Reflection Essay Example: An Ethical Dilemma

The Terri Schiavo case is a tale of choice and the right to die in the face of severe medical conditions. I was shocked to find out that Schiavo's life was the center of a national debate that went on for more than a decade while the patient was living in an irreversible persistent vegetative state. Terris husband was for letting her wife be removed from life support stating that she would not have preferred to be placed on artificial life support without the prospect of recovery. On the other hand, there were Terris parents who opposed such a view and opted for their daughter to be placed on life support while receiving artificial nutrition and hydration. In the end, Terri Schiavo was taken off life support in 2005 (The Economist, 2005).

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The case represents a dark episode in every health practitioners professional life since there are few guidelines that can be used to administer the most appropriate care to patients. There have been other similar cases in the nation, but were unique as compared to Schiavos case. Karen Ann Quinlan entered into a persistent vegetative state in 1975, and her case quickly deteriorated and her family was allowed to remove her from life support after New Jersey Supreme Court ruling. In the end, she succumbed to pneumonia in 1985. In another case, Nancy Cruzan was also diagnosed to be in a persistent vegetative state and her legal case also reached the Supreme Court. The court decided that there needs to be clear and convincing evidence that indicates Nancy Cruzan wished to die. The Cruzan family did not possess such evidence, but later did and she was detached from life support in 1990 (The Economist, 2005).

A major issue regarding the Schiavo case is that there was a lack of settled and clearly defined law that would allow solving the problem as quickly as possible. The uniqueness of this case is that it heavily relied on a family dispute rather than professional understanding as a way of solving a problem. The end-of-life law that had been developed for more than two decades was under threat since other issues had not been catered for in this particular incident.

A significant detail about the Schiavo case is that there was a lack of defined law with regards to taking people off artificial feeding tubes. In Florida, it was common for terminally ill patients to be weaned off ventilators. The law in Florida did not have a clear guideline as to the manner of operations that should take place with regards to taking patients off feeding tubes. However, in a 1990 Florida case referred to as the Guardianship of Estelle Browning, the Florida Supreme Court essentially expanded the right-to-die protocols. It was decided that Browning has a constitutional right to accept or deny access to the use of medical treatment (The Economist, 2005). At the same time, the right extended to all decisions important to ones health.

As it can be seen, the case took on a legal path that required little professional expertise from the medical profession. The end-of-life debate was concentrated on the patients intent as well as medical status. Terri Schiavo did not have clear instructions with regards to her becoming ill and unable to make decisions on her own. American law is clear that Terris husband is responsible for her well-being. At the same time, the decade-long case battle sort medical advice from doctors who clearly identified Terri Schiavo to be in a persistent vegetative state. Even if she opened her eyes and smiled, these were merely reflex actions. While in a persistent vegetative state, she was unable to communicate since she was not aware of her surroundings (The Economist, 2005).

It seems clear that, from a medical perspective, a healthcare provider could do little to settle this dilemma that dragged on for many years in the U.S Justice System (McCormack, 1998). However, I believe healthcare providers should have a greater say when it comes to end-of-life decisions. Their decisions with regards to Terris situation would not have been based on sentimental value. I wish to state that all life is important, and these decisions are not as straightforward as they come. However, the extent of medicine does not have the ability to provide a solution that could turn around Terri Schiavos life (The Economist, 2005). There needs to be a consideration of the quality of life that such patients are forced to go through while in such a state. Advances in medicine can prolong the life of a person. In the U.S, the most common reason for requesting assistance to die is no longer intolerable physical suffering, but rather an existential suffering, whereby a patient has lost the meaning of having to live (McCormack, 1998).

Ethical and legal issues are constantly at play, and doctors and nurses have to understand the intricate dynamics involved in such a matter before making the final decision on a persons life (McCormack, 1998). In the Terri Schiavos case, the state took on an unorthodox approach to providing a lasting solution to all the aggrieved parties by even involving the Congress and the Presidency (The Economist, 2005). At the moment, euthanasia was illegal in most states while physician aid in dying (PAD), also referred to as assisted suicide, was legal in the states of Vermont, California, Oregon and Washington. In situations where there is a clear lack of information from an afflicted patient, it is advisable that physicians be referred to in order to arrive at viable solutions (Will, 2015).

References

McCormack, P. (1998). Quality of life and the right to die: an ethical dilemma. Journal of Advanced Nursing, 28(1), 63-69. http://dx.doi.org/10.1046/j.1365-2648.1998.00762.x

The Economist. (2005). The sad case of Terri Schiavo. The Economist. Retrieved 13 June 2016, from http://www.economist.com/node/3789436

Will, G. (2015). Is It Ethical to Affirm a Right to Die? National Review Online. Retrieved 13 June 2016, from http://www.nationalreview.com/article/423253/it-ethical-affirm-right-die-george-will