Deciding when to remove the feeding tube
Level - UndergradDuring the recent debate over whether Terri Schiavo’s feeding tube should have been removed, there were calls for additional testing to be conducted to better determine the current level or nature of her consciousness and whether improvement in her condition was possible or likely. In the aftermath, many have called for the creation of laws to help guide decisions regarding patients like Ms. Schiavo. Your group has been challenged with preparing a report for a congressional committee studying this issue.
The congressional committee is turning to you because of their concern to “bridge the gap” between science and technology on the one hand and ethics and policy on the other. They hope that the policymaking process, which will begin with the study prepared by this committee, will be characterized by productive, well-informed, and non-divisive debate and will conclude with a good policy resolution. They are worried that important policy issues, such as those surrounding the role of biotechnologies in life and death decision making, may not be adequately addressed in the policymaking process because the issues may get caught up in larger, longstanding debates that continue to divide Americans along religious, ideological, or political lines. They are worried that this not only may make it difficult to arrive at a good policy resolution, but to arrive at any resolution at all. Meanwhile, they know from their constituents that many thousands of patients and families and health care institutions are struggling every day to resolve these issues on a case-by-case basis in an atmosphere of distress, confusion, guilt, and, often, conflicts that tear families apart.
The congressional committee would like to be apprised of the state of the art of technologies for assessing brain function and to have recommendations regarding the appropriateness of requiring the use of some or all such technologies for cases like Ms. Shiavo’s.
You have both distinctive technological expertise and, because of the nature of the technologies in this realm, the distinctive opportunity to address and then communicate your recommendation as to the best policy resolution of this issue. If your recommendation is to contribute to the committee’s hope for a productive, well-informed, and non-divisive policy process, you will need to explain how and why you arrived at your recommendation. This way, the committee and future policymakers can benefit from your expertise, your research and analysis of this issue, your reflection and internal discussion, and your reasons for arriving at your recommendation.