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HSM-542 Week 5 Discussion 2: Schiavo Case (GRADED A+)

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HSM-542 Week 5 Discussion 2: Schiavo Case (GRADED A+) HSM 542 Week 5 Discussion Question 2 Schiavo Case (graded) Read the account of the 2003 Terri Schiavo case in your supplemental textbook. If you were the CEO of the organization that cared for Terri Schiavo, what issues would you consider most critical for your ethics committee to consider in that case? The Terri Shiavo case was a difficult ethical situation due to the fact that Terry did not have an advance directive. When there is no advance directive, hospital administrators must rely on other criteria in order to make decisions concerning the welfare of the patient. Typically, cases such as the Shiavo case are decided using four different perspectives: 1. the patient's medical indication, 2. the patient's preference, 3. the patient's quality of life 4. the social contextual factors[Min06] Once it had been confirmed that Terry was in a persistent vegetative state and would most likely never recover then the decision making fell to a will or advance directive. Since this was not available, the next of kin (husband and family) would become the decision makers for Terry. However, neither party was a compelling candidate for making a decision concerning Terry’s life. Michael Schiavo gave up his right to the inheritance he would have received after the death of Terri Schiavo. Although he never divorced Terri Schiavo, he had two children with another woman after Terri Schiavo was declared in a PVS. Therefore, we feel it was inappropriate that Michael Schiavo was still the legal guardian of Terri Schiavo[Min06]. But Terry’s parents were not good choices for making decisions concerning Terry because The parents of Terri Schiavo had the strong conviction that Terri wanted to live. Since the parents were next of kin, they should have been the legal guardians, yet during the 15 years from 1990 to 2005, they did not provide any substantial care to their daughter nor did they give Michael Schiavo any financial help. Thus, it is difficult to understand the motives of either Michael Schiavo or the parents[Min06]. From this standpoint the only ethical considerations left were the quality of life and the social contextual factors. The quality of life for a PVS patient is rather bleak. It is described as: PVS patients are unable to respond to their environment and require 24-hour care for feeding and maintaining personal hygiene. Without the round the clock care, survival of these patients is problematic. Since PVS patients' sense of pain is inconsistent and they do not show any significant clinical responses, it is speculated that they also do not have high levels of functional activity (including thought) of the cerebral cortex[Min06]. The quality of life was really the determining factor for Terry Schiavo. The social contextual factors surround the case were, at best, ambiguous. There were opinion differences between family and Michael Schiavo but the motivations for these opinions were not clear. As a result the decision to remove Terry’s feeding tube was made on the basis of the patient's quality of life. While this ethical decision making process was not perfect it did work to resolve the situation in the best possible means for the patient. References Lai, M.-L. (2006). The Ethical Issues Raised by the Terri Schiavo Case. Retrieved from Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan:

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HSM-542 Week 5 Discussion 2: Schiavo Case (GRADED A+)


HSM 542 Week 5 Discussion Question 2
Schiavo Case (graded)
Read the account of the 2003 Terri Schiavo case in your supplemental textbook. If you were
the CEO of the organization that cared for Terri Schiavo, what issues would you consider
most critical for your ethics committee to consider in that case?
The Terri Shiavo case was a difficult ethical situation due to the fact that Terry did not have an
advance directive. When there is no advance directive, hospital administrators must rely on other
criteria in order to make decisions concerning the welfare of the patient. Typically, cases such as
the Shiavo case are decided using four different perspectives:
1. the patient's medical indication,
2. the patient's preference,
3. the patient's quality of life
4. the social contextual factors[Min06]
Once it had been confirmed that Terry was in a persistent vegetative state and would most likely
never recover then the decision making fell to a will or advance directive. Since this was not
available, the next of kin (husband and family) would become the decision makers for Terry.
However, neither party was a compelling candidate for making a decision concerning Terry’s
life.
Michael Schiavo gave up his right to the inheritance he would have received after
the death of Terri Schiavo. Although he never divorced Terri Schiavo, he had two
children with another woman after Terri Schiavo was declared in a PVS.
Therefore, we feel it was inappropriate that Michael Schiavo was still the legal
guardian of Terri Schiavo[Min06].
But Terry’s parents were not good choices for making decisions concerning Terry because
The parents of Terri Schiavo had the strong conviction that Terri wanted to live.
Since the parents were next of kin, they should have been the legal guardians, yet
during the 15 years from 1990 to 2005, they did not provide any substantial care
to their daughter nor did they give Michael Schiavo any financial help. Thus, it is
difficult to understand the motives of either Michael Schiavo or the
parents[Min06].
From this standpoint the only ethical considerations left were the quality of life and the
social contextual factors. The quality of life for a PVS patient is rather bleak. It is described as:
PVS patients are unable to respond to their environment and require 24-hour care
for feeding and maintaining personal hygiene. Without the round the clock care,
survival of these patients is problematic. Since PVS patients' sense of pain is
inconsistent and they do not show any significant clinical responses, it is
speculated that they also do not have high levels of functional activity (including
thought) of the cerebral cortex[Min06].
The quality of life was really the determining factor for Terry Schiavo. The social
contextual factors surround the case were, at best, ambiguous. There were opinion differences
between family and Michael Schiavo but the motivations for these opinions were not clear. As a
result the decision to remove Terry’s feeding tube was made on the basis of the patient's quality
of life. While this ethical decision making process was not perfect it did work to resolve the
situation in the best possible means for the patient.

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