In Contrast, in 1990 Terri Schiavo collapsed in the hall of her apartment and experienced severe hypoxia for several minutes. Four months after her injury, she was judged to be incompetent and her husband was appointed her legal guardian. Because she was unable to swallow, she underwent placement of a percutaneous endoscopic gastrostomy (PEG) tube. By the end of the year, Mrs. Schiavo was determined to be in a persistent vegetative state without leaving a will determining her wishes for end of life treatment. Mrs. Schiavo’s family attempted various rehabilitation techniques including regular and aggressive physical, occupational, and speech therapies. “Despite their best efforts and explorations of all potentially viable treatments, her condition…show more content… In the case of Mr. B., he was able to make his own decisions and act upon himself. On the other hand, Terri Chiavo was required to depend on someone else to make her end of life choices. “In general, respecting autonomy at the end of life can be particularly strenuous as most people become increasingly dependent on others. Several autonomy-related challenges may arise, such as unwanted dependence, losing control and limitations to activities.”8 Chiavo’s incident was not planned, thus she was unable to determine who would make decisions for her if she became unable to do so herself. Although the dependence might have been unwanted, it became required. This leads to the ethical issue as to when is someone else able to decide what is best for a patient while still trying to provide the patient with autonomy and respect their…show more content… This doctrine comes up in discussions relating to end of life decisions. Some end of life decisions appear to have good effects of reducing pain but at the same time it’s effects shortens the patient’s lives. Thus there is a moral distinction between intending to kill an individual and intending to help an individual who’s death is foreseen but unintended. An example in end of life care that is normally seen in today’s society is the use of pain reliving drugs. The intention is to relieve pain but the drugs end up shortening the life of the patient. “The DDE provides a moral justification for interventions aimed at benefiting a patient that may result in life being shortened. In order for it to be applied the following criteria have to be met (Beauchamp and Childress, 1994): The intended end, in this case the relief of distressing symptoms, must be a good one. The bad effect, the patient’s death, may be foreseen but must not be intended. The bad effect must not be the means of bringing about the good effect, so the death of the patient cannot be the method by which the distress is relieved. The good effect must on balance outweigh the bad effect. For a patient in the dying phase the risk of shortening love of the benefit of comfort is considerably less than in an otherwise healthy