This blog post deeply explores whether the ‘right to die’ is a fundamental right that the Constitution should guarantee, focusing on the Karen Quinlan case in the United States from legal, ethical, and social perspectives.
On April 15, 1975, 21-year-old American Karen Quillan attended a friend’s birthday party before suddenly losing consciousness and being admitted to the intensive care unit of a nearby hospital. After nine days with no improvement, she was transferred to St. Clare’s Hospital, which had a neurologist on staff. From the outset of her hospitalization, Karen remained in a coma, her life sustained by a ventilator. Initially fed orally, then via a nasogastric tube, she gradually began exhibiting the neurological damage characteristic of stroke patients. Her muscles stiffened and contracted, and her weight dropped significantly.
Hospital staff estimated Karen’s chances of recovery at one in a million. Her family came to accept that the possibility of her regaining consciousness was virtually nonexistent. They recalled that she herself had stated during her lifetime that she did not wish to have her life prolonged in a vegetative state, dependent on machines, should anything terrible happen. Accordingly, Karen’s parents requested the hospital to remove the ventilator sustaining her life. This decision was also based on moral and religious counsel. The parish priest advised that prolonging life through extraordinary means like a ventilator was not a moral obligation for Catholics, citing the position of Pope Pius XII.
However, Karen’s attending physicians, Moss and Yavet, refused the parents’ request. They later expressed concern that the parents might reverse their decision, potentially leading to a medical malpractice lawsuit. They even declined to accept Karen’s own request for transfer. Consequently, Karen’s father, Joseph Quinlan, sought out attorney Armstrong for a legal resolution. The case was assigned to Judge Muir of the New Jersey Probate Court.
Armstrong went a step further than simply requesting Karen be transferred to a hospital to remove the ventilator; he legally raised the issue of ‘letting her die’. When Joseph Quinlan stated he wanted his daughter’s ventilator removed, Judge Muir instead ruled that Karen’s parents could no longer serve as her legal guardians. Consequently, Armstrong had to present legal grounds to let Karen die. He first argued that Karen was legally brain dead, but Judge Muir ruled that since her brainstem was still functioning, she did not meet New Jersey’s criteria for brain death.
Karen’s attending physician testified that there was no precedent for removing the ventilator at that time. Morse’s attorney, Forgio, argued that ending a life based on an assessment of another person’s quality of life could not be justified. He fiercely criticized the act, stating it was legally and medically killing a living person, ultimately no different from Nazi gas chambers. Emphasizing the sanctity of life, he left a strong impression on the court with the statement, “We are not God.”
In November 1975, nearly seven months after Karen’s hospitalization, Judge Muir ruled that Karen’s ventilator should not be removed. He determined that Karen had left no written directive, that her parents’ statements regarding her death could not serve as conclusive evidence, and that the Constitution did not explicitly grant a ‘right to die’.
Karen’s parents appealed, and in January 1976, the New Jersey Supreme Court ruled in their favor. The higher court held that the privacy rights guaranteed by the U.S. Constitution could extend to include the decision by the family of a terminally ill patient lacking decision-making capacity to remove life-sustaining equipment. This ruling sparked a broad debate extending beyond a simple family victory, encompassing medical ethics, legal rights, and the dignity of human death. Subsequently, this case became a pivotal starting point for medical, legal, and ethical debates on euthanasia and served as a catalyst for shifting societal perceptions regarding the ‘right to die’.
