Introduction
Undoubtedly, the end of life is an emotional moment that raises serious physical and psychological concerns among the affected parties. For relatives, the death of a loved one causes serious emotions such as sadness and depression in severe cases. However, patients facing imminent death bear the brunt of end of life issues. For example, one is likely to experience physical pain, hopelessness, loss of dignity, depression, and other negative emotions. Besides the negative emotions such a moment causes on the patient and relatives, the end of life raises serious bioethical concerns, especially in circumstances where family and healthcare professionals need to make decisions that can either prolong or terminate one’s life. The Terri Schiavo case demonstrates the bioethical challenges that end of life issues present.
Case summary
The case involves the physical and mental incapacitation and eventual death of Terri Schiavo. Schiavo had been in a vegetative state from 1990 until she died in 2003. Schiavo’s condition made it impossible for her to engage in any physical activity, including necessary actions such as walking and eating. Besides, the disease had affected her brain, dealing a blow to her cognitive abilities. As a result, she could not speak. The fact that Schiavo could not walk, eat, talk, or understand meant she was in a persistent coma.
Schiavo’s condition resulted in serious bioethical concerns, especially regarding the use of feeding tubes. Schiavo’s husband, Michael, contested the use of the feeding tube, arguing that his wife’s wish was not to be kept in a vegetative state. However, Schiavo’s parents were against Michael’s suggestion. To fulfil his wife’s wishes, Michael files a case in court to compel health experts to remove the tube. Eventually, his wishes were met. However, in a reply, Governor Jeb Bush and the Florida legislature ordered the tube’s reinsertion. The push and pull between Michael on the one hand and the state and Schiavo’s parents, on the other hand, saw the tube removed and reinserted thrice before the patient eventually died.
Bioethical Analysis
Schiavo’s case presents several bioethical issues, especially concerning the role of family members in supporting patients on palliative care to make critical end of life decisions. Pinto, Piñeros, & Zapata (2018) contend that providing the family of the affected person with the opportunity to provide care and make critical decisions is one of the pillars supporting and managing the end of life issues for patients on palliative care. While the doctors attending Schiavo adhered to this principle, the differences between Michael and his in-laws made it challenging to provide the necessary support. For example, the failure to agree on whether to remove or continue using the feeding tube meant that she would continue living in a vegetative state. In sum, although doctors adhered to the principles of the intersubjective nature of the end of life issues, disagreements between Schiavo’s relatives made it challenging to arrive at an amicable solution.
Deciding on whether removing the feeding tube was in the patient’s best interests was also a major bioethical issue in the Schiavo case. According to Mondragón, Salame-Khouri, Kraus-Weisman, & De Deyn (2020), doctors should consider such factors as pain, deficits in memory awareness, and decisional incompetence when making decisions about the end of life process. Accordingly, deciding whether to remove the feeding tube should have depended on whether Schiavo was in pain and whether she was suffering from decisional incompetence and memory deficits. The challenge was, the patient was somehow interacting with her environment as demonstrated by her smiling at her mother, and asking doctors to stop a procedure they were conducting on her. On the whole, the fact that Schiavo sent mixed signals raised serious bioethical concerns.
Conclusion
Generally, the bioethical issues described above caused doctors to make specific decisions regarding Schiavo’s health condition. For example, the patient’s family members’ disagreements made it challenging to formulate the way forward, which meant that the status quo would be maintained. However, the ruling by the court in favour of Michael led to the removal of the feeding tube. The bioethical issue regarding a patient’s decisional and memory capabilities also caused healthcare experts to make certain decisions. For example, since Schiavo demonstrated the ability to understand and recognize people, doctors chose not to remove the feeding tube.
References
Mondragón, J. D., Salame-Khouri, L., Kraus-Weisman, A. S., & De Deyn, P. P. (2020). Bioethical implications of end-of-life decision-making in patients with dementia: a tale of two societies. Monash bioethics review, 38(1), 49.
Pinto, B. B. J., Piñeros, L. B., & Zapata, E. (2018). My life: bioethics, cinema and end of life care. Hos Pal Med Int Jnl, 2(5), 272-278.
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