Before she passed away in 2005, Terri endured a 15-year struggle with the irreversible persistent vegetative state. Her passing caused a moral, medical, and social crisis that made most Americans aware of the problems associated with end-of-life situations and choices. When it was suggested to remove her feeding tube, there was a prior legal dispute on the choice to take her life. The discussions exposed the differences of opinion on euthanasia and issues of end-of-life care (Montero, 2011). The core bioethical value that must be upheld in all situations like this one is the respect for autonomy. Medical practitioners have a duty of provided ultimate care to promote the saving of life rather than ending it. At the same time, there is an argument by bioethicists that largely believe on the irrelevancy of the niceties of distinctions. They argue that it is not acceptable for anyone in Mrs Schiavo's condition to continue suffering by living in a minimum quality life. Instead, there is needed to take a measure like ending their lives by withdrawing nutrition and hydration.
Issues that Affect the End of Life
Issues that affect the end of life include advanced directives, patient self-determination, the death with dignity act, and physician-assisted suicide. Advanced directives at the end of life is a document that people express in writing about their wishes to be euthanized as required by law (Montero, 2011). Patient self-determination facilitates the need for patients to provide legal documents about their decision of their end of life. At the same time, there were steps to revoke licenses by physicians that helped their patients to end their lives. As such, the Oregon's Death with Dignity Act was enacted. The act allows for deaths by lethal inducements following requests from patients as long as they follow the provisional requirement by the law. Self-determination is a core value for social workers. Advanced directives and patient self-determination among other factors help in promoting the bioethical issues that concern the end of life and euthanasia. The many ethical considerations surrounding the case were made intense for the reason that no one would have certainly known what Mrs Schiavo wanted. It necessitated the need for a balance in assuring basic minimum healthcare as well asking patients to sign directives early enough.
Factors Affecting the Decision about the End of Life
Several factors that affect the decision about the end of life matter by physicians. In as much as patients' healthcare providers have the duty of ensuring that their patients gain quality life, it is equally important to consider the health condition of the patient. Schiavo was suffering from an irreversible persistent vegetative condition. Therefore, any form of treatment would be futile. Besides the quality of life, personhood is another factor that affects the decision, as her neurological conditions were too severe that it denied her personhood and the duty to care (Koch, 2005). If all her cerebral functions had stopped then the removal of her feeding tubes, denying her nutrition and making her dehydrated would not have caused her any pain. The patient had a limited state of suffering from an unacceptable minimum quality of life. There was nothing that could be done to give her a better life. At the same time, there was a natural way of ending Schavio's suffering through hydration and nutrition. Drawing from the unending suffering and a natural way of ending suffering, it was permissible for the physicians taking care of Mrs Schiavo to give death a helping hand (Koch, 2005).
References
Koch, T. (2005). The challenge of Terri Schiavo: lessons for bioethics. Journal of medical ethics, 31(7), 376-378.
Montero, D. (2011). End-of-life issues in the United States after Terri Schiavo: implications for social work practice. Advances in Social Work, 12(2), 164-180.
