Terri Schiavo: Unsettling the Settled
32 Pages Posted: 4 Sep 2005
Abstract
The controversy over the removal of nutrition and hydration from Terri Schiavo unsettled a number of issues that might have appeared settled in the law and ethics of end-of-life decision-making. Three of these issues are examined in this article: the role of surrogate decision-making, the relevance of the physical condition of the patient in questions of treatment refusal, and the significance of artificial nutrition and hydration as the kind of treatment refused. While the article acknowledges that the law of end-of-life decision-making is due for re-examination, it urges caution. The changes that might be needed in the law are not those that the right-to-life advocates have urged. Rather, other changes should be considered - for example, statutory inclusion of the minimally conscious state among those conditions in which life-prolonging procedures might be rejected and judicial review of decisions to continue (rather than end) the provision of nutrition and hydration to those in a permanent vegetative state.
Keywords: Schiavo, end-of-life, surrogate, nutrition and hydration, persistent vegetative state, permanent vegetative state, permanently unconscious, minimally conscious state, life-prolonging procedures, treatment refusal, life-sustaining procedures, hand feeding, tube feeding, proxy, right to life, Cruzan
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