| Karen Ann Quinlan | |
 Karen Ann Quinlan in 1972, prior to her brain injury | |
| Born | March 29, 1954 Scranton, Pennsylvania |
|---|---|
| Died | June 11, 1985 (aged 31) Morris Township, New Jersey |
Karen Ann Quinlan (March 29, 1954 – June 11, 1985) was an important person in the history of the right to die controversy in the United States. Year 1972 ( MCMLXXII) was a Leap year starting on Saturday (link will display full calendar of the Gregorian calendar. Events 1461 - Wars of the Roses: Battle of Towton - Edward of York defeats Queen Margaret to become King Year 1954 ( MCMLIV) was a Common year starting on Friday (link will display full 1954 Gregorian calendar) Events 1184 BC - Trojan War: Troy is sacked and burned according to the calculations of Eratosthenes. Year 1985 ( MCMLXXXV) was a Common year starting on Tuesday (link displays 1985 Gregorian calendar) This article is about the Township of Morris in New Jersey Other places in New Jersey with similar names are Morristown, Morris Plains, and Moorestown Events 1461 - Wars of the Roses: Battle of Towton - Edward of York defeats Queen Margaret to become King Year 1954 ( MCMLIV) was a Common year starting on Friday (link will display full 1954 Gregorian calendar) Events 1184 BC - Trojan War: Troy is sacked and burned according to the calculations of Eratosthenes. Year 1985 ( MCMLXXXV) was a Common year starting on Tuesday (link displays 1985 Gregorian calendar) For the 1987 film see Right to Die (film The term " right to die " refers to various issues related to the decision of whether an
When she was 21, Quinlan became unconscious after coming home from a party, and lapsed into a persistent vegetative state. A persistent vegetative state (PVS is a condition of patients with severe Brain damage in whom Coma has progressed to a state of wakefulness without detectable After she was kept alive on a ventilator for several months without improvement, her parents requested the hospital discontinue active care and allow her to die. The hospital refused, and the subsequent legal battles made newspaper headlines and set significant precedents. In Common law legal systems, a precedent or authority is a Legal case establishing a principle or rule that a Court or other judicial
Not only was the case legally important, it was remarkable for its rare appeal to religious principles. Because she and her family were Catholics, several principles of Catholic moral theology were critical in deciding the case and thus influencing a development in American law, an influence replicated around the world. Ethics is a branch of Philosophy dealing with right and wrong in human behavior The case is credited also with the development of the modern field of bioethics. Bioethics is the philosophical study of the ethical controversies brought about by advances in Biology and Medicine.
Although Quinlan was removed from active life support during 1976, she lived on in a coma for almost a decade until her death from pneumonia in 1985. Year 1976 ( MCMLXXVI) was a Leap year starting on Thursday (link will display full calendar of the Gregorian calendar. Pneumonia is an inflammatory illness of the Lung. Frequently it is described as lung Parenchyma / alveolar inflammation and abnormal
Quinlan's case continues to raise important questions in moral theology, bioethics, euthanasia, legal guardianship and civil rights. Ethics is a branch of Philosophy dealing with right and wrong in human behavior Bioethics is the philosophical study of the ethical controversies brought about by advances in Biology and Medicine. Euthanasia (literally "good death" in Ancient Greek) refers to the practice of ending a life in a painless manner A legal guardian is a person who has the legal authority (and the corresponding duty to care for the personal and Property interests of another person called a ward Her case has affected the practice of medicine and law around the world. Two significant outcomes of her case were the development of formal ethics committees in hospitals, nursing homes and hospices, and the development of advance health directives. Advance health care directives or advance directives are instructions given by individuals specifying what actions should be taken for their health in the event that they are
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Early life
Karen Ann Quinlan was born on March 29, 1954, in Scranton, Pennsylvania, to a young unmarried mother of Irish American ancestry. Events 1461 - Wars of the Roses: Battle of Towton - Edward of York defeats Queen Margaret to become King Year 1954 ( MCMLIV) was a Common year starting on Friday (link will display full 1954 Gregorian calendar) A single parent (also lone parent and sole parent) is a Parent who cares for one or more children without the assistance of another parent in the home Irish Americans (Gael-Mheiriceánach are citizens of the United States who can claim ancestry originating in Ireland. A few weeks later, she was adopted by Joseph and Julia Quinlan, devout Roman Catholics who lived in Landing, New Jersey. Landing is a small settlement and unincorporated area located within Roxbury Township, New Jersey, on the south shore of Lake Hopatcong near She was soon joined by two (unadopted) siblings: Mary Ellen (born 1956) and John (born 1957). [1]
Karen Ann and her family lived in Landing for the next two decades uneventfully.
According to some friends, Quinlan lived a wild, reckless lifestyle and used drugs including heroin, cocaine and methadone. Heroin ( INN: diacetylmorphine, BAN: diamorphine) is a semi-synthetic opioid synthesized from Morphine, a derivative Cocaine ( benzoylmethyl ecgonine) is a Crystalline Tropane Alkaloid that is obtained from the leaves of the Coca plant Methadone ( Dolophine Amidone Methadose Physeptone Heptadon and many others is a synthetic Opioid, used medically as an Analgesic, Antitussive However, the evidence regarding her drug use is contradictory and her parents deny she was a drug user.
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In April 1975, shortly after she turned 21, Karen Quinlan left her parents' home and moved in with two roommates in a house a few miles away. Around the same time, she went on a radical diet, reportedly in order to fit into a dress that she had bought. She weighed 115 pounds (52 kilograms) when admitted to the hospital.
On April 15, 1975, a few days after moving into her new house, Quinlan attended a friend's birthday party at a local bar. Events 1450 - Battle of Formigny: Toward the end of the Hundred Years' War, the French attack and nearly annihilate English Year 1975 ( MCMLXXV) was a Common year starting on Wednesday (link will display full calendar of the Gregorian calendar. She had eaten almost nothing for 2 days. At the party, she reportedly drank a few gin and tonics — and took a tranquilizer, believed to be phenobarbital, but perhaps valium or methaqualone — when she suddenly felt faint. A gin and tonic is a highball Cocktail made with Gin and Tonic water, usually garnished with a slice of lime or Lemon Phenobarbital ( INN) or phenobarbitone (former BAN) is a Barbiturate, first marketed as Luminal by Friedr Diazepam (daɪˈæzɨpæm first marketed as Valium by Hoffmann-La Roche, is a Benzodiazepine derivative Drug. Methaqualone is a Sedative drug which is similar in effect to Barbiturates a general CNS Depressant. Shortly thereafter she was taken home and put in bed. When friends checked on her about fifteen minutes later, they found she was not breathing.
An ambulance was called and mouth-to-mouth resuscitation was attempted. Artificial respiration is the act of simulating respiration, which provides for the overall exchange of gases in the body by pulmonary ventilation external respiration and internal Eventually, some color returned to her pallid skin, but she did not regain consciousness.
Karen Quinlan was admitted to Newton Memorial Hospital in New Jersey in a coma. She remained there for nine days in an unresponsive condition before being transferred to St Clare's Hospital, a larger facility.
Coma
Karen Quinlan had suffered irreversible brain damage after experiencing an extended period of respiratory failure (lasting no more than 15–20 minutes). Brain damage, or Acquired brain injury, is the destruction or degeneration of Brain cells. Respiratory failure is a medical term for inadequate Gas exchange by the Respiratory system. No precise cause of her respiratory failure has been given, although her mother has said that the doctors' best guess was that she fell asleep or passed out and aspirated on her own vomit. In Medicine, aspiration is the entry of secretions or foreign material into the trachea and Lungs The patient may either inhale the material Vomiting (also called throwing up, emesis) is the forceful expulsion of the contents of one's Stomach through the Mouth and sometimes the She was in a coma. Her eyes were "disconjugate" — that is, they no longer moved in the same direction together — and her EEG, while not flat, showed only abnormal slow-wave activity.
She was in a very deep form of unconsciousness called a persistent vegetative state. A persistent vegetative state (PVS is a condition of patients with severe Brain damage in whom Coma has progressed to a state of wakefulness without detectable
Over the next few months she remained in hospital and her condition gradually deteriorated. She lost weight - eventually weighing less than 80 pounds (36 kilograms). She was prone to unpredictable, violent thrashing of her limbs. She was only kept alive by nasogastric feeding and the constant presence of a ventilator to help her breathe. Nasogastric intubation is a medical process involving the insertion of a plastic tube ( nasogastric tube NG tube) through the Nose, past the Throat
Legal battle
After seeing Karen like this for several months, her family finally came to the conclusion that she was beyond hope, and decided to remove her from the ventilator. Hospital officials refused. They were probably wary of a recent, well-publicised case where a doctor, Kenneth Edelin had been charged with manslaughter for performing a late-term abortion. Manslaughter is a legal term for the killing of a human being in a manner considered by law as less culpable than Murder. Late-term abortions are Abortions which are performed during a later stage of Pregnancy. The boundaries of the "right to life" was a topical issue and the hospital's lawyers did not want to risk a legal quagmire. Right to life is a phrase that describes the belief that a Human being has an essential Right to live particularly that a human being has the right not to be
The Quinlan family persevered, and in 1976 they took their case to the New Jersey Supreme Court, which ruled in their favor. Year 1976 ( MCMLXXVI) was a Leap year starting on Thursday (link will display full calendar of the Gregorian calendar. Note! Article is BELOW this infobox scroll down --> The New Jersey Supreme Court is the highest court in the U When she was taken off the respirator, Quinlan surprised many by continuing to breathe unaided, and was fed by artificial nutrition for nine more years.
Death
She lived in a persistent vegetative state until her death from pneumonia in 1985. A persistent vegetative state (PVS is a condition of patients with severe Brain damage in whom Coma has progressed to a state of wakefulness without detectable Pneumonia is an inflammatory illness of the Lung. Frequently it is described as lung Parenchyma / alveolar inflammation and abnormal Year 1985 ( MCMLXXXV) was a Common year starting on Tuesday (link displays 1985 Gregorian calendar) Quinlan was buried at Gate of Heaven Cemetery in East Hanover, New Jersey. Gate of Heaven Cemetery is a Cemetery located in East Hanover, New Jersey, United States. East Hanover Township is a township in Morris County, New Jersey, United States. [2]
Catholic moral theology and the New Jersey Supreme Court decision
At the time legal guardianship was assigned by a New Jersey court to her father, Joseph Quinlan, his religious affiliation as a Catholic was taken into consideration positively as Karen herself was a Catholic. This brought the Catholic Church's moral teaching to bear on the case as relevant material. The New Jersey Supreme Court decision on the groundbreaking and precedent setting case quotes extensively from an address given by Pope Pius XII to medical professionals on the matter of preservation of life:
- "The request of plaintiff for authority to terminate a medical procedure characterized as "an extraordinary means of treatment" would not involve euthanasia. Note! Article is BELOW this infobox scroll down --> The New Jersey Supreme Court is the highest court in the U Pope This upon the reasoning expressed by Pope Pius XII in his "allocutio" (address) to anesthesiologists on November 24, 1957, when he dealt with the question:
- 'Does the anesthesiologist have the right, or is he bound, in all cases of deep unconsciousness, even in those that are completely hopeless in the opinion of the competent doctor, to use modern artificial respiration apparatus, even against the will of the family?'
- His answer made the following points:
- 1. 'In ordinary cases the doctor has the right to act in this manner, but is not bound to do so unless this is the only way of fulfilling another certain moral duty.
- 2. The doctor, however, has no right independent of the patient. He can act only if the patient explicitly or implicitly, directly or indirectly gives him the permission.
- 3. The treatment as described in the question constitutes extraordinary means of preserving life and so there is no obligation to use them nor to give the doctor permission to use them.
- 4. The rights and the duties of the family depend on the presumed will of the unconscious patient if he or she is of legal age, and the family, too, is bound to use only ordinary means.
- 5. This case is not to be considered euthanasia in any way; that would never be licit. The interruption of attempts at resuscitation, even when it causes the arrest of circulation, is not more than an indirect cause of the cessation of life, and we must apply in this case the principle of double effect. The principle of double effect ( PDE) also known as the rule of double effect ( RDE) the doctrine of double effect ( ' " (from the text of the New Jersey Supreme Court decision, "On the Matter of Quinlan" (1976)
Extraordinary means
Catholic moral theology does not require that "extraordinary means" be employed in preserving a patient's life. Such means are any procedure which might place an undue burden on the patient, family or others and is beyond the basic care required for the ordinary sustenance of life and dignity, food, water, air, hygiene. A patient always has the right to refuse extraordinary means of treatment even if this will hasten natural death. However, only the patient has this right which may be expressed legally through guardianship or advanced expression of their wishes.
It is to this principle that Karen Quinlan's parents appealed when they requested that the extraordinary means of a respirator be removed. The court honored this principle in finding in their favor.
The requirement of an expressed or implied will of the patient by Catholic moral theology is a guarantee against the undue influence of governmental or other agencies which might not have the patient's best interests as a motivation in such personal matters.
Autopsy findings
While Karen Ann was alive but unconscious, the extent of damage to her brainstem could not be precisely determined. However when she died her entire brain and spinal cord were studied carefully. The brain is the center of the Nervous system in animals All Vertebrates and the majority of Invertebrates have a brain The spinal cord is a long thin tubular bundle of Nerves that is an extension of the Central nervous system from the brain and is enclosed in and protected While her cerebral cortex had moderate scarring, it seemed that her thalamus was extensively damaged bilaterally. The cerebral cortex is a structure within the Brain that plays a key role in Memory, Attention, perceptual Awareness, Thought, The thalamus (from Greek θάλαμος = room chamber, IPA= /ˈθæləməs/ is a pair and symmetric part of the brain Her brain stem (which controls breathing and cardiac functions) was undamaged. The brain stem (or brainstem) is the lower part of the Brain, adjoining and structurally continuous with the Spinal cord. These findings suggest that the thalamus plays a particularly important role in consciousness. Consciousness has been defined loosely as a constellation of attributes of Mind such as Subjectivity, Self-awareness, Sentience, and the [3]
Cultural influence
A TV movie was made about Karen Quinlan, with Piper Laurie and Brian Keith playing her parents. Piper Laurie (born January 22, 1932) is an American actress of stage and screen noted for her role in the television series Twin Peaks Brian Keith (November 14 1921 – June 24 1997 was an American stage film and television actor
The 1981 film The Verdict, starring Paul Newman and Jack Warden, chronicled the case of a woman in a persistent vegetative state, though in that case the cause was medical negligence. Year 1981 ( MCMLXXXI) was a Common year starting on Thursday (link displays the 1981 The Verdict is a 1982 Feature film which tells the story of a down-on-his-luck alcoholic Lawyer who pushes a Medical malpractice Paul Leonard Newman (January 26 1925 &ndash September 26 2008 was an Academy Award Jack Warden ( September 18 1920 – July 19, 2006) was an Emmy Award -winning Academy Award -nominated American
Taking sedatives with alcohol is often jokingly referred to as having a "Karen Ann Quinlan Cocktail. "
Comedian Denis Leary mentions her in the screenplay of his show, No Cure For Cancer, though he does mention she woke up when she was taken off life support, which never happened. Denis Colin Leary (born August 18, 1957) is a Golden Globe - and Emmy Award -nominated American Actor, Comedian No Cure for Cancer is one of Denis Leary 's standup routines from the early 1990s
In Truly Tasteless Jokes by Blanche Knott, the following joke appeared: Q: What's the New Jersey state vegetable? A: Karen Ann Quinlan
References
- ^ Quinlan, J and Quinlan, J. Blanche Knott is the credited author of the politically incorrect Truly Tasteless Jokes book and its many follow-ons D. (1977). Karen Ann: The Quinlans Tell Their Story. New York: Bantam Books. ISBN 0-385-12666-2
- ^ "Tearful Rites for Karen Quinlan", Bergen Record, June 16, 1985. The Record (colloquially called The Bergen Record or The Record of Hackensack) has the second largest circulation of New Jersey 's daily Events 1487 - Battle of Stoke Field, the last dying breath of the Wars of the Roses. Year 1985 ( MCMLXXXV) was a Common year starting on Tuesday (link displays 1985 Gregorian calendar) Accessed August 4, 2007. Events 70 - The Destruction of the Second Temple in Jerusalem by the Romans. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. "A procession of about 75 cars then drove to Gate of Heaven Cemetery in East Hanover. "
- ^ Kinney, H. C. , Korein, J. , Panigrahy, A. , Dikkes, P. and Goode, R. (1994). Neuropathological Findings in the Brain of Karen Ann Quinlan -- The Role of the Thalamus in the Persistent Vegetative State. The New England Journal of Medicine. 330:1469-1475.
Further reading
- Colen, B. D. (1976). Karen Ann Quinlan: Dying in the Age of Eternal Life. New York: Nash Publishing. ISBN 0-8402-1368-9
- Quinlan, J. D. (2005). My Joy, My Sorrow: Karen Ann's Mother Remembers. Cincinnati: St. Anthony Messenger Press. ISBN 0-86716-663-0
- Pence, G. E. (2004). "Comas: Quinlan and Cruzan" in Classic Cases in Medical Ethics, 4th ed. ISBN 0-07-282935-4
- Kenny, Robert Wade (2001). 'Toward a Better Death: Applying Burkean Principles of Symbolic Action to Interpret Family Adaptation to Karen Ann Quinlan's Coma'. Health Communication, Volume 13, Issue 4, pages 363 - 385.
- Kenny, Robert Wade. 'A Cycle of Terms Implicit in the Idea of Medicine: Karen Ann Quinlan as a Rhetorical Icon and the Transvaluation of the Ethics of Euthanasia'. Health Communication, Volume 17, Issue 1, pages 17 - 39.
See also
External links
The Texas Advance Directives Act (1999 also known as the Texas Futile Care Law, describes certain provisions that are now Chapter 166 of the Texas Health & Safety The Baby Doe Law or Baby Doe Amendment is the name of an amendment to the Child Abuse Law passed in 1984 in the United States that sets forth specific criteria and Euthanasia (literally "good death" in Ancient Greek) refers to the practice of ending a life in a painless manner The Texas Advance Directives Act (1999 also known as the Texas Futile Care Law, describes certain provisions that are now Chapter 166 of the Texas Health & Safety Futile medical care refers to the belief that in cases where there is no hope for improvement of an incapacitating condition that no course of treatment is called for Theresa Marie Schindler "Terri" Schiavo ( December 3 1963 – March 31 2005 was an American woman who suffered brain damage and became dependent on a Feeding tubeDapyx Software network: MP3 Explorer | Ebook Manager | Zenithic