The “right to die” and the Karen Ann Quinlan case at 40

By Dave Andrusko

Karen Ann Quinlan

Karen Ann Quinlan

The name Thaddeus Pope may ring a bell with particularly careful readers of NRL News Today. We have written before about Pope, who is Director, Health Law Institute, Mitchell Hamline School of Law, in St. Paul, Minnesota, and author of the hugely influential “Medical Futility Blog.”

He is a major player in the field of bioethics and a fervent believer in (as the title of the blog suggests) medical futility, as elastic (and deadly) a term as you could imagine.

So why do I bring his name up today? I ran across a post from Tuesday titled, “Quinlan at 40: Exploring the Right to Die in the US.”

It turns out there will be an all-day conference November 11 at the Georgia State University Law School building. The usual rogues gallery of right-to-die luminaries will participate.

For many people, the name Quinlan will be greeted with a blank stare. To quote from the Los Angeles Times’ obituary

[“Karen Ann] Quinlan lapsed into a coma on April 15, 1975, at her boyfriend’s birthday party. She had apparently consumed several gin and tonic drinks on top of what doctors said was a “therapeutic” amount of a mild tranquilizer and aspirin. The mixture was never firmly established as the cause of her condition. After doctors said that Quinlan would never return to a “cognitive state,” her parents sought court permission to disconnect her from a respirator.

In the case of In re Quinlan, the New Jersey Supreme Court in March 1976 held that the parent-guardian of Miss Quinlan could order withdrawal of the respirator that was believed to sustain Karen’s life. However, when the respirator was withdrawn on May 22, Karen unexpectedly continued to breathe on her own.

But note: as NRL News wrote, “Withdrawal of nutrition and hydration was never an issue and Karen lived for another decade.”

According to the 1986 Times obituary, her family, who adopted Karen at birth, “has annually celebrated a Mass at which her parents and her brother and sister prayed and sang Karen’s favorite song, ‘Amazing Grace.’”

The Quinlan case established the principle of “substituted judgment,” whereby someone else, such as a relative, must be given the ability to choose, purportedly on the incapacitated person’s behalf, to exercise that right. As NRL News wrote, “Quinlan led the nation in applying this substituted-judgment doctrine to rejection of life-preserving medical treatment.”

Forty years later, food and water are routinely withheld, even in instances where prior to incapacity, a person had said they would want them administered. In those jurisdictions–so far very limited–where assisted suicide has been legalized, it will take only someone bringing a court case to establish the “right” of a grandmother with Alzheimer’s disease to be killed at the direction of someone deemed to have the authority to make that decision.

“Quinlan at 40” is a reminder of far we have come, the odds we face, but also of the critical importance of resisting the latest iteration of the anti-life ethos, assisted suicide.