The Case of Terri Schiavo: Critical Thinking, Ethical Decision Making, and Philosophical Analysis An interdisciplinary teaching unit for grades 11-12 Science, Health,Social Studies, Civics, US History, Philosophy, Ethics, and Psychology. Unit Abstract In 2005, after a protracted legal battle, Terri Schiavo, who Some of the questions students will explore in the course of had spent fteen years in a permanent vegetative state, this unit are: How can we distinguish between good and bad was disconnected from life support and subsequently died. arguments used in ethical claims? Why is it important for an The question at the center of the erce and public debate honest and productive debate to be clear about the over her fate—and the overarching question students will concepts used? What, for example, do we mean by “life” try to answer in this unit—is whether the decision to discon- and “death”? Are there cases where this distinction gets tinue life support for Terri Schiavo was justi ed or not. blurred? What exactly do we know about Terri Schiavo’s condition, and what are the limits to what we can know The attempt to answer this question will lead students to about her mental state? Can recent advances in neurosci- explore the profound ethical and philosophical implications ence and technology improve our ability to know what a of this case, while at the same time enhancing their critical person in a coma is thinking? Does a person in a permanent thinking skills. vegetative state have a “right to life”? Does it make a differ- ence if we still consider her a person, or the same person? Students will learn how to: Is it in that person’s interest to be kept alive? Is her life still • Use informal logic to critically examine meaningful? What makes life meaningful, and when—if and evaluate arguments used in ethical ever—does life stop being meaningful? Should people have claims a “right to die”? And who should decide for a person, if she • Clarify the meaning of key concepts by can’t decide for herself? exploring their philosophical significance By addressing these questions, this unit will allow students • Assess relevant information and facts to appreciate the complex nature of cases like that of Terri used in the debate Schiavo that involve life-extending technologies and surro- gate decision-making. It will demonstrate the importance of While emphasis will be placed on the rst two items understanding such cases, of critically examining (evaluation of arguments and conceptual analysis), this unit arguments, concepts and facts, and of seeking insight from will equally illustrate the importance of a thorough familiarity a variety of disciplines. And lastly, and maybe most impor- with the medical, psychological, and biological facts, as tantly, it will help students gain insights about the ethical well as the legal, social, and historical dimensions of this and philosophical questions they may encounter in their multi-faceted case. It thus provides pedogoical hooks to own lives. science units on brain anatomy, neurobiology, physiology, and nutrition, as well as topics in the humanities, such as constitutional law, civics, US history, and Social Studies. UNIT OUTLINE AND SEQUENCE OF TOPICS 2. Personhood Is Terri Schiavo (still) a person? Introduction Is she the same person? What does it mean to be a “person,” The introductory segment engages students in a and to stay the same person pre-assessment activity, provides students with basic through time? information about the Schiavo case and allows students to share their rst reactions and intuitions about the case. 3. Personal Rights Does Terri Schiavo have a “right to Part I: life”? Informal Logic and Evaluation of Arguments Does every person have a “right to in Ethical Claims life”? In the rst part of this unit, students will be introduced to 4. Quality of Life some of the statements put forth by the different parties What is in Terri Schiavo’s best involved in the Schiavo case (1). With the help of informal interest? logic, students will examine and evaluate the underlying arguments for soundness and validity (2). Students will What makes life meaningful? then identify concepts used in the debate that require 5. Autonomy further analysis and clari cation (3). Who should decide for Terri Schiavo? 1. Presentation and examination of Should everybody be allowed to decide for herself? statements used in the Schiavo case. When and why should other people 2. Introduction to informal logic and be allowed to decide for us? further examination and evaluation of arguments. Conclusion 3. Identi cation of key concepts used A nal discussion about the case and whether the decision in the debate that require further to disconnect Terri Schiavo from life support was justi ed or not. Students will take another survey to see if their analysis and clari cation. opinions have changed. If so, what was the decisive element that made them change their opinion? If not, did Part II: the reasons for their decision change? Conceptual Analysis and Essential Questions In the second part of the unit, students will engage in a Learning Outcomes and Enduring Understanding discussion of some the key concepts used in the debate • To learn how to use informal logic to critically over Terri Schiavo and their philosophical signi cance. In examine arguments used to support ethical claims each segment, students will engage in a discussion of one of these concepts and their philosophical implications, • To develop strategies to explore the meaning and before applying the insights gained in that discussion to philosophical signi cance of fundamental concepts, the case. At the end of each segment, students will such as “Life”, “Death”, “Person”, and “Right” consider and formulate an answer to the respective essen- • To assess the validity of information and facts tial questions. presented as part of an ethical claim • To realize that understanding a complex case like 1. Life and Death that of Terri Schiavo may require the consultation of What state is Terri Schiavo in? various disciplines (e.g. medicine, biology, neurosc- ence, ethics, philosophy, etc.) Is she dead, alive, or somewhere in between? • To appreciate the ethical and philosophical What is the difference between life implications of cases that involve life-extending technologies and surrogate decision-making and death? • To understand and appreciate the scientific and technological challenges (and future possibilities) of diagnosing the mental state of comatose patients Procedures and Activities of this segment, students will take a vote on whether they believe the decision to disconnect Terri Schiavo from life This unit uses a student-centered and interactive approach support was justi ed or not: 1) Right decision; 2) Wrong to teaching. Activities are designed to allow for a decision; 3) Not sure. Another vote taken at the end of the maximum degree of student participation and collabora- unit will show if the unit changed students’ opinion about tion. Each activity is marked as an individual-, partner-, or the case. group activity, or as a teacher-directed class discussion. 1. Students will answer the following questions in a The following icons are used to designate the questionnaire. The questions listed here are just different types of activities: suggestions and may be altered or amended ac- cording to grade level, subject, and course focus. - Individual Activity 1. Do you have personal experience with a person who is unconscious? Are you familiar with cases of people who - Partner Activity are or were in a coma? 2. What can cause people to become - Group Activity unconscious, and what are some of the characteristic features of being in a coma? 3. Do you believe the life of a person in a - Teacher-Directed Class Discussion coma should be sustained at all cost? Why? Why not? Assessment 4. Do you agree with the statement: It is Assessment may include pre- and post-assessment activi- never justi ed to knowingly in ict harm ties, short re ection papers on the essential question(s) in on another person? Why? Why not? each segment (formative assessment), as well as a nal 5. What makes you a person? project (summative assessment). The nal project could consist in an individual project (e.g. testifying as an expert 6. Are there certain rights that every person bioethicist at the Schiavo trial) or a group project (e.g. role should have? What are they? playing in a discussion between the main players in the 7. What are characteristic features of a good case). life? What could you not live without? Pennsylvania State Curriculum Alignment 8. Can people ever be truly free? What are (See Appendix II) the limits of our personal freedom? How important is freedom to you? 1. Science and Technology, Environment and Ecology (Grade 12): 3.2., 3.6., 3.7., 3.8. 9. When is it ok to make decisions for other people? When is it ok for other people to 2. Civics and Government make decisions for you)? (Grade 12): 5.1 (J, L), 5.2 (A, G) 10. What would you want to happen to you if 3. Health, Safety and Physical Education you were to fall into an irreversible coma? (Grade 12): 10.1. 4. Reading, writing, Speaking and Listening 2. Students will share and discuss their ndings (Grade 11): 1.2., 1.6. (A, D, E) with a partner and then report their ndings to the class. 3. Students will be introduced to the ease of Terri Introduction Schiavo and provided with basic information about her life and the events that led up to her This introductory segment begins with a pre-assessment death. activity (questionnaire), tapping into students’ previous knowledge of, and personal experience with some of the In February of 1990 at the age of 26, Terri Schiavo issues addressed in this unit.