Permanent Vegetative State Case Study

CO-250-Middlesex

Permanent Vegetative State: The Case of Terri Schiavo

The case I have decided to study is case 5 in chapter 10, which is a case that created ethical dilemma. This is the case of Terri Schiavo, a twenty six years old female that suffered a heart attack and permanently lost consciousness. Three years in coma she was finally diagnosed with Permanent Vegetative State (PVS). This is a state where by a patient loses one or both of the brains’s hemisphere and patient is unaware of the surroundings. There is no hope for recovery. In the case of Terri Schiavo, electroencephalogram was done, she was observed for three years and lots of physicians came to conclusion that Terri will never recover. Although Terri was still breathing on her own, moan, cry, and occasionally opens her
eyes and pupils constrict in presence of light.These reflexes were medically explained as functions of the brain stem that also controls the breathing which is still intact and working. Terri could no longer swallow anything on her own. Terri was been fed with food, water and other nutrients via a G.tube. In 1998, eight years after Terri suffered the heart attack, Michael, Terri’s husband requested permission from the courts to disconnect her feeding tube. Although Terri had no advance directive, but the husband testified in court that Terri would not want to be kept alive under the condition of PVS .Terri’s parent on the other hand pray to the courts not to grant Michael’s wish. Terri’ parents’ argument is that as a Roman Catholic Terri would find it unethical to have a feeding tube removed and left her to die. Her parents also based their premise on the brain stem reflexes. Another dimension was introduced to the Schiavo case in 2004 when Pope John Paul II put out a public statement about PSV excerpt:
“The sick person in a vegetative state…still has the right to basic health care (nutrition, hydration, cleanliness, warmth, etc), and to prevention of complications related to his confinement to bed…..I should like particularly to underline how the administration of water and food, even when provided by artificial means, always represent a natural means of preserving life, not a medical act…..Until it is seen to have attained its proper finality …” (Burnor and Raley, 211). The protracted battle over Schiavo’s life went on for over seven years. During this time Terri’s feeding tube was disconnected three times and reconnected two times and the third time was left disconnected permanently. On March 3, 2005 fifteen years after her heart attack and went into PVS, Terri Schiavo died. Autopsy finally confirmed the medical diagnosis of PVS. The above story poses a dilemma that could be approach from so many angles and different theories.
First I will like to start with the natural law theory. This theory “identifies natural values as including those things that human beings innately desire and need” (Burnor and Raley, 183), this includes but not limited to life, health, liberty and property. In order to sustain life human beings need food, water and comfort.it also states that these natural values are good and that we have a moral obligation to promote them. However, according to natural law theory, there is no moral obligation in keeping a patient alive by nonnatural means. In the case of Schiavo, surgical insertion of a feeding tube is not natural; a feeding pump which is an electrically operated machine is also needed to get the nutrition and hydration through the tube. Another aspect of the natural law theory to explore is the issue of natural right, right holder and autonomy. In case of Schiavo she has lost autonomy in every sense of the term, if that is the case, there is no moral obligation to keep her alive with the resources meant for bonafide right holders. If there is no autonomy there is no
right. Running the issue through Kant’s deontological theory which states in part “the only thing that is good in and of itself is the good will. The goodwill, will freely choose to do its moral duty, that duty, in turn, is dictated solely by reason” (Burnor and Raley, 159). This theory will not find any reason to keep Schiavo alive beyond the three years it took to diagnose her with PVS. On the other hand the theory will most likely argue for euthanasia in this case as goodwill to keep her from protracted hunger and a dignifying way to die. Utilitarianism argues that the only moral act is the act that brings about greatest amount of overall utility and least amount of overall disutility. Running the case of Schiavo through this principle, it is clear that disconnecting the feeding tube will bring about greatest amount of utility. First Michael the husband will be happy that his wife is left to die in peace, the court will be happy that the case is resolved and will no longer take the time of the court. There are also the people who can actually use the resources and benefit from it instead of tying it down with Schiavo’s case. The only disutility done is that the parent will be unhappy. In conclusion, looking at the case objectively, I will support the idea ending the dilemma sooner by leaning towards Kant’s theory. The question arise here is does keeping Schiavo alive have any fundamental moral worth? “Where fundamental good should have its goodness intrinsically and so should always contribute more goodness in any situation to which it is added” (Burnor and Raley, 156) the answer to the above question is No, She is not contributing any goodness to herself, to her surrounding or the society at large.Working through all the applicable theories none actually support the idea of keeping perpetually on the feeding tube. Also the issue of disconnecting and reconnecting the feeding tube does more disservice to her than serve any tangible purpose. REFERENCE

Burnor, R. and Raley, Y. (2011) Ethical Choices: An Introduction to Moral Philosophy with Cases: New York, Oxford University Press.