The Terri Schiavo Case Legal Ethical and Medical Perspectives

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Peter Singer`s famous statement that “after nearly two thousand years of dominating our thoughts and decisions over life and death, the traditional Western ethic [of the sanctity of life] has collapsed” was clearly premature.21 The Schiavo case signals a resurgence of this collapsed ethic as a lexicographically superior value, primordial in which the norm remains the sacredness of life. regardless of “quality”. Whether those who advocate a “culture of care” will do so consistently and realistically – for example, the tax increases that a fully caring culture would certainly require – is another, albeit important, question. In the following paragraphs, we report on how the three issues are taken into account in the legal decision. While Terri Schiavo`s case remains troubling, it was one of the most contentious medical cases in history, focusing on medicine, ethics, law, and the role of the family in decision-making. Numerous case studies have stated that all responsible stakeholders worked so poorly to meet the needs of a patient who was left in a persistent vegetative state after several minutes of severe hypoxia (Quill, 2005). Then, the role of the legal representative is determined. This intention must be able to be expressed through a legal representative; However, it is clarified that if they are found, we indicate the entire sentences in the text relating to the analyzed dimensions, while we describe/summarize the concepts that we found in both legal documents, if we found that the text could be open to interpretation regarding the subject, since there is no specific sentence. Taxpayers represent the public with different interests and opinions in Terri`s case. They can influence the decisions of courts and other key stakeholders.

In some cases, public opinion about what happens in a courtroom may lack sufficient evidence and facts, and therefore credibility. Nevertheless, taxpayers may have both moral and ethical concerns in such cases. MP analyzed and interpreted the documents collected, wrote the text and revised the different versions of the manuscript; LP and DT collected the final court decisions and interpreted them from a legal point of view, drafted parts of the text and reviewed the final version of the text; DS analyzed and interpreted the collected documents from a clinical perspective, wrote part of the text, and revised the final version of the manuscript. All authors have read and approved this version of the manuscript. Prior to Terri Schiavo`s case, there were other cases of persistent vegetative states and minimal state of consciousness (MCS). In all these cases, medical experts must intervene to determine the differences between the persistent vegetative state and the minimal state of consciousness (Fins, 2008). These uncertainties pale in comparison to the greatest: in what ethical framework should such cases be judged? Bioethicists, assuming the facts are clear and the framework for their application is obvious, dismiss the concerns of those who argue consistently from a different ethical framework. The result will be to marginalize their own position and guarantee their status as non-participants in the ethical, moral, legal and political debates that this case usually promotes. The Schindlers appealed the decision.

Nevertheless, the judge upheld his verdict. After a few days, the Schindlers submitted a new affidavit to assess Terri`s current condition, which experts noted as irreversible neurological damage and were undoubtedly in a persistent vegetative state, but the judge concluded that such claims were unconvincing and were not supported by any facts. Nevertheless, the verdict remained the same. In January 1992, Eluana Englaro was 21 years old in Italy when she had a traffic accident and was hospitalized, where anoxic brain damage was detected. Her father had been fighting for more than a decade to have his feeding tube removed, claiming that Eluana specifically raised the issue a year before her accident, when one of her friends had a motorcycle accident and suffered severe brain damage. She had told her father that she would rather die and not be resuscitated if she was in such a state. The Milan Court of Appeal ruled that Eluana`s condition was irreversible and that the decisive factor must be the patient`s will before she was unable to work, as recalled by her family and friends. Finally, in 2008, Englaro won the support of the highest court. The Court of Cassation ruled that food could be stopped [13].

Following this decision, various religious and non-religious organisations tried to overturn the judgment of the European Court of Human Rights, but without success. Meanwhile, the social affairs minister and a Vatican spokesman confirmed that the decision was wrong and that the deprivation of artificial nutrition and hydration was “inhumane murder.” Mr Englaro decided to transfer his daughter to a private clinic in order to enforce the judgment, since the retirement home where she had been held since 1992 had opposed the execution of such a decision. The ministry tried to outlaw the activity of the private clinic (where Eluana was hospitalized after Lombard authorities said that every public clinic in its territory did not have to stop feeding and hydration in this particular case) and threatened to pass the legislation through parliamentary debate. Eluana died three days after doctors at the private clinic began a medical protocol on phasing out nutrition and hydration. The Terri Schiavo case has raised important medical, legal and ethical questions in history. More importantly, it highlighted the relevance of individual autonomy and the interests of freedom when one cannot communicate. In this case, and in other previous cases, the courts have always “confirmed the possession and control of [their] own person, free from all .. The interference of others” (Mathes, 2005). It is self-determination as enshrined in the United States Constitution. It is time to redefine the ethical principles of care for people with disabilities It should be noted that the problem in such a case is overgeneralization. Therefore, it is essential to understand cases in their specific legal and medical context.

Terri showed some forms of minimal cognitive and motor activity in a few cases identified several months after the explanation of the vegetative state. However, severe cortical impairment affected all long-term reactions. The distance between this definition of the person and that of the person as a discrete and existential being is at the heart of a now famous exchange between Harriet McBryde Johnson, a lawyer specializing in disability law, and Peter Singer, a bioethicist at Princeton University5 (for a detailed analysis, see footnote 3). She described caring for a family at home for a stubbornly oblivious teenager as “beautiful,” an act Singer found somewhat “strange.” The gap between their ethical frameworks was large enough to prevent both from clearly arguing the primary values and resulting constructs that led to the seemingly aesthetic judgments.20 Knowing how difficult it is to analyze legal and ethical discussions about people with DOC, let`s focus our discussion on one topic: In both MSDs and EE cases, the people who work for patient care were the subjects who initiated the legal process. Patients were of course not able to do this alone, but we considered it particularly important that judges be consulted if, and only then, there was a contrast between two parties (husband versus parents or father versus Italian state) on two points (the law as a guarantee of life and restoration of self-expression) and not on other things. such as types of medical or economic treatments. A judgment rendered by Judge George Greer of the 6th Clearwaterin District Court in February 2000, based on the testimony of Michael Schiavo (husband), his brother and her brother`s wife, in which it was shown that Theresa had made casual statements to them a year before her injury that she did not want to be kept alive artificially, concluded that Theresa`s feeding tubes (through feeding tubes, hydration and food are provided) should be removed. The Schindler family says Theresa has always shown a strong will to live and that they resisted stopping their daughter`s diet. Justice Greer upheld the court`s original decision in November 2002 and ordered the removal of the feeding tubes on January 3, 2003. Numerous courts of appeal and Federal Court motions have delayed this second reference until October 15, 2003.

TMS endured six days of dehydration before public support for the disabled woman prompted the Florida legislature to pass the “Terri Act,” which authorized the Florida governor to restore Theresa Schiavo`s feeding tubes. A few months later, after missing the opportunity to decide other aspects of the Theresa Schiavo case, the Florida Supreme Court bypassed the 2nd District Court of Appeals and declared itself competent to rule on the appeal of the “Terri Act.” The U.S. Supreme Court subsequently paved the way for the third removal of Theresa`s feeding tube. TMS died on March 31, 2005 at a hospice in Pinellas Park. As the Terri case showed, it became clear that decision-making was transferred to others who could not have fully expressed how Terri wanted her end of life. The problem arose because Terri had not legally determined who should make such decisions in the event of a case. From the perspective of physicians, judges, bioethicists and the public, this case shows the challenge of not issuing an advance directive.

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