I have chosen to discuss the case of Terri Shiavo which was a very big ethical case back in 2005. She had been left on a ventilator for 15 years. So let’s start from the beginning. On February 25, 1990 Terri Schiavo had a cardiac arrest that was causes by extreme hypokalemia (low potassium) brought on by an eating disorder (Quill, 2005). As a result of this cardiac arrest Terri developed severe hypoxic – ischemic encephalopathy which is another way of saying lack of oxygen to the brain (Quill, 2005). During this period she exhibited no evidence of brain function and eventually scans of her brain showed severe atrophy of her cerebral hemispheres (Quill, 2005). Her electroencephalograms were fat, indicating no functional activity of the cerebral cortex (Quill, 2005). All of her neurologic examinations were indicative of her being in a persistent vegetative state (Quill, 2005). As we know persistent vegetative state can include periods of wakefulness alternating with sleep, the patient will also have some reflexive responses to light and noise and some basic gag and swallowing responses (Quill, 2005). However regardless of these responses the patient will have no signs of emotion, willful activity or cognition (Quill, 2005). There are very few cases where a person comes out of a vegetative state after being that way for three months(Quill, 2005). Despite this known fact Terri’s parents fought to try to keep their daughter alive.
Terri did not leave any written directive saying what she would want done in a situation like this, meaning that the decision is left up to the next of kin, in this case her husband, Michael Schiavo (Quill, 2005). Florida law designates the spouse as the decision maker over the patients other family members...
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...with how the case was handled. Like I mentioned before I think the family was unreasonable but that being said maybe if I was in a situation like this I would see differently. I can see the families point of view. They did not want to let their daughter go and had been blinded by the hope that maybe she would wake up. This does happen to a lot of family members in the case of persistent vegetative states because they do have involuntary motor function so they think they are still capable of being alive. This was a very sad case but I thought it was an interesting one for my case analysis.
References
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The case of Marguerite M presents an ethical dilemma. Medical ethics play a special role in medicine and is directly concerned with its practice. Its role has continued to evolve as changes develop in
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... in terms of living or dying. By this logic, people in vegetative states should also have rights analogous to that of an infant at least. Many people practice or research medicine for the altruistic reasons and derive pleasure and a purpose in life by restoring the injured and sick to proper health. If a potential treatment can be developed by doctors and researchers to restore people in vegetative states to normal cognitive levels, it would be considered wrong to allow such a person to die because, like an infant, there exists the chance for them to develop an ability to function as long as research is continued to find a way to reverse such a condition.
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In an effort to provide the standard of care for such a patient the treating physicians placed Ms. Quinlan on mechanical ventilation preserving her basic life function. Ms. Quinlan’s condition persisted in a vegetative state for an extended period of time creating the ethical dilemma of quality of life, the right to choose, the right to privacy, and the end of life decision. The Quilan family believed they had their daughter’s best interests and her own personal wishes with regard to end of life treatment. The case became complicated with regard to Karen’s long-term care from the perspective of the attending physicians, the medical community, the legal community local/state/federal case law and the catholic hospital tenants. The attending physicians believed their obligation was to preserve life but feared legal action both criminal and malpractice if they instituted end of life procedures. There was prior case law to provide guidance for legal resolution of this case. The catholic hospital in New Jersey, St. Clare’s, and Vatican stated this was going down a slippery slope to legalization of euthanasia. The case continued for 11 years and 2 months with gaining national attention. The resolution was obtained following Karen’s father being granted guardianship and ultimately made decisions on Karen’s behalf regarding future medical
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Physician-assisted suicide refers to the physician acting indirectly in the death of the patient -- providing the means for death. The ethics of PAS is a continually debated topic. The range of arguments in support and opposition of PAS are vast. Justice, compassion, the moral irrelevance of the difference between killing and letting die, individual liberty are many arguments for PAS. The distinction between killing and letting die, sanctity of life, "do no harm" principle of medicine, and the potential for abuse are some of the arguments in favor of making PAS illegal. However, self-determination, and ultimately respect for autonomy are relied on heavily as principle arguments in the PAS issue.
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On April 15, 1975, the Quinlan family received a tragic phone call at approximately 2am; their daughter, Karen Ann, was in a coma. Earlier that evening, Quinlan was at a party and consumed drugs and alcohol. She became unconscious and eventually fell into an irreversible coma. She was conditioned to be in a persistent vegetative state. Since she was unable to recover from her coma, Quinlan’s parents requested her life support to be withheld. The removal of life support was more complicated than what the Quinlan family imagined it to be. They had to take the case to court to have the request approved. The first round in Superior court, the Quinlans lost. Eventually, the family took the case to the New Jersey Supreme Court. The court ruled that Quinlan’s father is appointed as her guardian and can make any decision regarding her care. It took the family over a year to have the approval to remove their daughter from life support; it took five days for Karen Ann Quinlan to be weaned off her respirator. Miraculously, she was able to breathe on her own for the next nine years until she died of pneumonia. This case led to the creation of the “living will” and required medical institutions to allow patients to live their last stage in life with dignity and respect (Karen Ann Quinlan Hospice
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