The Terri Schiavo issue raised some fundamental questions to the extent that it became not only a medical issue but also a political and legal one. Doctors determined that she was in a Permanent Vegetative State (PVS). After caring for her and even trying to get her alternative treatment, her legal guardian, the husband, decided that it was the time for the nutrition and hydration tubes to be disconnected since she showed no signs of improving. Her parents objected to that. This became a legal and political issue with court hearings and even the state legislature passing a law to keep her alive. This essay is an examination of the ethical issues that arose due to the case.
The first ethical question concerns the issue of self-autonomy of the individual, and whether, in cases of substituted judgment, an apparent conflict of interests on the part of the responsible person is a consideration in determining the fate of the person in a PVS. According to Geppert, Andrews and Druyan (2009), autonomy has a basis in cognitive ability, and thus, one loses it when he or she goes into a PVS. Because the person in that state cannot make decisions on their own, a legal guardian has to do a “substituted decision” for the person in a PVS (Ditto, 2006). In the case of Terri Schiavo, the husband claimed that he was exercising his wife's wishes in asking for the disconnection of the nutrition and hydration tubes (Ditto, 2006). However, he also had an apparent conflict of interests in doing so as he was already living with a girlfriend, whom he could not marry as long as Terri was alive, and he was also due to get compensation after her death (Ditto, 2006). Thus, one can question whether it was ethical for Terri’s husband to assume substituted judgment for her.
The second issue concerns the question whether it is just and ethical for anyone to keep a person in a vegetative state when there is no chance of them improving. This raises the question of keeping a person in a state in which they cannot enjoy any quality of life (Geppert, Andrews, & Druyan, 2009). While medically people wake up from comas, there is hardly any possibility of one ever gaining consciousness after a PVS due to significant brain damage (Fins, 2006). While some might argue that it is alright to keep a person alive in this state in the hope that the person will gain consciousness one day, some might not agree with this assertion.
Terri Schiavo’s husband and the parents disagreed on whether to discontinue her nutrition and hydration, which raised the issues of beneficence and maleficence of disconnecting her feeding and hydration tubes. Therein lies another ethical issue. Some of the medical ethicists claimed that disconnecting her nutrition and hydration tubes was akin to starving Terri, while others said that it was the gentlest way of letting her die (Fins, 2006). Thus, this issue seemed to conflict ethically. On the one hand, the husband and some doctors had a profound conviction that they were doing what was right for Terri (Fins, 2006). On the other hand, the parents and others were persuaded that even if the husband was not acting out of malice, he was not doing the right thing in asking for the disconnection.
As is apparent from the discussion, the Terri Schiavo case raised some complex ethical issues. In the first place, since she was not personally autonomous anymore due to her permanent vegetative state, her husband had to make a substituted decision on her case while he had an apparent conflict of interests. Secondly, the question whether it was just and ethical to maintain someone in a permanent vegetative state when there was no chance of him or her improving also arose. Lastly, the question of the beneficence and the maleficence of disconnecting Terri Schiavo’s feeding and hydration was also an issue.