Terri Schiavo

30Oct07

One of the most high-profile cases of euthanasia in recent years was that of American woman Terri Schiavo. She collapsed after a heart attack in 1990 and spent the next fifteen years in a coma. Terri was in’persistent vegetative stat’ (PVS) which meant that she not in a coma, but was unable to react to external stimuli, speak to anyone, or feed herself. To all intents and purposes she was unable to interact with others, and doctors agreed that she was unlikely to ever recover. As you can imagine, her condition deteriorated over years of inactivity. Followig a dispute over the appropriate kind of care for Terri, a rift developed between her husband, Michael Schiavo, and her parents, the Schindlers. By 1994, Michael had accepted Terri’s condition as irreversible and agreed a ‘do not resuscitate’ order with her physician.

Terri had not left a living will to indicate what her wishes woud have been in this situation. Michael petitioned in 1998 that she would have chosen to have her life support removed. A judge agreed, and this set into motion all kinds of legal to-ing and fro-ing between Michael Schiavo, the Schindlers, and all kinds of people who felt strongly about what should happen to Terri, including medical and legal experts, politicians and various media figures.

The ruling to remove her feeding tube came a number of times, and was repeatedly overturned upon legal appeal. Jeb Bush, Governor of California, actually changed the law to keep Terri alive. The legal challenges aimed at keeping her on life support were all deemed unconstitutional. Her feeding tube was removed for the last time on 18th March 2005. She died on March 31.

Before the autopsy, members of the Schindler family had maintained that Terri was aware of her visitors and reacted to stimulation.  Her postmortem showed the shocking extent of her brain damage. Examination of Schiavo’s nervous system revealed extensive injury. The brain itself weighed 615 g, only half the weight expected for a female of her age, height, and weight, an effect caused by the loss of a massive amount of neurons. Microscopic examination revealed extensive damage to nearly all brain regions, including the cerebral cortex, the thalami, the basal ganglia, the hippocampus, the cerebellum, and the midbrain.

The neuropathologic changes in her brain were precisely of the type seen in patients who enter a PVS following cardiac arrest. Throughout the cerebral cortex, the large pyramidal neurons that comprise some 70% of cortical cells – critical to the functioning of the cortex – were completely lost. The pattern of damage to the cortex, with injury tending to worsen from the front of the cortex to the back, is also typical. There was marked damage to important relay circuits deep in the brain (the thalami) – another common pathologic finding in cases of PVS. The damage was, in the words of Thogmartin, “irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons.”

You can read a summary of the events of the case at : http://news.bbc.co.uk/1/hi/world/americas/4358877.stm

Questions

1. Was it right to remove Terri Schiavo’s feeding tube?

2. Would it have made a difference to the moral rightness of the action if she had left a living will which expressed her wish not to be kept alive?  If you think it makes a difference, what kind of difference does this consent make?

3. If someone expressed a wish to be kept alive as long as possible, would they be entitled to this right, no matter what the circumstances?

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One Response to “Terri Schiavo”

  1. 1 Hurricane

    I believe that removing the feeding tube was definitely the right thing to do. Whether or not she had a living will that specified that she would not want to be kept alive. Terri Schiavo (whose case was actually in Florida, not California) was way beyond repair and as this discussion says, she did not respond to any stimuli. She wasn’t a ‘person’ anymore. She didnt respond to pain, pleasure, she couldnt make decisions, etc.
    Im surprised so many legal affairs arose so long after it was determined that she would never recover from her vegetative state. I understand that the family did not want to let go of their daughter, but after fifteen years of no progress?? What are they fighting for other than more time for them to watch her breathe?
    The money spent to keep her alive for so long must be astronomical. Even if she had a living will that requested she be kept on life support for as long as needed, I would still support euthanasia in cases like these.
    With the postmortem reports on the extent of her brain damage confirming her hopeless case, I’d hope future cases like Terri’s won’t be dragged out past 10 years. if that.


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