"into the Hands of the Lord" At Last

By Otto Friedrich

Karen Ann Quinlan could never know that she was a famous legal case, that her "right to die" was the subject of a book, Karen Ann, and a movie, In the Matter of Karen Ann Quinlan, or that on her 31st birthday this past April, cards of good wishes came from all over the world. Throughout all this, for more than ten years, she lay in a coma, curled into a fetal position, shrunken to little more than 60 lbs., unable to see or speak.

Her father Joseph, a shipping supervisor at a pharmaceutical company, came to visit her every day at the nursing home in Morris Plains, N.J. "It's a habit, a routine," he said to the New York Times. "I couldn't break it for the life of me. I still have to stop there every day, even in snow, just to be sure that she's not lacking for anything." Her mother Julia came two or three times a week. "There's a radio in her room that is always on," she said, "and once in a while we bring down a tape and play some songs for her. I just couldn't imagine anyone lying in bed for ten years and not being talked to or held or touched."

"Karen is in limbo," the mother said in January. "We're all in limbo . . ."

Until her accident, Karen had lived a fairly ordinary life. She was born Mary Anne Monahan in a hospital for unwed mothers in Scranton, Pa. The Quinlans adopted her at four weeks, renamed her, and gave her a strict Roman Catholic upbringing in Roxbury Township, N.J. She was an average student, good at swimming and skiing, popular with classmates.

Nobody knows exactly what went wrong in the spring of 1975. Karen was having some troubles, getting and losing jobs and finally moving in with friends. On the night of April 14, she apparently swallowed a number of tranquilizers shortly before drinking several gin- and-tonics with friends at a tavern. & Suddenly she fell unconscious. Seeing that she had stopped breathing, her friends called an ambulance. She was given oxygen and put on a respirator, but she never regained consciousness. After Karen had remained in a coma for three months with no prospect of recovery, her parents asked her two doctors to take her off the respirator and let her "pass into the hands of the Lord"; the doctors refused. With the support of their parish priest, the parents went to court to ask permission for Karen to die "with grace and dignity." No U.S. court had ever granted such a right, and the controversy attracted international attention.

The arguments were complex and painful. The Quinlans' lawyer argued that Karen had a constitutional right to die, based on both freedom of religion and the right to privacy, that it would be cruel and unusual punishment to keep her alive "after the dignity, beauty, promise and meaning of earthly life have vanished." A court-appointed guardian for Karen countered that the parents had no right to propose what amounted to euthanasia. The doctors' lawyer claimed that no court could determine whether or not Karen might yet recover. The state attorney general also felt obliged to intervene and sided with the doctors.

The judge ruled against the Quinlans, but when they appealed to the state supreme court, it granted their plea. In a landmark decision based on the right to privacy, it ruled that "no compelling interest of the state could compel Karen to endure the unendurable." The Quinlans thought their ordeal was nearly over. When the respirator was finally turned off, however, Karen remained alive, year after year.

The New Jersey landmark was not binding in other states, of course, and laws on the right to die remain a confused patchwork. Courts have generally but not uniformly ruled that a competent patient has a right to refuse medical treatment (34 states and the District of Columbia recognize "living wills" that forbid extreme treatments). The incompetent and comatose present complex problems. If doctors and families agree to withhold treatment, doctors often quietly practice what they call "judicious neglect," but disagreements still end noisily in court.

In the matter of Karen Ann Quinlan, the parents' petition has finally been granted. After she succumbed to pneumonia last week, held in the arms of her weeping mother, Joseph Quinlan said, "She died with dignity."