On April 14, 1975, 21-year-old Karen Ann Quinlan partied with friends at a New Jersey bar, mixing gin and tranquilizers along the way. By the end of the night, she collapsed and fell into a permanent coma, igniting a firestorm that changed the way Americans looked at death.
Quinlan sparked the right-to-die movement and came “to define modern death, more so than any other person in history,” according to the new book “Modern Death: How Medicine Changed the End of Life” by Dr. Haider Warraich.
Hoping to fit into a dress, the young woman had eaten little in the days leading up to the party. After she collapsed at the bar, friends brought her back to her house and performed mouth-to-mouth resuscitation, but it was “later determined that her brain lacked oxygen for at least two 15-minute periods.”
Three days later, a neurologist examined her and found her to be comatose with “extensive damage to higher parts of the brain.”
Days became months, and Quinlan, who was being fed through a tube placed down her nose and into her stomach, showed no signs of recovery as she dropped from 115 to less than 70 pounds.
Five months after her admittance into the hospital, her parents, Joseph and Julia, both devout Roman Catholics, requested that the physicians, Robert Morse and Arshad Javed, take her off the ventilator. They refused. Joseph even drew up an agreement removing any legal liability for the two doctors, but they still resisted, fearing that removing Quinlan from the ventilator could lead to murder charges. Shortly after, the Quinlans filed suit, and their child’s predicament jumped from private tragedy to media sensation.
Initially, writes Warraich, the attorney general and prosecutor believed the case would “challenge New Jersey’s established definition of death.” But Quinlan was found to have some electrical activity in her brain and the ability to breathe on her own for short periods of time, so when the case went to trial, all agreed that she wasn’t dead.
The decision upended a system where doctors were regarded as unimpeachable authorities.
Nothing else about her case was quite so conclusive.
The two-week trial, attended by hundreds of journalists, centered around whether Joseph could be appointed his daughter’s legal guardian for the purpose of ordering her off the ventilator.
“In many ways, the trial would lay the template for future high-profile trials,” writes Warraich. “The Quinlans received thousands of letters and packages, including many from faith healers, many of whom claimed to be able to cure Karen of her ailments.”
Despite the support of three Catholic priests who sat with them in court — basing their position on a 1957 address by Pope Pius XII stating that “physicians had no duty to prolong medical treatment in the face of no hope of recovery against a patient’s wishes” — the judge ruled that only the doctors could decide Quinlan’s fate. He wrote in his decision that a doctor will “do all within his human power to favor life against death.”
The judge, Justice Robert Muir Jr., also wrote that “there is no constitutional right to die,” and that, writes Warraich, “in this case, a decision to terminate the ventilator would amount to homicide and an act of euthanasia.”
The Quinlans filed an appeal in New Jersey Supreme Court. By then public opinion was starting to shift in their direction, especially after a neurologist testified that Quinlan’s present state left her comparable to a fetus with an undeveloped brain.
In March 1976, after two months of deliberations, the New Jersey Supreme Court found in the Quinlans’ favor, with Justice Richard Hughes writing that this was a “matter of transcendent importance.” The decision turned on the Quinlans’ right to privacy, noting that “no external compelling interest could compel Karen to endure the unendurable.”
Joseph was appointed his daughter’s legal guardian and he removed her from the respirator, although she was still fed through a tube. Breathing on her own, Quinlan never emerged from her coma but survived another 10 years, dying of pneumonia at 31 in 1985.
The decision upended a system where doctors were regarded as unimpeachable authorities.
Suddenly, patients and family members were allowed into decision making over medical care.
“The case changed how care was delivered at the bedside and how physicians discussed grave matters with patients and their families,” writes Warraich. “Finally, it started to become clear what the rights of the patient actually were.”
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