Ken Goodman

KEN GOODMAN: It's significant that by watching Congress, you didn't learn very much about the case. 15 years ago last month, actually, in February, she had a heart attack as a result of a potassium imbalance caused by an eating disorder. That's pretty well established. She was, unfortunately, like many people, not able to be resuscitated in time, and as a result, suffered hypoxic or anoxic brain injury. Large portions of her cerebral cortex were damaged, severely damaged by that heart attack. In fact, she's been described as being neurologically devastated. Since then she's been taken to various forms of rehabilitation. They haven't worked. She's been in a number of different organizations. And in fact, when neurologists were able to examine her, made a diagnosis that she's in what's called a persistent vegetative state. What's happened in the intervening 15 years is that brain tissue that died 15 years ago has now been replaced with spinal fluid. That is to say, her cerebral cortex is full of spinal fluid. Electro-encephalograms of her brain show that her cortical EEG is flat. She has what's been called cortical death. All of the stuff that you're hearing, all of the videos you're watching, all of the testimonies that you're getting wind of that suggest this poor woman is there thinking about lunch and she's interacting, they're all false. They're wishful thinking, and they underscore the tragedy of this awful case. Poor Miss Schiavo cannot see, she cannot hear, she cannot feel, and she never will be able to again, according to credible neurologists. People who disagree with that are trying to advance an agenda by, well, by a number of other things, by allying themselves unhappily with the disability rights movement, a movement they didn't care too much about before Terri Schiavo. Terri Schiavo is not disabled, by the way, according to any credible definition. And the use of disability language and the use of starvation language is purely intended to deceive people and move forward a narrow political agenda. This was settled area in law, medicine and ethics for a generation. Just because you have a device or a treatment, in this case a percutaneous endoscopic gastrostomy, doesn't impose on you a moral duty to use it. Same with ventilators, same with dialysis, same with chemotherapy and everything. In this case, we have activist judges --


Kenneth W. Goodman, Ph.D., FACMI

Title/Position: Director, Bioethics Program; Co-Director, UM Ethics Programs

Kenneth W. Goodman is founder and director of the University of Miami Bioethics Program and its Pan American Bioethics Initiative and co-director of the university’s Ethics Programs, including its Business Ethics Program. The Ethics Programs have been designated a World Health Organization Collaborating Center in Ethics and Global Health Policy, one of six in the world.

Dr. Goodman is a Professor of Medicine at the University of Miami with appointments in the Department of Philosophy, Department of Health Informatics, Department of Epidemiology and Public Health, Department of Electrical and Computer Engineering, School of Nursing and Health Studies and Department of Anesthesiology.

He chairs the Ethics Committee of the American Medical Informatics Association, for which organization he co-founded the Ethical, Legal and Social Issues Working Group. He is a Fellow of the American College of Medical Informatics, the only philosopher or ethicist to be elected. He is past chair of the American College of Epidemiology’s Ethics Committee.

In Florida, he directs the Florida Bioethics Network, chairs the adult ethics committee for Jackson Memorial Health System, is vice chair of the Sylvester Comprehensive Cancer Center/University of Miami Hospital and Clinics Ethics Committee and directs activities for the UHealth/University of Miami Hospital ethics unit.

Dr. Goodman’s research has emphasized issues in health information technology, including bioinformatics or the use of computers in genetics, and in epidemiology and public health. He has edited a book on the Terri Schiavo case for Oxford University Press, published a book about ethics and evidence-based medicine for Cambridge University Press, co-authored a book of case studies in ethics and health computing for Springer-Verlag and co-authored another volume of case studies, in ethics in public health, for the American Public Health Association. He has also co-authored a book on artificial intelligence, edited a book on ethics and medical computing, co-edited a volume on artificial intelligence, and published and presented numerous papers in bioethics, including end-of-life care, the philosophy of science, and computing.

Current funded work includes an NIH/Fogarty International Center grant to help expand research ethics education around the Americas. He has led a Robert Wood Johnson Foundation-funded project to identify and address ethical issues in the use of electronic personal health records.

The Case of Terri Schiavo
Ethics, Politics, and Death in the 21st Century
Kenneth Goodman
274 pages | 234x153mm
978-0-19-539908-0 | Hardback | 12 November 2009
Price: £30.00

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First balanced, comprehensive scholarly treatment of the case

The case of Terri Schiavo, a young woman who spent 15 years in a persistent vegetative state, has emerged as a watershed in debates over end-of-life care. While many observers had thought the right to refuse medical treatment was well established, this case split a family, divided a nation, and counfounded physicians, legislators, and many of the people they treated or represented. In renewing debates over the importance of advance directives, the appropriate role of artificial hydration and nutrition, and the responsibilities of family members, the case also became one of history's most extensively litigated health care disputes. The Case of Terri Schiavo assembles a team of first-hand participants and content experts to provide thoughtful and nuanced analyses. In addition to a comprehensive overview, the book includes contributions by Ms. Schiavo's guardian ad litem, a neurologist and lawyer who participated in the case, and scholars who examine issues related to litigation, faith, gender, and disability. The volume also includes a powerful dissent from the views of many scholars in the bioethics community. The book is intended for students, health care professionals, policy makers, and other in search of carefully reasoned analyses of the case that will shape our view of death and end-of-life medical care for decades.

Readership: Clinicians (doctors, nurses); Students (medical, nursing, bioethics); Lawyers; Policy makers (legislators and staff)

List of Contributors
1: Terri Schiavo and the Culture Wars: Ethics vs. Politics, Kenneth W. Goodman
2: At Theresa Schiavo's Bedside: A Guardian's Role and Reflections, Jay Wolfson
3: Schiavo, Privacy, and the Interest of Law, Daniel N. Robinson
4: The Schiavo Maelstrom's Potential Impact on the Law of End-of-Life Decision-Making, Kathy L. Cerminara
5: The Continuing Assault on Personal Autonomy in the Wake of the Schiavo Case, Jon B. Eisenberg
6: A Common Uniqueness: Medical Facts in the Schiavo Case, Ronald E. Cranford
7: Crossing the Borderlands at Nightfall: New Issues in Moral Philosophy and Faith at the End of Life, Laurie Zoloth
8: Disability Rights and Wrongs in the Terri Schiavo Case, Lawrence J. Nelson
9: Framing Terri Schiavo: Gender, Disability, and Fetal Protection, Robin N. Fiore
10: Terri Schiavo and Televised News: Fact or Fiction?, Robert M. Walker and Jay Black
Appendix: Timeline of Key Events in the Case of Theresa Marie Schiavo
Kenneth Goodman, Professor, University of Miami

Jay Black, Ph.D., retired as Poynter Jamison Chair in Media Ethics and Press Policy, Emeritus, at the University of South Florida in St. Petersburg; Kathy L. Cerminara, J.D., L.L.M., J.S.D., Professor of Law at the Nova Southeastern University Shepard Broad Law Center; Ronald E. Cranford, M.D., was a Senior Physician in Neurology at Hennepin County Medical Center in Minneapolis, a Professor of Neurology at the University of Minnesota and a Faculty Associate at the University of Minnesota's Center for Bioethics; Jon B. Eisenberg, J.D., was one of the attorneys on Michael Schiavo's side in the Terri Schiavo case;; Robin N. Fiore, Ph.D. is Adelaide R. Snyder Professor of Ethics and Associate Professor of Philosophy at Florida Atlantic University in Boca Raton; Kenneth W. Goodman, Ph.D., is a Professor of Medicine and jointly of Philosophy at the University of Miami, where he directs the Bioethics Program and co-directs the Ethics Programs; Lawrence J. Nelson, Ph.D., J.D., is a Senior Lecturer in Philosophy at Santa Clara University in Santa Clara, Calif.; Daniel Robinson, Ph.D., is a member of the Oxford University Philosophy faculty and is Distinguished Professor, Emeritus, Georgetown University; Robert M. Walker, M.D., is Director of the Division Ethics, Humanities, & Palliative Medicine at the University of South Florida College of Medicine, Tampa;; Jay Wolfson, Dr.P.H., J.D., is the Distinguished Service Professor of Public Health and Medicine at the University of South Florida in Tampa; Laurie Zoloth, Ph.D., is Director of the Center for Bioethics, Science and Society and Professor of Medical Ethics and Humanities at Northwestern University, Feinberg School of Medicine

"This book does a thorough job of illuminating various parts of the case by experts close to it, effectively dispelling the rumours and media hoopla and helping readers to come away with a new perspective on the crucial events." - Doody's Notes