The Terri Schiavo Case

Paper Summary:

This paper examines how although tragic, the plight of Terri Schiavo provides a valuable case study, and the conflicts and misunderstandings surrounding her situation offer important lessons in medicine, law and ethics. The author reviews the current medical understanding of persistent vegetative state, including the requirements for patient examination, the differential diagnosis, and the practice guidelines of the American Academy of Neurology regarding artificial nutrition and hydration for patients with this diagnosis. Next it examines the legal history including the 2000 trial, the 2002 evidentiary hearing and the subsequent appeals. The author argues that the law did not fail Terri Schiavo, but produced the highest-quality evidence and provided the most judicial review of any end-of-life guardianship case in U.S. history.
Outline
Abstract
Introduction
Understanding the Persistent Vegetative State
Legal History and Commentary
Competing Ethical Frameworks
Conclusion
References

From the Paper:

"The Schiavo case rests critically on the concept of the persistent vegetative state and the certainty of the prediction that a patient in this state will have no meaningful recovery. The persistent vegetative state is distinguished from several other states of reduced consciousness. Brain death implies the loss of not only all higher brain functions but also all brainstem functions, including pupillary light reflexes, reflex eye movements, respirations, and gag and corneal reflexes. Determination of brain death is straightforward and is generally accepted as a criterion for death. Coma is a complete state of unresponsiveness to stimuli, although the patient may have brainstem reflexes."

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