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Legal Case Study

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Legal Case Study This study is about a 41 year old woman whose name is Terri Schiavo. She was in a persistent vegetative state for 15 years with a brain injury before she died on March 31, 2005. This paper discusses her 15 year ordeal, the effects of it on her husband and family, Terri’s right to die, and the importance of end of life choices. We discuss the ethical and legal issues involved in the decision making of this case. Her husband and family disagreed on how to handle her situation, whether or not to remove her feeding tube. Even though their Terri was in both of their best interest, they could not agree on, would removing the feeding tube be killing her or letting her die?
Ethical Importance Terri had left no written instructions as to what her wishes might be if she were no longer able to make her own medical decisions. The only thing that the court and her family had to go on was what her husband and family remembered her saying in conversation over the years. The memories of her husband and family were very different. In the beginning of this ordeal they both agreed that everything should be done for Terri’s survival because at that time there was hope. After a while, when Terri did not appear to be changing, or getting better, her husband believed that the quality of life that Terri had was not the quality that she would have wanted had she been able to voice her opinion. “Michael Schiavo said his wife had said that she would never want to be kept alive in a vegetative state. He asked the courts to allow doctors to remove her feeding tube so she could die.” (Schiavo Timeline, 2005). It was then that the battle became public. Was it ethical for the feeding tube to be pulled to either let her die or was it to help her die? This battle went on for 15 years. According to her husband, she just existed, being fed from a tube, laying in bed, depending on others to take care of her every need. Her parents saw it - very differently. They spent a lot of time at her bedside talking to her and seeing those small responses from her that could easily be mistaken for a response, a smile, and her eyes watching them move about the room. During the course of 15 years, the feeding tube was removed three times before the last and fatal time. Her husband continued to protest that she would not want to be kept alive by artificial means. In the end, on March 31, 2005, Terri died 13 days after her feeding tube was removed.
Impact on Future Practice Throughout nursing school we are taught continuously that it is the patient that is most important and we are to advocate for their wishes. The outcome of this woman’s life if very tragic but it does reinforce that the patient is what is most important and it also emphasizes the importance of filling out an advance directive before something happens to you while you still can. You need to have a Health Care Proxy and advance directive and to make your family aware of your wishes in case you become incapacitated. “The positive outcome from this case is that it raises the public's awareness of the importance of discussing end-of-life issues with family members and underscores how an advance directive, a living will and/or durable power of attorney for health care, clarifies and provides evidence of the wishes of an individual regarding end-of-life decisions.” (Blakeney, 2005)
Legal Ramification The court eventually sided with Michael Schiavo and the feeding tube was removed. Terri died two weeks later. Even though Terri did not have a living will or advance directives the court believed her husband that she did not want to live like a vegetable. If it were you or I, would we want to live like a vegetable? I know that I would not want to be fed by a tube, always have -someone help me to take a bath, and not be able to take care of myself when I go to the bathroom. The legal system has now experienced this type of lawsuit and decided that Terri did not have to live that way. “The outcome of the Schiavo case remained consistent with established Florida statutory and case law, and honored Terri Schiavo’s state constitutional right to privacy. Although Schiavo may not affect advance directive law and policy in palliative medicine immediately, evidence suggests it has already increased interest in creating living wills.” (Kollas, para. 1, 2006). A good thing has come out of this trial. It has made people more aware of what their choices should be for their advance directives and that their directives need to be filled out and signed before they are needed.
Violated Ethical Principles In order to tell if there were any ethical principles violated, depended on how one looks at the whole ordeal. If one believes that it was not ethical to remove the feeding tube then there then the ethics were violated, but if they believe that it was ethical to remove the feeding tube than the ethics were not violated. It is my opinion, removing the feeding tube should have happened a long time ago. Keeping Teri alive the way she is, was cruel to her and to her family. It also violated her rights to die with dignity and not to live in a persistent vegetative state. I believe that ethics were not violated in this case. “Pat Robertson called the removal of her feeding tube “Judicial murder,” and House majority leader Tom DeLay described it as an “act of medical terrorism.” (Eisenber, 2005). I have a feeling that if given a choice, any member of congress or court that were so vocal about the horrific tragedy of removing the feeding tube would change their tune if it were to be them living a persistent vegetative state. The decisions on both sides were very difficult for her family to make. One thing is certain, everything that was done for Terri by her husband and family was done out of love for her.
Impact on the Standards of Practice

References
Blakeney, B. (2005). American Nurses Association Statement on the Terri Schiavo Case. ANA American Nursing Association. http://nursingworld.org/FunctionalMenu Categories/MediaResources /PressReleases/2005/pr03238523.aspx. Retrieved on January 16, 2011.
Eisenberg, D. (2005, April). The Terri Schiavo Case. Time Magazine. Vol. 165, Iss.14, p. 23. The New York Times Company. https://www.msu.edu/course/hm/546/schiavo_case.htm. https://www.msu.edu/course/hm/546/schiavo_case.htm.
In depth: Terri Schaivo. Schiavo Timeline. (2005). CBS News online. http://www.cbc. ca/news/background/schiavo/. Retrieved on January 16, 2011.
Kollas, C., Boyer – Kollas, B. (2006, October). Closing the Schiavo case: an analysis of legal reasoning. Department of Paliative Medicine. M. D. Anderson Cancer Center, Orlando, FL. pubmed.gov. U. S. National Library of Medicine, National Institute of Health. 9(5): 1145 – 63. Retrieved on January 16, 2011. http://www.ncbi.nlm.nih.gov/pubmed/17040153.

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