Theresa Marie Schiavo had been in a vegetative state for 15 years undergoing artificial hydration and nutrition which were then stopped causing her death. Her death was the culmination of a long and hard-fought battle between her parents and her husband regarding whether she should remain in a vegetative state on life support machines or whether to let her die.
Her demise caused a dispute between not only her husband and her parents but assumed national proportions as it even pitted the state Governor against judges as well as other interested parties against each other as it went on to become one of the most significant end-of-life cases in the United States (Cerminara & Goodman, 2013).
This essay looks at the case of Terri Schiavo and the ethical issues that arose from it, the definitions used to judge cases similar to it from a bioethics perspective and it will attempt to determine which of the two opposing parties was more ethically correct in its stance.
Theresa Marie’s ordeal began on February 25, 1990 when, after suffering a heart attack caused by an imbalance of potassium in the body, she got brain damage due to insufficient oxygen in the brain. She was admitted at the Humana Northside Hospital where she was given (PEG) percutaneous endoscopic gastrostomy for hydration and nutrition purposes. She was later transferred to the College Park Rehabilitation Center, a skilled healthcare facility (Cerminara & Goodman, 2013).
After a series of transfers to various medical and rehabilitation institutions where she received care and some experimental treatment, her husband Michael Schiavo was confirmed as her legal guardian by the court.
She was then awarded a $250,000 out of court settlement for malpractice by one of her physicians. In another malpractice case she was awarded more than a million dollars by the jury whereby $750,000 was put in a trust fund for her medical care and $300,000 was awarded to her husband Michael Schiavo (Cerminara & Goodman, 2013).
Michael later had a falling out with his in-laws, the Schindlers, over his wife’s therapy where he accused them of demanding a share of the malpractice money. After this falling out, the Schindlers moved to court in an attempt to nullify the guardianship of Michael to their daughter which the court dismissed (Cerminara & Goodman, 2013).
Terri was described by physicians as being in a persistent vegetative state meaning that although she appeared to have a normal level of awareness and some attentiveness and she also slept normally, she had no content of consciousness. In the words of a few hardliners, she existed but did not live. She could not experience emotion, could not think, interact with her environment and she had no memory. Some would argue that the fact, that she did not show any physical sign of distress, did not mean that she was not suffering and as such could not be used as an excuse to terminate her life.
What is being alive? Is life merely defined by locomotion of a person and by their ability to interact with their environment and those surrounding them, the perception and/or reciprocation of emotion, the perception of pleasure and pain and the ability to react to such? A person in Terri’s condition may feel all that is around them but may lack the ability to express it.
All of Terri’s bodily functions continued despite her condition so by all definitions she was alive and she would only reach an end stage/terminal scenario when the hydration and nutrition were removed. She might have lived to a ripe old age had the nutrition and hydration continued. The removal of hydration and nutrition for Terri was tantamount to euthanasia which is ethically deplorable and medically unwarranted (Koch, 2005).
The proponents of the cessation of hydration and nutrition for Terri chiefly her husband Michael were highly unethical. It was Michael’s duty as Terri’s guardian to care for her which by all accounts he did until he sought the termination of his wife’s life support. His decision is unethical because the termination of life support is forbidden in most situations.
Furthermore the second guardian to Terri “Richard Pearse” reported that Michael’s move to terminate life support for his wife might have been influenced by the potential inheritance he stood to gain if his wife were to die (Cerminara & Goodman, 2013).
There are those who challenge the prognosis of persistent vegetative state as being doubtful, inconclusive. Their argument gains credence from some clinical studies published in the recent past, some of which state that the vegetative state cannot be definitively characterized by a total failure of cortical function. Others have found that some 12 to 34 percent of patients claimed to be persistently vegetative maintain minimal consciousness and may respond to treatment (Koch, 2005).
With the realization that patients in a persistent vegetative state are conscious even minimally, the argument about quality of life flies out the window as even small gestures go a long way in improving the quality of life.
Terri may not have been able to converse with her loved ones, may not have enjoyed food and drink as she used to but may have been able to appreciate simple gestures from those she loved such as smiles, soothing words and their presence. Hence it was not up to others to define her quality of life or lack thereof and decide the limits of her existence.
Cerminara, K., & Goodman, K. (2009). Key Events in the Case of Theresa Marie Schiavo. Retrieved from: https://welcome.miami.edu/
Koch, T. (2005). The challenge of Terri Schiavo: lessons for bioethics. Journal of Medical Ethics, 31(7), 376-378.