Persistent vegetative state

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June 11, 1985: Karen Quinlan Dies, But the Issue Lives On

1985: Karen Ann Quinlan, brain-dead and nine years removed from the respirator doctors employed to keep her alive, finally dies. Her case is a landmark in the ethical debate over the lengths medical science should go in trying to preserve a life that is deemed irretrievably lost. Karen Quinlan was a 21-year-old college student in 1975 when she ingested a combination of drugs and alcohol at a party. Feeling unwell, she was put to bed by friends who later returned to find that she had stopped breathing. By the time help arrived, Quinlan's oxygen-deprived brain was severely damaged, and she was reduced to what doctors describe as a persistent vegetative state. Quinlan was kept alive with life-support technology, including feeding tubes and a respirator that enabled her to breathe. While there was some low-level brain function, her cognitive abilities were wiped out. When months passed without any improvement in her condition, Quinlan's parents asked that she be removed from life support and allowed to die. Doctors refused, saying she didn't meet the criteria for brain death, meaning she could not be declared legally dead by existing medical standards. The state of New Jersey also intervened, saying it would prosecute any physician who helped end Quinlan's life. Joseph Quinlan, Karen's father, sued to have life support discontinued, but was denied by the court. He appealed to the New Jersey Supreme Court, where he based his case on the First (freedom of religion) and Eighth (cruel and unusual punishment) Amendments. Although the court rejected both arguments, it ultimately ruled in Joseph Quinlan's favor on the basis of U.S. Supreme Court precedents affirming an individual's right to privacy. It also rejected the state's argument that removing life support constituted a homicide, saying that Quinlan's death would result from natural causes. Following the court's ruling, Karen Quinlan was removed from the respirator. But she did not die. Instead, she continued breathing unaided and lived for another nine years before infection and pneumonia finally killed her. She was 31. The autopsy disclosed severe damage to her thalamus, that part of the brain that controls -- among other things -- the processing of sensory information. Quinlan's case is a milestone, a legal precedent for other right-to-die cases. It is also a milestone in bioethics, touching as it does on a number of moral and ethical issues surrounding the end of life. As a direct result of the Quinlan case, in fact, hospitals and other health care facilities nationwide established ethics committees. It's not an issue that will resolve itself anytime soon. The implications of prolonging life under extraordinary circumstances are only bound to multiply with every advance in medical technology. Source: Various