had artificial
  nutrition and hydration since the time of her
  heart failure.
• According to Terris doctors, she is in a
  permanent vegetative state. She does have some
  neural reflexes, such as opening her eyes and
  blinking, but these are brain stem reflexes. The
  majority of her cerebral cortex has been
  permanently destroyed, so that she has no
  capacity for consciousness, thinking, feeling, or
  pain sensation. Terris physicians hold no hope
  for Terris rehabilitation or recovery.
• Terris husband, Michael, maintains that early in
  their marriage, Terri verbally expressed her
  wishes that she would not want to be kept alive
  by life-sustaining treatments. There is no
  written advance directive or living will.

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• In 1998 Michael sought a court order to have her
  feeding tube removed. A Florida court judge ruled
  that the feeding tube could be removed. Terris
  parents appealed the ruling, but the Supreme
  Court refused to hear the case. The tube was
  removed, but the parents were successful in
  getting a stay to the court order which meant
  that the tube was reinserted two days later.
  Supporters displayed placards reading Keep Terri
  alive and Starvation is murder.
• Following subsequent court hearings, another
  judge ruled that Mrs. Schiavo had no hope of
  recovery and ordered her feeding tube to be
  removed on 3 January 2003. Again, the parents
  appealed and lost their appeal. Again the judge
  accepted medical testimony that there was no hope
  for recovery from Terris severe brain damage,
  accepted her husbands testimony that Terri would
  not want to be kept alive by artificial nutrition
  and hydration, and upheld the court order to
  remove the feeding tube. The tube was removed on
  15 October 2003.

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• Terris parents turned to their last resort
  State Governor Jeb Bush. Bush was successful in
  passing a bill through the Florida Legislature
  which gave him the authority for this one time to
  overturn the court order the law is being called
  Terris law. On 22 October, Terri was moved
  from the hospice (which had cared for her for
  more than ten years) to a hospital which has
  begun intravenous rehydration. An independent
  guardian has been appointed for Terri, Dr. Jay
  Wolfson. He has 30 days to review the whole
  history of Terris case and make a recommendation
  concerning whether or not the feeding tube should
  be re-inserted.
• Floridas Supreme Court ruled that Terris law
  was unconstitutional. What this means is that
  the court order to remove the feeding tube should
  be carried out. This past November (2004)
  Terris parents tried one more time to gain
  custody of Terri and maintain her artificial
  nutrition and hydration. The Schindlers claimed
  that if Terri were competent, she would choose to
  continue tube feeding, even for decades, because
  she is Catholic. In March 2004, Pope John Paul
  II stated that persons in a persistent vegetative
  state have the right to continued life support
  through artificial nutrition and hydration. On
  Wednesday December 29th, a Florida Court of
  Appeals denied the request of Terris parents to
  launch a new appeal.

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Ethical Dilemma

• Reaching a decision for Terri when no advance
  directive exists.
• Would Terri really want the tube to be removed?
  Or would she want to remain alive in the
  vegetative state until her natural death?

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Focus question

• Should Terri Schiavo's feedings have
• been continued?

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Terris feedings should have been continued

• Terri Schiavos Catholic faith
• Michael Schiavo is no longer qualified to serve
  as Terri's agent.
• All life is sacred and worthy of protection

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Tube in Rebuttal

• Catholic faith is fluid. They dont always
  practice their faith to the extent of their
  religion.
• Spousal Vs. Parental decision making.
• Definitions of life and humanity

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Terris feedings should NOT have been continued

• Guardian requested tube removal
• The right to die with dignity
• Guardian sacrifices money to ensure Terris
  wishes are met

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Tube out Rebuttal

• Violated guardianship
• A best guess! Is not ground to decide on a
  persons choice to die. Benefit of doubt should
  always be given to life.
• Terri unconsciously paid for her own death.

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Summary

• Death is becoming a decision for each of us about
  how we want to die. More reflection in advance
  and discussion with loved ones will help to avoid
  this kind of tragedy. But it will not avoid all
  issues.

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References

• Dalhousie University, Faculty of Law Health Law
  Institute End of Life Projecthttp//as01.ucis.da
  l.ca/dhli/cmp_welcome/default.cfm
• Withholding and withdrawal of potentially
  life-sustaining treatment
• http//as01.ucis.dal.ca/dhli/cmp_ww/default.cfm?
  
• Address of Pope John Paul II on the care of
  persons in a persistent vegetative state
  http//www.vatican.va/holy_father/john_paul_ii/spe
  eches/2004/march/documents/hf_jp-ii_spe_20040320_c
  ongress-fiamc_en.html
• Joint Statement on the Vegetative State
  http//www.vatican.va/roman_curia/pontifical_acade
  mies/acdlife/documents/rc_pont-acd_life_doc_200403
  20_joint-statement-veget-state_en.html