6-2 Final Project Milestone Three_ Draft of Final Project II_ Bioethic
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Southern New Hampshire University *
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IHP-420-X3
Subject
Medicine
Date
Dec 6, 2023
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docx
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7
Uploaded by phillipmorrison12
Student: Phillip Morrison
Date: 10/8/23
Professor: Mary Vongarlem
Institution: Southern New Hampshire University
Introduction:
Terri Schiavo, a 27-year-old individual, had an unobserved cardiac arrest at her place of
residence in St. Petersburg, FL, on February 20, 1990. Upon seeing his wife in an unconscious
state, Michael Schiavo promptly contacted emergency services by dialing 911. The patient was
effectively resuscitated by emergency medical services (EMS); nonetheless, she had significant
cerebral impairment as a result of the oxygen deprivation after the cardiac arrest incident. As a
result of this occurrence, Terri experienced a coma. According to Pavel (2018),
a coma has an
extended period of incapacitating unconsciousness, generally spanning several weeks.
The fundamental issue of concern among the stakeholders, such as Mr. Schiavo, the
Schindlers, and the healthcare experts, revolved on the matter of Terri Schiavo's autonomy in
exercising her agency in relation to her medical treatment.
The Terri Schiavo case garnered significant attention in the field of bioethics, where
several ethical concerns were extensively discussed and analyzed. In several instances pertaining
to end-of-life circumstances, a notable interplay exists between ethical considerations, medical
practices, scientific knowledge, familial preferences, and legal frameworks. The family engaged
in a legal dispute about the question of whether Terri should be granted the right to continue
living or the freedom to choose to end her life.Following the occurrence, her cerebral function
was impaired due to a lack of oxygen, resulting in her entering a condition of prolonged
vegetative consciousness.
Robert and Mary Schindler, Terri's parents, worked hard to make sure their daughter got
the best care and therapy possible. A little over ten weeks later, there was still no improvement to
be seen, so the doctors changed their description to persistent vegetative state (9). If someone is
in a coma and then wakes up, they may have this condition, which makes them only able to do
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unwanted actions.After this, Pavel (2018) says the patient's brain function starts to weaken and
their level of awareness starts to decrease.The main issue that concerned everyone involved—
including Mr. Schiavo, the Schindler family, and the medical professionals—was Terri Schiavo's
freedom to choose her own medical care.
According to a publication by Harvard Health Publishing, a persistent vegetative state is
classified as an alternative level of consciousness. The individual exhibits a level of familiarity
with their environment, yet their level of responsiveness to stimuli seems to be less substantial
than expected for a wakeful state (HHP, 2020, para. 1). The individual comprehended that the
manner in which she was leading her life was not desirable, as shown by her conversations with
Michael Schiavo prior to February 25, 1990. Ms. Schiavo made a formal request for the removal
of the tube that was administering vital nutrition necessary for her survival.
Then, over the next two years, a number of interventions, such as physical and speech
therapy, as well as a number of trial treatments, were put in place to help her get better.
Unfortunately, there was no improvement that could be seen, and Terri continued to need enteral
nutrition through a feeding tube while she was in a persistent vegetative state for a long time. Her
parents strongly pushed for more brain tests and exams so that they could look for any signs that
might show that their daughter might be able to get better. According to the tests that were done,
there were no visible signs of improved brain function. This confirmed the diagnosis that she
would stay in the same state.
In 1998, Michael, the spouse of the individual in question, filed a petition with the 6th
Circuit Court of Florida, seeking the removal of his wife's feeding tube. Subsequently, he
expressed the opinion that Terri would not have want to persist in her current position and
circumstances. The parents promptly expressed their opposition to his choice and advocated for
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her to stay in her current condition. The individuals involved expressed a desire to sustain Terri's
life and said that, due to her Catholic faith, Terri would not have made a decision to terminate her
own life. This particular legal matter saw many hearings inside the court system, exceeding a
total of 10 instances, spanning over several years.
During the course of Mrs. Schiavo's case, a total of fifteen appeals were submitted,
leading to the initiation of many petitions and judicial proceedings, culminating in the filing of
five lawsuits in federal district courts. On several occasions, the feeding tube of Mrs. Schiavo
was subjected to removal and subsequent reinsertion for the whole of the legal processes.
Following a protracted conflict, much media attention, and several demonstrations, a decision
was reached on March 18, 2005, to discontinue the use of Terri's enteral feeding tube. She
subsequently died on March 31, 2005.
Bioethical Analysis:
There will always exist those who express dissatisfaction with choices pertaining to the
conclusion of one's life, and it is seldom that unanimous contentment will be achieved with
regard to the resultant resolution. Advocates for the preservation of life uphold the principle of
sanctity of life, extending their concern to those who are in vulnerable circumstances, lack the
ability to advocate for themselves, including unborn fetuses, infants, individuals with
impairments, and elderly individuals who depend on life-sustaining medical interventions. The
concept of the sanctity of life asserts that every individual, regardless of their stage of
development, level of consciousness or self-awareness, and various demographic characteristics
such as religion, ethnicity, education level, race, color, gender, physical ability or disability,
language, character, behavior, social status, and so on, should be regarded as equals and possess
immeasurable worth.
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It further emphasizes that individuals must be treated in a manner that aligns with their
moral status, thereby upholding their inviolable dignity (Barankze, 2012). The concept of the
right to life encompasses all phases of an individual's existence and has to be respected until the
individual's death occurs organically, without any human interference.
As per the legislation in Florida, the jurisdiction where Schiavo resided and underwent
medical care, Michael Schiavo held the legal guardianship over her, superseding other relatives.
This was due to the permanent state of incapacitation she experienced and the absence of a
designated health care proxy (Quill, 2005).
Conclusion:
The individuals responsible for the well-being of Terri encountered a myriad of diverse
conditions during the protracted legal dispute over a period of 15 years. The emergency medical
services (EMS) effectively performed their duties by successfully resuscitating Terri inside the
confines of her residence subsequent to her discovery in an unconscious state. The individuals
administered cardiopulmonary resuscitation (CPR) in order to save life. The patient was revived
after seven instances of defibrillation during her transfer to Humana Northside Hospital in St.
Petersburg, FL. Terri resided at this location for a duration of three months while in a comatose
state.
Following her awakening, she remained unresponsive and in a condition of vegetative
consciousness despite undergoing many therapeutic interventions. The therapists had difficulties
in administering a diverse range of therapeutic interventions due to the patient's state of brain
death. However, they were bound by their professional code of ethics to provide her treatment
that upheld principles of dignity, respect, and privacy. The media attempted to contact them for
updates on Terri's status, but they chose not to provide any information in order to preserve her
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secrecy (Quill, 2005).
The examination of Terri's case study underscores the significance of autonomy as a key
factor to be taken into account in similar circumstances. In order to honor the preferences of
patients about their end-of-life care, surrogate medical decision-makers are designated.
Physicians are obligated to uphold the ethical concept of beneficence in their role as advocates
for their patients. Consequently, the healthcare providers had a duty to activate the relevant legal
provisions safeguarding Mrs. Schiavo's rights and seek an alternative healthcare surrogate if it
became evident that Mr. Schiavo was not acting on her behalf.
The primary concern among the stakeholders, including Mr. Schiavo, the Schindlers, and
the healthcare professionals, was around the question of Terri Schiavo's autonomy in making
decisions about her medical treatment. The post-mortem examination afterwards ascertained that
it was unable to establish Mrs. Schiavo's capacities and aptitude. Healthcare providers should use
caution in avoiding any actions that may restrict Mrs. Schiavo's autonomy or agency.
References:
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Pavel, B. (2018). Important Issues in Coma and Neuromonitoring. Current Topics in Intensive
Care Medicine. doi: 10.5772/intechopen.79448
Harvard Health Publishing (2020). Coma and Persistent Vegetative State. RetrievedDecember
04, 2020, from
https://www.health.harvard.edu/diseases-and-conditions/coma-and-
persistent-vegetative-state
Quill, T. E. (2005). Terri Schiavo — A Tragedy Compounded. New England Journal of
Medicine, 352(16), 1630–1633. doi: 10.1056/nejmp058062
Baranzke, H. (2012). “Sanctity-of-Life“—A bioethical principle for a right to life? Ethical
Theory and Moral Practice, 15(3), 295–308. doi: 10.1007/s10677-012-9369-0
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