Quinlan, Karen Ann (1954–1985)

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Quinlan, Karen Ann (1954–1985)

American woman whose removal from a ventilator set a precedent for future legislation governing an individual's right to die. Born on March 29, 1954, in Scranton, Pennsylvania; died of respiratory failure due to acute pneumonia on June 11, 1985, in Morris Plains, New Jersey; adopted daughter of Joseph Quinlan (an employee in the accounting department of a pharmaceutical firm) and Julia Quinlan (a church secretary); graduated from high school in 1972; never married.

Destined to become what the Chicago Tribune termed "a symbol of the right of the terminally ill to decide their fates with their families," Karen Ann Quinlan was born in Scranton, Pennsylvania, on March 29, 1954. She was adopted as an infant by Joseph and Julia Quinlan of Landing, New Jersey, and was later joined by two natural siblings, John and Mary Ellen. The Quinlans were devout Catholics, with Julia working as a church secretary. Described as a carefree, talkative, exuberant child, Karen wrote poetry, played the piano, and enjoyed athletics (she instructed her brother in the how-to's of wrestling). During the summers, she worked as a lifeguard. In 1972, she graduated from high school.

Quinlan was 21 on April 14, 1975, when she was brought to a hospital by friends after she had collapsed and stopped breathing during a party. Although it was thought by doctors that a mix of three gin and tonics, a low dose of Valium, and a strict diet may have impaired her breathing, the precise cause of her coma was never discovered. Other contributory factors may have been low blood sugar; lead poisoning resulting from a job in a factory; or a possible fall a few weeks earlier, which may have caused the bump that was discovered underneath her hair a few days after she became comatose. A grand jury investigation was held concerning an alleged beating she may have received before she was brought to the hospital, but the investigation turned up no evidence of foul play.

Soon after Quinlan was brought to the hospital she was placed on a respirator. She survived a bout of pneumonia, but her condition continued to deteriorate. Several months after her arrival at the hospital, doctors concluded that she would never achieve a "cognitive state." Bereft of hope, her parents watched the obvious pain she experienced when breathing via the ventilator, and they recalled her earlier expressed wish that elaborate life-saving measures never be applied to her. Wanting her pain to come to an end, the Quinlans made the decision to have the ventilator disconnected. Recalled her father: "That decision was so difficult for me. I was the last holdout. I did a lot of praying for guidance." With the support of their priest, the Quinlans made their wishes known to the hospital staff, who did not do as asked, telling them that Quinlan's father would have to become her legal guardian before any consideration would be given to their request. Desperate to help their daughter, the Quinlans found legal representation with Paul Armstrong, a young Legal Aid lawyer. Realizing the great significance of the Quinlans' request, Armstrong foresaw a precedent-setting case which would evolve legal standards to deal with the new lifesaving technologies insofar as they had the potential to stand in the way of an individual's right to die. With his wife Maria Armstrong as his legal secretary, and a close friend, James Crowley, assisting him, Armstrong accepted the case while refusing to take money from the Quinlans.

After their petition was denied by the New Jersey Superior Court, the family—feeling that their actions were in accordance with church doctrine, which in hopeless cases permitted no extraordinary medical measures to be taken—appealed the case to the state's Supreme Court. On March 31, 1976, the seven Supreme Court justices issued a unanimous decision to overturn the lower court's ruling. Joseph Quinlan, made his daughter's guardian, now had the authority to have life-support equipment disconnected if he wished. The court determined that if such action were taken and death resulted, then death "would not be homicide but rather expiration from natural causes," meaning that no one would be criminally liable for Quinlan's death.

Even with this judgment, however, Quinlan was not removed from the ventilator for almost two months. When the equipment was finally taken away, she did not succumb as expected and began breathing unassisted. For the next ten years of her life, she would never regain consciousness. In a permanent vegetative state, Quinlan was moved to the Morris View Nursing Home and cared for by Dr. Joseph Fennelly and six other physicians who volunteered their services. Her family remained dedicated to her, with her father making the 40-mile drive every day to be with her. During the several months before her death at age 31, her conditioned worsened dramatically as she was victim to lung infections. She died on June 11, 1985. The Karen Ann Quinlan Center for Hope was founded by the Quinlan family as a hospice for patients with terminal conditions and their families.

Since the time that Quinlan's case made international news, with a black-and-white photograph of her in a coma published throughout the globe, many courts and legislators have reinforced a patient's right to die. John Fletcher of the University of Virginia's Center for Biomedical Ethics commented in 1996 on the significance of the Quinlan decision: "The case was the first one to draw the attention of the country

and the courts to the problem of being a prisoner in a helpless body, supported only by medical technology." The legal validity of living wills—documents informing doctors of the manner in which individuals wish to be treated if they are found to be incompetent or can no longer communicate—was recognized by a California law a year after the Quinlan case. "They say we were the pioneers," remarked Quinlan's father. "We just did what we had to do."