Subject Administration Health/Medical/Hospital Administration

Question

Organize the basic concepts, principles and information using the "four-topic" method to help distill the case down to its essence.
1. Introduction Identify and briefly define the major theme of the case (confidentiality and truthfulness, death and dying, maternal/fetal conflict or social justice)
2. Medical Indications should explore diagnosis, treatment goals, acute/chronic condition, possibilities of success, etc.
3. Patient Preferences should explore mental capacity, informed consent, advance directives, etc.
4. Quality of Life should elaborate on prospects for return to normal life, physical, mental, and social deficits, palliative care, etc.
5. Contextual Features should explore legal, cultural, religious, and familial issues).
6. Conclusion: Please include references from the readings, links, other literature and/or personal experience to support the answers to the questions posed in the case study and your final decision/solution to the dilemma.

Case:
Michael Schiavo said he awoke early on the morning of February 25, 1990, to find his wife collapsed in the hallway of their home."
Terri Schiavo suffered from bulimia nervosa which, among other things, can result in heart failure due to the loss of vital minerals such as potassium.
The purging activity of a bulimic robs the body not only of the calories contained in food but also the nutrition which our organs need to function.
This appears to be what happened to Terri Schiavo--a loss of potassium caused heart failure which lead to brain damage.
She opened her eyes a month after collapsing in 1990 but has never regained consciousness.
In July of 1990, Terri is brought to the home where her husband and parents live; after a few weeks, she is brought back to the rehabilitation center as her family was unable to care for her.
In November of 1990, she was sent to California for an experimental procedure, the implanting of a thalamic stimulator into her brain.
In 1994, she was transferred to a nursing home which, presumably, is when the rehabilitative treatments stopped.
In 2000, she was transferred to a hospice facility.
Michael Schiavo was appointed Terri's guardian in June, 1990.
It was not until May of 1998 (more than 8 years after Terry became unconscious) that Michael petitioned the court to have her feeding tube removed stating that he believed he was carrying out Terri's wishes.
Terri's parents, Bob and Mary Schindler, and her sister, Suzanne Vitadamo, have vigorously contested the petition.
On February 11, 2000, Judge Greer (the Florida trial judge in the case) found Terri Schiavo to be in a "persistent vegetative state" which is the finding necessary to under Florida law to allow for removal of a feeding tube.
From here, the case has been a long and sad tale that has seen Terri's feeding tube removed by court order three times and reinserted by court order twice.
The Florida Legislature and the U.S. Congress both passed special laws designed to intervene in this case.
The Governor of Florida, Jeb Bush, attempted to use the Florida law to personally intervene in the case and keep Terri alive but the law was declared unconstitutional.
On March 26, 2005, the Court of Appeals for the Eleventh Circuit rejected the final appeal in the case to have the feeding tube reinserted.
This case is different than most right to die cases for three reasons:
(a) Terri Schiavo left no written record of her wishes should she end up in a persistent vegetative state, (b) she is not terminally ill and only requires artificial means to be fed (i.e., her body is able to carry on all other functions), and (c) there is conflicting evidence regarding her degree of unconsciousness.

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On the morning of February 25, 1990 the patient was found by her husband collapsed on the floor of their home. Ms. Schiavo suffered from bulimia nervosa, a disease defined by the Mayo Clinic as an eating disorder which can be life threatening. Bulimia nervosa is an illness which the individual eats a vast amounts of food, secretly purges the food in an effort to rid the body of the calories by means of vomiting or taking part in superfluous amounts of exercise. (Mayo Clinic Staff, 2015). National Eating Disorder Association states (n.d.) the majority of individual suffering from bulimia nervosa are of average body weight. Changes in society, an individual suffering from depression can be a trigger affecting 1-2% of the young adult population. ...

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