Describe the provided case, including information on the stakeholders involved, the bioethical issue, and the time period of the incident that occurred.
Overview
Healthcare professionals provide support throughout the cycle of life, from birth to death. They have an obligation to provide humane and compassionate care to patients while adhering to their specific field’s code of ethics. Sometimes, healthcare professionals are privy to discussions between family members regarding end-of-life issues. In some instances, a healthcare facility may be in charge of providing information about advance directives to patients. Healthcare professionals should calibrate their own moral beliefs to align with their ethical and legal obligations. By studying issues contained within real-life cases, healthcare professionals can come to terms with their beliefs and obligations relative to end-of-life issues.
For Final Project II, you will submit a draft of your essay for your Milestone Three assignment, which will be submitted to scaffold learning and ensure quality final submissions. This milestone draft will be submitted in Module Six. The final product will be submitted in Module Eight.
In this assignment, you will demonstrate your mastery of the following course outcomes:
Analyze bioethical issues faced by various healthcare professionals for their impact on decision making
Prompt
In this project, you will analyze the Terri Schiavo case through the lens of the bioethical issue(s) related to the case. You will analyze the case to address what the bioethical issue is and what role end-of-life issues, such as self-determination and advanced directives, played in the case. Using your analysis, you will determine how this bioethical issue impacted the decisions made by the healthcare professionals involved in the case.
Your essay must address the following critical elements:
Introduction: Describe the provided case, including information on the stakeholders involved, the bioethical issue, and the time period of the incident that occurred.
Bioethical Analysis: Analyze the bioethical issue for the role end-of-life issues played in the case. Be sure to use appropriate terminology and support with secondary research.
Conclusion: Describe how the bioethical issue influenced the decisions of healthcare professionals involved in the case. Be sure to use specific examples.
What to Submit
Your bioethical short paper should be a 1- to 2-page Microsoft Word document formatted with 12-point Times New Roman font and one-inch margins. All citations and references should be formatted according to the most recent APA guidelines
Requirements: 1-2 pages
IHP 420 Terri Schiavo Documentary: The Case’s Enduring Legacy Video Transcript DAN RATHER: In the debate over a sick patient’s right to die, there has rarely, if ever, been a case like the one in Florida. NARRATOR: In 2003, America watched as a private family’s struggle became a very public feud. PETER JENNINGS: Terri Schiavo’s husband and her parents in Florida have been fighting for a long time about whether her feeding tube should be disconnected. NARRATOR: And a personal battle eventually sparked a political firestorm. REPORTER: I’m asking you, isn’t she being murdered? JOIE CHEN: An extraordinary session here on Capitol Hill. REP. JIM DAVIS: Tonight this Congress is about to commit a travesty. NARRATOR: Today, we’re still grappling with end-of-life issues. But will scientificadvancements help to clarify them or only make them more complicated? DR ADRIAN OWEN: Some patients who appear to be entirely vegetative are actually quite the opposite. [MUSIC P LAYING] NARRATOR: Terri Schiavo’s case started long before the cameras appeared. It was February of 1990 when the 26-year-old suffered a cardiac arrest. BOBBY SCHINDLER: She went several minutes without oxygen from her collapse and experienced a profound brain injury. The first couple days, doctors didn’t know if she was going to live or die. NARRATOR: Lack of oxygen left Schiavo with severe brain damage and in what doctors call a persistent vegetative state, or PVS, a condition in which the parts of the brain that control thinking and awareness are damaged or destroyed. Only the brain stem, which controls basic reflexes like breathing, remains. ARCHIVAL FOOTAGE: Good job! NARRATOR: Initially, Terri’s husband and parents cared for her together, exploring potential treatments and rehabilitation. But four years after her collapse, Michael Schiavo says, doctors gave him a grim prognosis. MICHAEL SCHIAVO: It was to a point where Terri wasn’t going to function. There was nothing more. A nd they told us, her mother was sitting right there at the time. There was nothing more they can do for Terri. NARRATOR: In 1998, Michael Schiavo petitioned to have his wife’s feeding tube removed, saying she had told him and others she wouldn’t want to live in this condition. Her parents, Bob and Mary Schindler, fought desperately to keep her alive, insisting that removing her feeding tube would be tantamount to murder. BOBBY SCHINDLER: People think Terri’s in a coma. She was brain dead, that she was terminal. Terri was not dying. Terri had a profound brain injury. And our family wanted to care for her just the way she was. NARRATOR: With no living will expressing her wishes, it was up to the state courts to decide Terri’s fate. DR ARTHUR CAPLAN: They went to court more than anybody has ever gone to court in my experience in fighting about an end-of-life care case. GEORGE FELOS: This was probably the most litigated case that I can think of. We were up and down the federal court system, the state court system, many, many times. NARRATOR: At least 19 judges heard the case through various appeals. And the decisions were all ultimately in Michael Schiavo’s favor, going back to the original court ruling that said that there was clear and convincing evidence that Terri would not want to be kept alive, and that her feeding tube should be removed. MICHAEL SCHIAVO: She told me what she wanted. And the courts heard it, over and over and over again.
NARRATOR: For Terri’s parents, the legal decisions were devastating. They appealed to the media and the public. MARY SCHINDLER: Please, please, please save my little girl. DR ARTHUR CAPLAN: They became a cause. They got picked up by talk radio. They had religious groups weighing in on their behalf. ARCHIVAL FOOTAGE: Spare this innocent child. DR ARTHUR CAPLAN: It was a fear across the board of euthanasia, assisted suicide, abortion, an abandonment of the disabled, if you will. That’s what a lot of the motives were that drove those who rallied to the side of Terri’s parents. ARCHIVAL FOOTAGE: To deliberately starve her to death is an act of cruelty. And ultimately, it’s murder itself. BOBBY SCHINDLER: Terri touched a nerve with so many people. Because they saw a family that was willing and wanting to care for her. T hey didn’t understand why they weren’t being allowed to do that. NARRATOR: On both sides–ARCHIVAL FOOTAGE: Let Terri live. NARRATOR: –emotions ran high. ARCHIVAL FOOTAGE: No one would want to live this way…20 times in court, 20 times…This is the Roe v. Wade of euthanasia. MICHAEL SCHIAVO: I used to say, what are these people doing? Why Terri? People’s feeding tubes are removed every day. To this day, I don’t know why. But it was very surreal. OPRAH WINFREY: Should Terri Schiavo live or die? ARCHIVAL FOOTAGE: What evidence is there that this woman has any brain function or not? NARRATOR: Michael Sc hiavo believes the media fanned the flames, especially after the Schindlers released a series of videos that they said proved Terri was conscious and aware. ARCHIVAL FOOTAGE: It’s Mommy! NARRATOR: But Caplan says the videos were misleading. DR ARTHUR CAPLAN: It was irresponsible beyond belief that it was run unchallenged and unexamined. It was too attractive to the media not to use. Here she is. But it was assembled selectively. And it was staged. And it did not indicate what she could do. NARRATOR: Caplan says that what looked like intentional responses in Terri were just reflexes that are common in people in a persistent vegetative state. DR ARTHUR CAPLAN: A lot of our bodily systems are run off that part of the brain that Terri still had. That tape used that fact and made it look as if she was thinking and feeling. NARRATOR: While most of the doctors who examined Schiavo believed she was in a vegetative state, not everyone in the medical community agreed. ARCHIVAL FOOTAGE: There’s a total of about 14 specialists in brain injury and stroke, which is her situation, who have come out to point out that she’s not in PVS, not in a coma, does respond, is alert, and actually has even the ability to communicate. NARRATOR: With each side entrenched, arguments turned to threats. GEORGE FELOS: It’s no fun getting up in the morning and looking under your car before you start the engine to see if there’s a device. Because you’ve had people contact you saying that they’re going to blow you to bits if you keep working on this case. MICHAEL SCHIAVO: My house was invaded day in and day out. And these are people pushing their views on me. And I don’t understand that. You have your view on things. And you have your beliefs on—that’s great. But don’t stand outside somebody else’s house and push that on them. [VOICES OF PROTESTERS] NARRATOR: And the more the fight played out in public, the more political it became.
REP SANDRA MURMAN: Who’s going to look out for this girl’s rights? We have to. NARRATOR: In 2003, Florida legislators passed Terri’s Law which gave Governor Jeb Bush the authority to reattach Schiavo’s feeding tube. The tube had been removed by court order six days earlier. GOV JEB BUSH: We did what was right and I’m proud of the legislature for responding. NARRATOR: The state law was eventually found to be unconstitutional. But in 2005, the fight moved to Capitol Hill. ARCHIVAL FOOTAGE: There are extraordinary events happening in Washington tonight as the U.S.Congress and president move toward passing a law before morning to intervene in the case of Terri Schiavo. NARRATOR: By then, Sc hiavo’s feeding tube had been removed again. SEN TOM DeLAY: If we do not act, she will die of thirst. NARRATOR: Conservative lawmakers led the charge to pass a law that would give Terri’s parents the chance to continue their fight in federal court. SEN BILL FRIST: These are extraordinary circumstances that center on the most fundamental of human values and virtues, the sanctity of human life. NARRATOR: Opponents argued that politicians had no place interfering in personal medical decisions. ARCHIVAL FOOTAGE: Do we really want to insert ourselves in the middle of families’ private matters all across America? JIM DAVIS: This Congress should respect the law and the rulings of courts and not trample the Constitution. NARRATOR: After a late night emergency session of Congress–ARCHIVAL FOOTAGE: For the relief of the parents of Theresa Marie Schiavo. NARRATOR: –the bill came to a vote. ARCHIVAL FOOTAGE: 203 yeas, 58 nays, bill is passed and without objection. A motion to reconsider is laid up on the table. [GAVEL] NARRATOR: The bill was then rushed over to President Bush who signed it after midnight. But the law wasn’t enough. A federal judge refused to order the feeding tube reinserted, because he found the arguments were unlikely to succeed in federal court. The Schindler family kept appealing to no avail. And on March 31, 2005, the long painful public struggle was over. ARCHIVAL FOOTAGE:The end came this morning for Terri Schiavo. And her husband’s lawyer says she died peacefully 13 days after her feeding tube was removed. BOBBY SCHINDLER: Terri, we love you dearly. But we know that God loves you more than we do. We must accept your untimely death as God’s will. NARRATOR: Schiavo’s autopsy eventually confirmed what had been so hotly contested for years in court proceedings. The damage to her brain had been massive and irreversible. Today, nine years after Schiavo’s death, while we are still struggling with end-of-life issues, advanced brain imaging is helping scientists better understand the minds of people who are unable to communicate. And they’re finding some surprising and unexpected results. DR ADRIAN OWEN: It might be possible in some of these cases that what you see is not what you get. NARRATOR: Dr. Adrian Owen is a neuroscientist who is using brain scans to search for glimmers of consciousness in patients who’ve been diagnosed in a vegetative state. He says it wouldn’t have worked with Terri Schiavo. But his method has shown promise with some patients. Owen puts them in a high tech scanner and asks them to imagine doing certain activities, like playing tennis or moving around their home.
DR ADRIAN OWEN: We’re trying to get the patient to do something when we ask them to do it. But of course they can’t move, because that’s part of the diagnosis of vegetative state. Now our question was, well, can some of these patients do it with their brain? ARCHIVAL FOOTAGE: I want you to imagine playing tennis only if the answer to the question is yes. Does your sister Jen have a daughter? We’re going to start the scan now. ARCHIVAL FOOTAGE: Imagine. NARRATOR: He looks to see if his question will activate a specific part of the brain. DR. ADRIAN OWEN: That’s pretty good. I mean, he’s got this whole band of activity. Stephen, we can see your brain lighting up when you’re trying to answer the question. NARRATOR: Even though the sample size is small, Owen’s work has garnered attention from the scientific community. He found that nearly 20 percent of the patients he’s tested, patients who meet the criteria for being vegetative, have shown signs of awareness, including some like Stephen who seem to answer simple yes or no questions using only their minds. For now, Owen is avoiding the toughest question of all. DR ADRIAN OWEN: We really haven’t got to the point of asking really tricky ethical questions, like do you want to live or die? In part, that’s because the appropriate ethical frameworks aren’t yet in place for deciding what we would do with that information. NARRATOR: Almost all of the patients who’ve shown evidence of awareness have suffered from trauma or blows to the head, not oxygen deprivation like Schiavo. But Bobby Schindler says the extent of her injuries wouldn’t have made a difference to his family. BOBBY SCHINDLER: I think it’s important to also understand that none of this mattered to my family in this battle. It didn’t matter to us if Terri never improved from her condition. We loved her unconditionally. And we loved her that way. ARCHIVAL FOOTAGE: The family of a little girl left on life support after tonsil surgery goes horribly wrong gets a really powerful ally. NARRATOR: Today, Schindler and his family remain in the public eye. They run a nonprofit in Terri’s memory to help families facing similar issues. BOBBY SCHINDLER: We have a team put together. And we’re doing everything we can to get Jahai out of the situation with the hospital. NARRATOR: In one way or another, Terri Schiavo’s plight continues to leave a mark on the nation. It inspired an initial increase in living wills and advance directives just after she died. And in 2007, she ranked just below Mother Teresa and Oprah on a list of people who moved us most in the last quarter century. MICHAEL SCHIAVO: I think the country have learned something. I hope they say, remember the Terri Schiavo story. What do you want me to do if something happens to you? And I’m hoping that’s Terri’s legacy. So now she’s at peace. She has what she wanted. And as her gravestone says at the bottom, I kept my promise. [MUSIC P LAYING]
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