What has Karen Quinlan taught us?
Rosemary FlaniganJune 15, 2009
I was surprised by Lorell’s identifying June 11, 2009 as the 24th anniversary of Karen Quinlan’s death, nearly 10 years after being weaned from the respirator.
That news reminded me of being young—and still teaching—and how I used the “Matter of Quinlan. Supreme Court of New Jersey 1976” when I taught ethics. I wanted the students to see the best arguments on issues, whether pro or con—and this case was the best example of legal reasoning, supported by good philosophical distinctions, that I could find for end-of-life issues.
I hope the students all memorized this “holding”: “The State’s interest to maintain life weaken, and a patient’s right of privacy grows, as the degree of bodily invasion increases and as prognosis dims.” I think that’s brilliant—and I hope I said it often enough that it drilled a hole in their heads.
Using the ordinary/extraordinary means distinction and the distinction between direct killing and allowing to die, the Supreme Court Justices declared 7-0 “. . .upon the concurrence of the guardian and family of Karen, should the responsible attending physicians conclude that there is no reasonable possibility of Karen’s ever emerging from her present comatose condition to a cognitive, sapient state and that the life-support apparatus now being administered to Karen should be discontinued, they shall consult with the hospital ‘Ethics Committee’. . . .”
I wonder how long it took the hospital to get an “Ethics Committee” up and running!!
So many years later—so many trips to the courtroom. But I hope that responsible advance care planning has eliminated many other such trips.
I was surprised by Lorell’s identifying June 11, 2009 as the 24th anniversary of Karen Quinlan’s death, nearly 10 years after being weaned from the respirator.
That news reminded me of being young—and still teaching—and how I used the “Matter of Quinlan. Supreme Court of New Jersey 1976” when I taught ethics. I wanted the students to see the best arguments on issues, whether pro or con—and this case was the best example of legal reasoning, supported by good philosophical distinctions, that I could find for end-of-life issues.
I hope the students all memorized this “holding”: “The State’s interest to maintain life weaken, and a patient’s right of privacy grows, as the degree of bodily invasion increases and as prognosis dims.” I think that’s brilliant—and I hope I said it often enough that it drilled a hole in their heads.
Using the ordinary/extraordinary means distinction and the distinction between direct killing and allowing to die, the Supreme Court Justices declared 7-0 “. . .upon the concurrence of the guardian and family of Karen, should the responsible attending physicians conclude that there is no reasonable possibility of Karen’s ever emerging from her present comatose condition to a cognitive, sapient state and that the life-support apparatus now being administered to Karen should be discontinued, they shall consult with the hospital ‘Ethics Committee’. . . .”
I wonder how long it took the hospital to get an “Ethics Committee” up and running!!
So many years later—so many trips to the courtroom. But I hope that responsible advance care planning has eliminated many other such trips.
Labels: aging and end of life, clinical and organizational ethics, Karen Quinlan, medical ethics
posted by Practical Bioethics at
9:16 AM
2 Comments:
This is a very good point to raise. Based on my first-hand experience with patients and families, I would say that it is close to nil.
And the greater question is really “how likely are they to invoke the resources in the midst of a family crisis?”
I know that when my mother was dying, I “knew” all kinds of things that I could not have utilized at the time due to being overwhelmed by circumstances.
Six months after her death, I sought out the social work supervisor and described one aspect of my experience to her.
She was horrified and said to me, “You know that you could have asked for another social worker?”
Yes, I “knew” it, but I did not have the emotional/psychological strength to follow through with that option. I could not bear the thought of “starting over” with someone else.
Did I mention that I was a hospice nurse at the time?
I think that we often sit on the perimeter of a situation and enjoy a more complete view of a situation than a patient or family does, or can at the time. We tend to forget that we have different knowledge and resources than they do.
One reason that I am such a proponent of the case manager/advocate role is so that an informed, objective professional can help guide folks through Troubled Times.
Linda
Linda L. Kerby
RN, C-R, BSN, MA, BA
Mastery Educational Consultations
Leawood, Kansas
I hope the students all memorized this “holding”: “The State’s interest to maintain life weaken, and a patient’s right of privacy grows, as the degree of bodily invasion increases and as prognosis dims.” I think that’s brilliant—and I hope I said it often enough that it drilled a hole in their heads.
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