Terri Schiavo’s Patient Rights and Death

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Introduction

Moral problems have always been important for human society since the time this society appeared. In different epochs the moral issues had different ways of the solution – some nations chose to solve them according to their religious norms, some others did not even recognize the importance of moral principles when the point was in reaching a certain goal. The situation with the attitudes towards the moral side of the concept of “death” was also different for different times and cultures.

Very often, in the past, people could not have the right to control their own lives, furthermore, they were unable to control death meaning that other people, who were higher by their social positions, decided for the rest of the people how they had to live and, how and when they would die.

With the course of time the relations in the human society developed into a higher stage of existence – people started to consider respect towards others’ thoughts and opinions to be an integral part of the interrelations of the society members. The picture seemed to be permanently improving until the issue of euthanasia and its conduct appeared on the horizon of the development of mankind.

Euthanasia is murder or relief from agony

Euthanasia is the process of stopping the medical maintenance of a patient’s life when the patient/herself does not want to suffer anymore and the doctors are sure that no improvements in the patient’s condition are possible. This is rather a controversial point concerning not only health but, firstly, ethics and morals (Featherman, 1992). The supporters of euthanasia claim it to be the only way out for those who have no hope for recovery and are tired of suffering.

Their opponents argue saying that a person in the state of a serious disorder can not decide adequately his future and the euthanasia based on the patient’s consent are not always properly motivated. Moreover, if there is no such a consent every act of euthanasia can be called simply killing of a person by his doctor. No matter what the attitude of people towards euthanasia problem is, all the attitudes are similar in the point that it is only the patient who has the right to decide whether to live or die and other people can not make such decisions for him/her (Bales, 1990).

The countries of the world are not united in concern of the euthanasia and assisted suicide issues. In the 19th century assisted suicides were outlawed throughout the world because, first of all, the religious Christian beliefs were too strong and did not approve of suicide in any of its possible forms. In the 20th century, the situation started to change together with the advances in medical science and changes in the moral attitudes of people towards the problem.

A large number of countries started legalizing euthanasia under the pressure of social groups fighting for the rights of sick people. Australia, Netherlands, Belgium, and a considerable group of other countries legally allowed euthanasia only at the end of the 20th – the beginning of the 21st century. In the USA euthanasia is legal in some the states, like Oregon, Pennsylvania, Florida but in some states, it is still considered to be killing (Hetherington, 1988).

The case that we are going to consider in the essay happened in one of the states of the US where euthanasia is allowed but its carrying out demands considerable legislative procedures. We are going to discuss the case of Terri Schiavo’s euthanasia carried out after 7 years of struggle between her husband, Michael who applied for the procedure for his wife, and Terri’s parents who opposed Michael saying that their daughter was conscious and wanted to continue struggling for life.

The most arguable point of the story is whether the US Court of Appeals contravened or respected Mrs. Shiavo’s rights by its decision to allow the removal of the feeding tubes which kept Terri alive for almost 15 years. The controversy of the situation is constituted by several factors which, together, formed one of the most resonant cases in the history of medicine and law (Kubler-Ross, 1989). So, let us trace the story briefly in its development.

The story about Terri Shiavo

Terri (Theresa) Shiavo get to the hospital in 1990 after a collapse that happened to her at home. The doctors found her with no pulse and no signs of breathing. Terri’s breathing was restored sometime later but such a long period without oxygen resulted in the damage of the parts of the brains dealing with cognition, perception, and awareness. The doctors diagnosed the case of brain damage and Terri’s health conditions started to constantly worsen. In 2002 the scanning of Terri’s brain showed that almost half of her brain’s tissue was damaged by hydrocephalus – the kind of liquid gathering in the brain when its natural outlet is blocked by some disease or another kind of damage.

Terri spent over 2 months in comma, even after returning to the normal sleep – wake cycle the doctors could not treat her. Different rehabilitation courses in various hospitals did not give any results and medics lost hope for Terri’s recovery. Her husband Michael applied to the Court about euthanasia for his wife because, according to his testimony, Terri told him that she felt pain and did not want to be kept alive artificially.

Terri’s parents, Robert and Mary Schindler, opposed Michael saying that their daughter was conscious and wanted to live, the medical aids gave her relief, at least temporary, and no pain disturbed her in the struggle for living. Series of trials followed Michael’s appeal and in 2001 the feeding tube that kept Terri alive was removed for the first time. But her parents’ appeal resulted in the fact that in two days the feeding tube was reinserted.

The trials in the Florida 2nd District Court of Appeal continued for another four years during which even the American government was involved into the Shiavo’s case. In 2003, when the feeding tube was removed for the second time, the actions of Terri’s parents supported by some social organizations led to the “Terri’s law” being passed by Florida legislation which allowed the governmental influence on the course of the case.

At once when the law was adopted Florida governor Jeb Bush ordered to reinsert the tube again. Finally, in 2005 the family conflict between Terri’s husband and parents was finished by the decision of the Florida 2nd District Court of Appeal – it stated that Terri did not want her suffering to continued and satisfied her husband’s claim according to which Theresa Shiavo’s feeding tube was removed for the last time on March 31st, 2005.

In Terri’s last hours only her husband was allowed to be near her, parents were kept outside until Michael left the hospice Terri died at. The autopsy proved that almost all regions of Terri’s brain were seriously damaged and there were no chances for her recovery. But even the skillful doctors who conducted the autopsy of Terri’s body could not say certainly whether she felt any pain or not. They said that it could not be found out with the 100% certainty so they did not made any conclusion concerning this side of the problem. Terri Shiavo was cremated after the autopsy and some days later her ashes were buried by her husband, Terri’s parents were not even informed about the time and place of the funeral.

This was the end of one of the most controversial cases in the history of the world’s law and medicine. But the end of the legislative procedures did not mean the end of the case’s consideration from ethical and moral points of view. There are different schools, of theories, considering the issues of the kind that we deal with in this essay, so let us view Shiavo’s case through the ideas of some scientists who took their time to examine the moral side of the problem of life and death, and especially, the issue of involuntary deprivation of life or judicial murder.

The first theory we are going to address in this essay is the one produced by the famous American scientists in the fields of psychology, ethics, and feminism Carol Gilligan. Her theory touches on the problems of inequality of male and female rights in regard to their personalities’ development, ethical upbringing, and the social attitude towards the issue (Mosher, 1999).

Gilligan is a critic of Kohlberg’s theory, according to which males usually reach a higher level of moral development than females do because of their determination to act according to laws and rules, while women more often choose to act motivated by their relationships and feelings. Carol Gilligan keeps to the point that the moral development of the two sexes differs indeed but it does not mean that one of the sexes is at the higher level and another at the lower. She also argues that women and men should be treated equally in respect of their rights but not as the same species. According to this theory, the case with Terri Shiavo can be viewed as the breaking of the standards.

Women do not have equal rights, Terri could not decide whether she would live or the feeding tube would be removed and she would die. Her husband made the decision for her based only on his opinion. In this episode we can observe the contradiction to the Kohlberg’s theory as the level of moral development of the male, Terri’s husband, can not be objectively estimated as the one that is higher that moral development of her mother, for example, who did her best to keep her daughter alive but did not succeed. I think that the actions of Terri Shiavo’s husband are immoral because a loving husband should hope and help his suffering wife and not to try to make his own life easier by taking away her life.

Another theory of moral development which can be applied to the case under consideration is the Bronfenbrenner’s theory (Boeree, 2003). This famous psychologist and ecologist singles out 5 levels of human moral development:

  • Self-oriented morality;
  • Authority-oriented morality;
  • Peer-oriented morality;
  • Collective-oriented morality;
  • Objectively-oriented morality.

In this case, we can not speak of the moral development level of Terri Shiavo as her health did not allow her to act in any way for us to estimate it but her family members’ actions deserve serious analysis. As for Terri’s parents, we can speak of their being at the fourth level according to Bronfenbrenner’s theory because all their deeds were directed at the defense of their daughter’s life. The same can not be applied to Michael Shiavo as his actions can be characterized as belonging simultaneously to the first, self-oriented, and the last, objectively-oriented morality levels.

The reasons for this fact are as follows: Terri’s husband could have his personal interest in his wife’s death as her heritage could become his property and he would have no more problems with the wife who was in the vegetative state. But we can not state it because there is no evidence, and here comes another side of Michael’s actions – an objectively oriented one. He understood clearly the absence of any hope for his wife’s recovery, so the decision about euthanasia was the way to relieve Terri and her relatives from the pain they did not have to stand.

So, morality, its development depending on the culture and time is rather a controversial topic to speak on. In the case of Terri Shiavo, we can not definitely state whether the Court contravened or respected the rights of Mrs. Shiavo as morality is rather subjective. No radical conclusions must be made in this case without the opinion of Terri Shiavo herself, and as we will never know this opinion the objective answer to the question will not be given.

References

Bales P, (1990). Life-Span Development and Behavior – Vol. 10. Hillsdale.

Boeree G, (2003). Moral Development. General Psychology. New York.

Featherman D, (1992). Life-Span Development and Behavior – Vol. 11. Hillsdale.

Featherman D, (1994). Life-Span Development and Behavior – Vol. 12. Hillsdale.

Hetherington E, (1988). Child Development in Life-Span Perspective. Hillsdale.

Kubler-Ross E, (1989). On Death and Dying. London.

Mosher R, (1999). Human Development Across the Life Span. Westport.

Mitchell M, (1997). Nutrition across the Life Span. Philadelphia.

Nelson C, (1994). Threats to optimal development. Hillsdale.

Osis K, (1997). What They Saw…At the Hour of Death. New York.

Raphael B, (1996). London. The Anatomy of Bereavement: A Handbook for the Caring Professions.

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