What gives us the right to decide when is someone's time to live or die? Do we have that power? Is it a paper that gives us that power? Is it a verbal message that someone once expressed, and we are following their wishes? Ethics are moral principles, and is it moral to let someone stay in a vegetative state with no quality of life, just because we want them around and we are having that hope that they might wake up someday from a coma?
In this essay, I would like to introduce to you the case of Teri Schiavo the case of the right to die. This essay will also reflect the importance of having an ADR informed consent, a living will, a Power of Attorney and most importantly a health care summary in place, should an unexpected accident occur, and you are unable to speak for yourself. This case will involve a young lady whose husband and parents are at war with one another on issues if she should be kept alive or die. Apart from it, this case became a huge ethical dilemma that the sixth circuit court of Florida and former President George W. Bush and at the time the Pope also become involved with this case. This case went on for about 15 years before her death occurred and to this day her case still sparks a debate.
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Terri was born on December 3, 1963, in Lower Moreland Township in Montgomery County, Pennsylvania. His parents Robert and Mary Schindler were a married couple at the time of her birth. Theresa attended Bucks County Community College and it was there she met her husband Michael Schiavo in 1982. As they began dating, two years later they got married on November 10, 1984, in Pennsylvania. In 1986 the two moved to St. Petersburg, Florida joining her parents who had moved there and retired. Michael worked as a restaurant manager and Terri worked as an Insurance Clerk. Terri's life took a turn for the worst when she collapsed in her apartment on February 25, 1990.
The cause of her failing health was cardiac arrest. There were more facts that there may have been a weight issue, doctors had found that Terri was trying to lose weight, and apparently, her potassium levels were extremely low. As they tried to resuscitate her, they failed to rush her to the nearest hospital which was Humana Northside. Her dieting rituals were now the cause of her declining health. As stated by former doctors who were trying to figure everything out, they have seen that she was also suffering from hypokalemia, which was at a 2.0 level which should have been at least 3.5 to about a 4. 9 for adults. This could be a cause of death, but doctors even tried other alternatives for her well-being.
Theresa was being fed by a nasogastric tube to having a percutaneous tube. It was then her doctors diagnosed her with a persistent vegetative state (PVS). All these things occurred one year after her cardiac arrest. As her condition was worsening, she had massive brain damage due to a lack of oxygen to her brain which left her comatose and eventually led to her vegetative state. As the years went on the doctors tried speech and physical therapy in hopes to return to her normal state, but they were unsuccessful. For years prior Theresa's husband and her parent's relationship were great, knowing that their daughter was suffering a great deal they allowed the husband to live in their condo for months at a time while this whole ordeal was going on, especially with him being out from work caring for his sick wife. In November of 1990, Michael Schiavo took Terri to the University of California, San Francisco for an experiment to help stimulate her nerves, this experiment took several months to conduct and it too failed. They came back to Florida and admitted her to a rehabilitation center in Bradenton Florida. It was then in those years of her rehabilitation efforts that her Husband started to organize legal documents, going to the courts to have a DNR (Do Not Resuscitate) order in place. However, her parents were very upset over this decision made by her husband. They did not approve of this order that was in place. This was then that Terri and her condition was taking a turn for the worst. As Terri was then moved back and forth to different rehabilitation centers. At the time all of this is happening, Terri's husband was appointed to be her guardian decided by the courts and this decision was made without Terri's immediate family knowing. In July of 1992, all therapy for Terri was reported stopped and no one knew the reason because her husband oversaw her care. Michael Schiavo initiated a medical lawsuit, claiming his wife suffered from an eating disorder, that the general practitioner and gynecologist failed to become aware of. He was suing for $20 million dollars. Based on evidence and the jury rewarded Michael Schiavo $600,000 for the loss of spousal and over and over $1.5 million went to Terri. Out of all the funds $ 780,000 was put into a fund to provide for Terri’s healthcare bills and therapeutic needs in the future if need be. Michael and Terri's parents began to feud in 1993, over money and the use of her care. Her parents begged her husband to begin therapy for Terri once again because they felt as if she could become better with special therapy, but the husband refused. It was then her husband cut off contact with her family. He also went through legal services to have her parent's access cut off from his wife, so they wouldn’t have any rights to their own daughter. There was also speculation that Mr. Schiavo's guardianship was underway being taken away because he was denying treatment for a urinary tract infection that his wife had gotten while in rehab. Michael felt as if treatment would cause her to die, and he wasn’t ready to risk his wife's life. In 1994, Michael later engaged Jodi Centzone, he also refused to dissolve his marriage to Terri Schiavo, which caused more turmoil in Terri's family. As years passed Michael sought attorneys for the right-to-die litigator, which will give him the right to decide on the death of his wife. George Felos who was an attorney filed a petition to withdraw life support. The courts started an investigation with came about a Guardian ad Litem which they felt should be denied based on conflict, this was dismissed. In the year 2000, a more legal petition was coming to the surface. In January of 2000, George W. Greer in Pinellas-Pasco's Sixth Judicial Circuit had the petition to withdraw life support for Terri. However, Michael Terri's husband told the courts that his wife's wishes were not to be put on life support, but her family said Terri wanted life support. Her family later went and appealed the case, which was going in the husband's favor, but they failed at getting it appealed. On April 21, 2001, Terri Schiavo’s feeding tube was removed Terri suffered for more than seventy hours without nutrition and lacking hydration, according to the medical records. Terri's family felt as though her husband was abusing her, so they filed for a Motion of relief from judgment before Judge Greer there was new evidence that Terri's neurological condition was better than before and they also had numerous affidavits from medical professionals that also supported their claims. But Judge Greer denied the motion, without even hearing their review. In 2002 another medical trial came to the surface where six physicians testified. Favor ruled that Terri would want to die and it is then that Judge Greer set a date for Terri to no longer be on Life Support. The judge also ordered that her enteral nourishment be removed. It is then people started to petition on behalf of Terri. These petitions signed by many people worldwide went to former Governor Jeb Bush of Florida to invoke Florida’s Adult Protective Custody statutes because there were allegations of neglect. There was also a bill that was passed in this huge case called “The Terri’s Bill”. Terri’s parents still tried to fight for their daughter’s health by having her tube reinstated, but the District Court denied her parent's request. Fourteen days passed and Terri didn’t have nutrition or was hydrated, On March 31, 2005, she died from severe hydration. Her husband held her in her arms as Terri took her final breaths Terri Schiavo's case and death took a toll on her family and many people that were hearing the news of this situation. There were so many ethical issues that were taking place in this case. The conflicts arose had Terri's husband gave Terri’s family a chance to voice their opinion about what shall be done in the best interest of Terri's medical situation. When it comes to medicine, law, and ethics there are so many situations that occurred. End-of-life issues draw so many questions and there are many solutions because no family should ever have to go through that what Terri and her family endured. Terri’s parents believed that she was making progress, and this was an ethical dilemma, that caused a lot of controversies that could have been avoided. There are a few ethical issues that thus case weighed heavy on this case. However, having a living will is the biggest ethical issue in medicine that many will face in life. A living will or also called an advanced directive, is a document that lets people state their wishes in case of a life-threatening accident and they are no longer able to speak for themselves. There are state laws on how this document can be prepared. Most times this document can be unfailing because sometimes people wish for changes and there are some medical doctors who would prefer an oral statement weather than a piece of paper stating end-of-life decisions. In this case, Terri Schiavo didn’t have any documentation, and for that, this caused a lot of the controversy between two families. Terri’s husband stated that his wife didn’t want to live in a vegetative state but was taking many years to testify with this claim leaving her for a few years in a state that she didn’t attest to. Terri’s parents had other claims, and this caused many different issues. Some may have felt that Terri's husband may have violated her wishes by living her in this state while giving the courts the power to decide the fate of his wife. A living also provides flexibility on different diagnoses that doctors may conclude, for instance, Terri’s parents tried to reason with her husband stating that if Michael had continued therapy and other medically needed treatments that there could have been a percentage or little certainty for Terri to make improvements. But their claim was denied by the courts, with families feuding over ill loved ones’ best to have their decisions already written, signed, and sealed. There are also laws regarding a living will having witnesses, people are close to you to make sure that this will is not ignored but granted in due time. The majority of living wills will also accompany another document called a durable power of attorney for health care decisions also. This gives a spouse or that patient child/children the ability to also make decisions if needed. There are many people whose lives are at stake because of laws that hinder what happens in end-of-life situations. This case was so big that it is used as a formal example worldwide in the medical field that shows how this ethical issue spark so many issues. The story of Terri Schiavo is very tragic and all costs could have been avoided. There are many arguments that Terri could be alive today or even had her own wishes granted had she done her proper documentation. Currently, more Americans are now realizing the importance of a living will, especially after hearing about the Schiavo case. There are many Americans who do not have a written will for their families to follow. Many lawyers and speculators would agree that it is important to start gathering a living will for yourself once in college. In most states, all living wills are to be drafted as early as age 18, and there are different statutes for each state regarding such documentation. There are also facts that when doing a living will you want to be sure to have open conversations with loved ones while preparing your will, so no one is confused as to what occurred in the writing process. There are so many people who avoid the topic of death because they are simply afraid and some even reject the thought of death. Consequently, no one wants to die is understandable, but just like this case, Terri didn’t expect to be put in such a predicament that would cost her life. Instead, she did trust that her family could make the right decisions for her. There are so many other facts that were well learned from this case that are crucial to all our lives. The series of events that took place was very much tragic, especially being that Terri didn’t have anything documented on her behalf. This case becomes a story that will be history, especially in politics surrounding Americans, dealing with the law and moral and ethical practices in the medical field. Another, solution that could help in cases such as this is that physicians should be able to incorporate having their patients and the general public fully educated about healthcare laws and the ethical decisions that will be made. Also, Terri’s doctors should have had more engagement in the political part of the process because they were the ones with the knowledge, who were treating her at the time. They knew what was best for her and her condition. Terri’s primary doctor should have had documentation of her wishes from prior visits before she is critically ill from previous good visits and follow-up exams.
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