Case Study

Perhaps the one case study that best depicts the effect that  therapeutic jurisprudence might have involves the case of Theresa  (Terri) M. Schiavo.  Ms. Schiavo suffered a cardiac arrest in February  1990.  She was without oxygen for approximately 11 minutes, or 5 to 7  minutes longer than most medical experts believe is possible to sustain  without suffering brain damage. At the insistence of her husband, she  was intubated, placed on a ventilator, and eventually extubated and  received a tracheotomy. The cause of her cardiac arrest was later  determined to be a severe electrolyte imbalance caused by an eating  disorder, as Ms. Schiavo had lost approximately 140 pounds, going from  250 to 110 pounds, in the months before her cardiac arrest. 

Ms. Schiavo was in a coma for the first 2 months after her  cardiac arrest.  She then regained some wakefulness and was eventually  diagnosed as being in a persistent vegetative state (PVS).  She was  successfully weaned from reflexive behaviors.  Characteristic of  persistent vegetative state, Ms. Schiavo was not able to eat food or  drink liquids, and a permanent feeding tube was placed so that she could  receive nutrition and hydration. 

Once the media became aware of Ms. Schiavo’s condition, court  battles regarding the removal or retention of her feeding tube were  initiated.  During these hearings and trials, sufficient medical and  legal evidence to show that Ms. Schiavo had been correctly diagnosed and  that she would not have wanted to be kept alive by artificial means was  introduced.  Laws in the state of Florida, where Ms. Schiavo resided,  allowed the removal of tubal nutrition and hydration in patients with  PVS.  The feeding tube was removed, but was later reinstated following a  court order.  

Questions:

1. What legal issues concerning the scenario do you see?
2. Do you see how the families’ desires conflict with Terry’s  intended wishes? Identify the legal issues involved with this situation  and then instruct a group of nurses about advanced directives and the  lessons learned from Terry Schiavo.
3. Finally, if you could make a law and put it into the Florida  Legislation, what kind of law would you write that gives tribute to the  suffering that Terry went through? Let’s call it Terry’s law in respect  for her…