8-1 Module Eight Short Paper: Bioethics

Robin McFadden

IHP 420

April 28, 2024

Instructor Sam Germana

8-1 Module Eight Short Paper: Bioethics

I. Introduction

The case of Terri Schiavo, often referred to as "The Face That Moved a Nation," revolves

around the highly publicized legal and ethical dispute over the care and ultimate fate of Terri

Schiavo, a woman who was diagnosed with a persistent vegetative state (PVS). The incident

occurred over a span of several years, starting in 1990 and culminating in Schiavo's death in

2005.

Terri Schiavo suffered a cardiac arrest in 1990, resulting in severe brain damage and

leaving her in a persistent vegetative state. This condition left her unable to communicate, eat, or

interact with her environment in any meaningful way. After several years of medical treatment

and legal battles between Schiavo's husband, Michael Schiavo, and her parents, Bob and Mary

Schindler, the case gained national attention and became the center of a heated debate over end-

of-life care and medical decision-making.

The stakeholders involved in the case included Terri Schiavo herself, whose wishes

regarding her medical care were at the heart of the controversy. Additionally, her husband,

Michael Schiavo, served as her legal guardian and advocated for the removal of life-sustaining

treatment based on his belief that Terri would not have wanted to live in her current condition.

On the other side, Terri's parents, Bob, and Mary Schindler, fought to keep their daughter alive

and opposed the withdrawal of life support.

The bioethical issue at the center of the case was the question of whether it was ethically

permissible to withdraw life-sustaining treatment from a patient in a persistent vegetative state,

especially when the patient's wishes were unclear and there were conflicting opinions among

family members and medical professionals.

8-1 Module Eight Short Paper: Bioethics

Throughout the legal battle, various court rulings and legislative interventions added

layers of complexity to the case, leading to impassioned debates about patient autonomy, the role

of family members in medical decision-making, and the ethical implications of prolonging life in

cases of severe neurological impairment. The Terri Schiavo case highlighted the complexities of

end-of-life care, the importance of advance directives and clear communication regarding

medical preferences, and the challenges of navigating ethical dilemmas in the absence of

consensus among stakeholders.

II. Bioethical Analysis

The ethical principle of autonomy, which emphasizes an individual's right to self-

determination and decision-making, was at the forefront of the debate. Schiavo's husband,

Michael Schiavo, argued that Terri would not have wanted to be kept alive in a vegetative state

and sought to have her feeding tube removed based on her expressed wishes. On the other hand,

Terri's parents opposed the withdrawal of life support, citing religious beliefs and the sanctity of

life.

This case raised complex legal and ethical questions surrounding the right to die, patient

autonomy, and the role of surrogate decision-makers. It also highlighted the importance of

advanced care planning and the need for clear documentation of end-of-life preferences. Despite

numerous legal battles and interventions by lawmakers, the courts ultimately sided with Michael

Schiavo's authority as Terri's legal guardian to make decisions on her behalf.

From a bioethical perspective, this case underscores the significance of respecting patient

autonomy and honoring individuals' wishes regarding end-of-life care. It also highlights the
8-1 Module Eight Short Paper: Bioethics

challenges and ethical dilemmas that arise when there is a lack of clarity or consensus among

family members and healthcare providers regarding the appropriate course of action.

According to a study by Prendergast and Luce (2009), advance directives are associated

with increased likelihood of patients receiving care consistent with their preferences and reduced

family distress and conflict. Additionally, a report by the President's Council on Bioethics (2005)

discusses the ethical complexities of end-of-life decision-making, emphasizing the need for a

balanced approach that respects patient autonomy while also considering broader societal values

and interests. The case of Terri Schiavo exemplifies the intricate interplay of medical, legal, and

ethical factors in end-of-life care decisions. It underscores the importance of advanced care

planning, clear communication, and respect for patient autonomy in navigating such complex

and emotionally charged situations.

III. Conclusion

The decision regarding end-of-life care and the withdrawal of life-sustaining treatment

was the bioethical issue at the center of the controversy. Terri Schiavo was in a persistent

vegetative state (PVS) following cardiac arrest, and her husband, Michael Schiavo, petitioned the

court to remove her feeding tube, asserting that Terri would not have wanted to be kept alive in

such a condition. This decision sparked a highly publicized legal and ethical debate that divided

healthcare professionals, legal experts, and the general public.

This bioethical issue influenced the decisions of healthcare professionals involved in the

case in various ways. The fundamental bioethical principle of patient autonomy conflicted with

the sanctity of life principle. Healthcare professionals had to balance Terri Schiavo's right to self-

determination, as expressed through advance directives, with the ethical obligation to preserve
8-1 Module Eight Short Paper: Bioethics

life. Some healthcare professionals, such as Terri's attending physicians, believed that

withdrawing life support was consistent with her wishes and in her best interests, aligning with

the principle of autonomy (Furrow et al., 2020).

Healthcare professionals were tasked with determining Terri Schiavo's best interests,

considering her medical condition and quality of life. Despite conflicting opinions among

healthcare providers, some believed that continued artificial nutrition and hydration constituted

medical futility and were not in Terri's best interests, leading them to support the withdrawal of

life support measures (Furrow et al., 2020).

There were many legal and ethical dilemmas regarding healthcare workers’ obligations to

respect patient autonomy while adhering to legal requirements and professional standards of

care. The involvement of court-appointed guardians, legal proceedings, and conflicting medical

opinions added complexity to the decision-making process for healthcare professionals (Furrow

et al., 2020).

This case raised broader questions about end-of-life care ethics, including the

appropriateness of artificial nutrition and hydration for patients in a PVS, the role of advance

directives in decision-making, and the moral and legal authority of surrogate decision-makers.

Healthcare professionals grappled with these ethical considerations while striving to provide

compassionate care and uphold their professional responsibilities (Furrow et al., 2020). The

bioethical issue surrounding Terri Schiavo's case significantly influenced the decisions of

healthcare professionals involved, shaping their perspectives on patient autonomy, the sanctity of

life, best interests, legal obligations, and end-of-life care ethics.

8-1 Module Eight Short Paper: Bioethics

References

Fremgen, B. F. (2019b). Medical Law and Ethics. Pearson.

Furrow, B. R., Greaney, T. L., Johnson, S. H., Jost, T. S., & Schwartz, R. L. (2020). Health Law:

Cases, Materials, and Problems (8th ed.). West Academic Publishing.

Prendergast, T. J., & Luce, J. M. (2009). Increasing incidence of withholding and withdrawal of

life support from the critically ill. American Journal of Respiratory and Critical Care

Medicine, 155(1), 15-20.

President's Council on Bioethics. (2005). Taking care: Ethical caregiving in our aging society.

Washington, DC: President's Council on Bioethics.