title: [Terri's case and the ethical challenge for an always more technologically advanced medicine].
abstract: BACKGROUND
  Highly technological medicine puts the physician in the condition of verifying always more and always better the patients' vital parameters. It also opens up new issues on the ethical side because it makes more difficult placing the borderline between life and death. The relation between the guarantee of the necessary cures, aggressive treatment and a possible request for euthanasia often appears smooth in the experts perception and in the public opinion. Indeed it feels involved in strongly expressing its opinion in a field which can affect each one of us or else in the treatment relation with patients and relatives.
  
  
  METHODS
  Terri Schiavo's recent death, after fifteen year of vegetative coma, occurred as a consequence of the withdrawal of feeding-tubes, has spread from the USA to Italy and the rest of the world the dramatic difficulty of clarifying issue of this impact. On one side there are solutions of an emotional kind, based on pietas, these affect the relatives who caring for such patients. This first considerations reveals its contradiction in the fact that the parents wish to keep on yielding their daughter's life and thus clash with her husband who, on the other hand, wants to interrupt all kind of treatment. On the other hand there are serious issues of a clinical and ethical kind according to which normal treatment is guaranteed at all cost and nutrition has to be considered as ordinary treatment. Aggressive treatment can reach other not lawful dimensions because they are against human dignity and end up in worsening pain and suffering.
  
  
  CONCLUSIONS
  Nowadays there is a pressing need for a wide information campaign for public opinion on these issues as well, as there is the possibility that all citizen can write a living will fully conscious of his responsibility. Furthermore it is even more urgent that medical class and all those who take care of these patients are able to harmonise their technical and scientific culture, keeping in mind a ethical and anthropological vision in order to fully understand the dignity of the dying during their last days, in an atmosphere of warm welcome and paying attention not only to the patients but to their close relatives as well. This because the weight of the treatment is on them, as is the psychological and emotional tension. The new kinds of burnout are so important that are being considered by present medicine as a new challenge.
authors.affiliation: Area di Medicina, Campus Bio Medico, Roma, Italia.
authors.forename: P
authors.initials: P
authors.lastname: Binetti
mesh_terms: D000328:Adult; D000574:American Medical Association; D001291:Attitude of Health Personnel; D001675:Bioethics; D005065:Euthanasia; D005260:Female; D006801:Humans; D016224:Living Wills; D028701:Patient Rights; D011639:Public Opinion; D014481:United States