The awe-ful power of choices….

American Nurses Association Statement on the Terri Schiavo Case Statement Attributed to
Barbara A. Blakeney, MS, RN, President
The Terri Schiavo case raises complex and emotional issues about the end of life. The American Nurses Association (ANA) recognizes the difficulty of the situation, however, ANA has consistently upheld the right of patients, or if the patient is incapacitated, the right of the designated surrogate, to decide whether to submit to or continue medical treatment.

As nurses, we are ethically bound to assist our patients in maintaining control over their lives and to help them preserve their dignity. The ANA believes that it is the responsibility of nurses to facilitate informed decision-making for patients and families who are making choices about end-of-life care. The Code of Ethics for Nurses specifically outlines the nurse’s obligation to protect the patient’s right to self-determination and the role of a designated surrogate in situations where the patient lacks capacity. In this case, Terri Schiavo’s physicians, over many years, have declared her to be in a “persistent vegetative state.” Furthermore, there is evidence that Terri Schiavo expressed her wishes not to have her life artificially maintained under such circumstances. ANA believes the Congress and the president have acted inappropriately in this case. It is unfortunate that Terri Schiavo has now become the symbol of so many political agendas.

The positive outcome from this case is that it raises the public’s awareness of the importance of discussing end-of-life issues with family members and underscores how an advance directive, a living will and/or durable power of attorney for health care, clarifies and provides evidence of the wishes of an individual regarding end-of-life decisions. ANA encourages everyone to have an advance directive in place. Advance directives are controlled by state law and vary by state. A federal law, The Patient Self Determination Act of 1990, requires that most health care facilities provide patients with information about advance directives and ask patients about the existence of advance directives. Physicians, nurses, social workers and attorneys are often resource persons in the community who can provide information and guidance concerning advance directives.

My thoughts and prayers go out to the family of Terri Schiavo. I recognize that this is an extremely difficult situation. I wish Terri Schiavo the dignity and peace she so deserves and that we would all wish for ourselves and our own loved ones at the end of life.

Sources: Code of Ethics for Nurses with Interpretative Statements, 2001
http://nursingworld.org/ethics/chcode.htm
Ethics and Human Rights Position Statement: Nursing and the Patient Self-Determination Act, 1991
http://www.nursingworld.org/readroom/position/ethics/etsdet.htm
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Please make a living will….it is the best way to ensure that your wishes are met, and relieves your family and the medical staff of the  ethical and emotional burden which contributes to the sort of mess we are seeing today