Karen Ann Quinlan

Karen Ann Quinlan (born 29 March 1954 in Scranton (Pennsylvania) ; died 11. June 1985 in Morris Township , New Jersey ) was an American woman who in May 1975 probably due to drug use at a party a cardiac arrest and in the I developed an apallic syndrome as a result . Through the litigation of their parents to the setting of their respiration , they became an important figure in the controversial debate about the passive euthanasia by treatment abandonment . Their fate was significant for the establishment of clinical ethics committees in the United States.

origin

Karen Ann Quinlan was of Irish American descent and the adoptive daughter of camp steward Joseph and secretary Julia, both strict Catholics . In addition to Karen Ann, they had two biological children, born in 1956 and 1957.

illness

After Karen Ann Quinlan one on 14 May 1975 to a dance celebration cardiac arrest suffered and their breathing for two 15-minute exposure was, she fell into a coma . The exact background of their collapse could not be clarified. The parents assumed the cause was that she was on a diet and took pills and alcohol at the party . Karen Ann was in the Catholic St. Clare's Hospital in Denville Township (New Jersey) with a respirator artificially ventilated .

Litigation

From a medical point of view, Karen Ann was permanently in an apallic syndrome with severe, irreversible brain damage in which she could neither think logically nor perceive and feel things around her. Because of this, her parents petitioned the Morristown, New Jersey court to have the ventilator turned off so that their daughter could die of natural causes . They justified it with the fact that their daughter had wished not to want to be kept alive with "extraordinary methods" ( extraordinary means of treatment ) in the sense of Catholic theology . A friend also confirmed this attitude and referred to how Karen Ann had witnessed an acquaintance's death from cancer. The treating physicians, however, rejected the request to forego intensive medical measures , “because such a decision would violate the current principles of practical medicine”. This led to a controversial debate on euthanasia among doctors and the public.

The parents went to the New Jersey Trial Court against this view. In 1975, however, they were unsuccessful because the court felt obliged to “protect the life of a helpless and disabled person.” There is no right to death that can be sued by anyone other than the person concerned .

In the next instance, however, they reached a groundbreaking verdict in the New Jersey Supreme Court on March 31, 1976 . Ultimately, the termination of life-prolonging measures was allowed, as the court placed the patient's “right of privacy” before the state's interest in the protection of life and the doctor's freedom of occupation.

In view of the arguments of the patient's father, the court sought advice from Catholic Bishop Lawrence B. Casey and cited longer parts of his opinion in its judgment. The bishop was referring to an " allocutio " Pope Pius XII. dated November 24, 1957 and came to the conclusion that attempts at resuscitation could be stopped here, even if they would result in the patient's death. To stop “extraordinary methods” of life support, such as artificial ventilation, is a morally correct decision.

The verdict led to the ventilator being turned off on May 17, 1976. However, the breathing had been able to stabilize then of Karen Ann Quinlan, as previously by a nurse, the process of weaning ( weaning was performed). As a result, she was able to breathe independently again and initially survived. She was looked after by her parents, it was said that they put a new dress on her every birthday.

death

Karen Ann Quinlan survived about another nine years until she died of pneumonia in 1985 at the age of 31 . She had not regained consciousness and was on the artificial feeding via a nasogastric tube and to antibiotic therapy have been instructed.

According to the results of the autopsy carried out 13 hours post mortem , the immediate cause of death was bronchopneumonia caused by bacteria in connection with endocarditis and meningitis . There were severe cachexia with a body weight of 27 kg, contractures , muscle breakdown, chronic bedsores and septic embolisms in the heart, kidneys, spleen and small intestine. Contrary to original expectations, the most severe damage was not in the cerebral cortex but in the thalamus , and the brain stem was relatively intact. This suggested that the thalamus could play an important role in perception and awareness .

Karen Ann Quinlan was buried in the Gate of Heaven Cemetery (East Hanover, New Jersey) .

Exemplary significance of the case

Similar to the later controversy surrounding Terri Schiavo , the patient's fate and the legal case triggered a public discussion “about the extent of patient autonomy for those unable to make decisions” and thus set a precedent . They led, initially in the United States, to the establishment of clinical ethics committees.

The New Jersey Supreme Court had asked for the advice of such a committee and thus confirmed its status by the highest court. In order to relieve the individual physician, the hopeless fear of civil or criminal liability treatments would continue, could one of physicians, ethicists, lawyers theologians, nurses and lay composite Committee are used, which, with its interdisciplinary give occupation to the individual critical medical support to confirm his decision or to raise concerns. This is more practicable than bringing about a judicial decision. The existence of such an advisory facility has been mandatory for American hospitals since 1991, and it has been recommended in Germany since 1997.

The later introduction of the permission of medically assisted suicide in the USA is attributed to the discussion about the life and death of Quinlan.

Media echo

The Quinlan family published two books on the case in 1977 and 2005. 1977 appeared the film In the Matter of Karen Ann Quinlan (German title: "Condemned to life"), in which Piper Laurie and Brian Keith Quinlan's parents played. Douglas Coupland dealt with the subject in 1997 in his novel Girlfriend in a Coma , which was filmed in 2014.

See also

• Living will
• History of euthanasia

literature

• Douglas Coupland: Girlfriend in a Coma: A Novel . 1st edition. Harper Perennial, Ney York City 2008, ISBN 0-06-162425-X .
• Julia Duane Quinlan: My Joy, My Sorrow: Karen Ann's Mother Remembers . St. Anthony Messenger Press, Cincinnati 2005, ISBN 978-0-86716-663-7 .
• Hannah C. Kinney, Julius Korein, Ashok Panigrahy, Pieter Dikkes, Robert Goode: Neuropathological Findings in the Brain of Karen Ann Quinlan - The Role of the Thalamus in the Persistent Vegetative State . In: N Engl J Med 1994; 330: 1469-1475. doi: 10.1056 / NEJM199405263302101
• Joseph Quinlan, Julia Quinlan, Phyllis Battelle: Karen Ann: the Quinlans tell their story . Doubleday , Garden City (New York) 1977, ISBN 978-0-385-12666-3 .
• BD Colen: Karen Ann Quinlan: dying in the age of eternal life . Nash Pub, New York 1976, ISBN 0-8402-1368-9 .

Web links

• Karen Ann Quinlan in the database of Find a Grave (English) , with copyrighted photo of Karen Ann Quinlan before their disease.
• The Supreme Court of New Jersey: In re Quinlan ( In the matter of Karen Quinlan, an alleged incompetent ), 355 A.2d 647 (NJ. 1976) (English)
• Ordinary and Extraordinary Means and the Quality of Life . By Wildes, Kevin W., in: Theological Studies, Vol. 57, No. September 3, 1996
• Charles P. Sabatino: Advance Directives and Advance Care Planning: Legal and Policy Issues. American Bar Association Commission on Law and Aging, accessed October 1, 2007 . 

Individual evidence

1. ^ "Karen Ann Quinlan dies after 10 years in a coma" , St. Petersburg (FL) Evening Independent , June 12, 1985, p1
2. ↑ ^{a b} The consequences of a coma case. (No longer available online.) In: kma - Das Gesundheitswirtschaftsmagazin . August 16, 2012, archived from the original on February 15, 2015 ; Retrieved April 27, 2014 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.  
3. ↑ ^{a b} Michael Anderheiden, Wolfgang Uwe Eckart (Ed.): Handbook of dying and human dignity . Walter de Gruyter, Berlin 2012, ISBN 978-3-11-024644-5 ( limited preview in the Google book search).
4. ↑ Quinlan, J and Quinlan, JD (1977). Karen Ann: The Quinlans Tell Their Story . New York: Bantam Books. ISBN 0-385-12666-2 .
5. ↑ ^{a b c d} Der Spiegel No. 25/1985: Obituary for Karen Ann Quinlan. In: Der Spiegel. June 17, 1985. Retrieved October 12, 2014 . 
6. ↑ Barbara Häcker: The ethical problems of euthanasia: a critical analysis . In: Philosophy in Context . tape 5 . LIT Verlag, Hamburg 2008, ISBN 978-3-8258-8951-7 , p. 20 ( limited preview in Google Book search).
7. ↑ ^{a b} Kinney, HC, 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.
8. ↑ ^{a b} Sylke Geißendörfer: The self-determination of the incapable of decision-making at the limits of the law: on the debate about "passive euthanasia" through the waiver of treatment, custodial approval procedures, living wills and their legal regulation options . LIT Verlag, Berlin 2009, ISBN 978-3-643-10049-8 , pp. 292 f . ( limited preview in Google Book search).
9. ^ ^{A b c} Barbara Hepp: Covenants of life: medical ethical perspectives in the works of Paul Ramsey . Herbert Utz Verlag , Munich 1999, ISBN 3-89675-399-1 , p. 179 ( limited preview in Google Book search).
10. ↑ “It may be justified to discontinue extraordinary medical procedures or those that are disproportionate to the expected result. One does not want to bring about death in this way, but only accepts that they cannot prevent it " Catechism of the Catholic Church, No. 2278. 1997, accessed on October 16, 2014 . 
11. ^ Basic ethical questions in medicine, p. 2. (PDF) (No longer available online.) In: University of Würzburg: Chair for Moral Theology. 2010, archived from the original on October 19, 2014 ; accessed on October 16, 2014 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.  
12. ↑ When death is not quicker. In: Die Zeit, November 7, 1975 No. 46. November 7, 1975, accessed on May 4, 2014 . 
13. ↑ The Supreme Court of New Jersey: In re Quinlan ( In the matter of Karen Quinlan, an alleged incompetent ), 355 A.2d 647 (NJ. 1976) (English)
14. ↑ Sylke Geißendörfer: The self-determination of the incapable of decision-making at the limits of the law: on the debate about "passive euthanasia" through waiver of treatment, custodial approval procedure, living wills and their statutory regulation options . LIT Verlag, Berlin 2009, ISBN 978-3-643-10049-8 , pp. 292 ff . ( limited preview in Google Book search).
15. ^ In re Quinlan: "Competent medical testimony has established that Karen Ann Quinlan has no reasonable hope of recovery from her comatose state by the use of any available medical procedures. The continuance of mechanical (cardiorespiratory) supportive measures to sustain continuation of her body functions and her life constitute extraordinary means of treatment. Therefore, the decision of Joseph * * * Quinlan to request the discontinuance of this treatment is, according to the teachings of the Catholic Church, a morally correct decision. (emphasis in original) "
16. ↑ Barbara Häcker: The ethical problems of euthanasia: a critical analysis . In: Philosophy in Context . tape 5 . LIT Verlag, Hamburg 2008, ISBN 978-3-8258-8951-7 , p. 20, 21, 62, 63 ( limited preview in Google Book search).
17. ^ René Ammann: Last years. In: Die Weltwoche Online. Retrieved June 14, 2014 (issue 40/2004). 
18. ↑ ^{a b} Peter de Thier: Front crumbles. In the United States, any form of euthanasia was frowned upon until the mid-1970s. But the front is crumbling, and three states are already allowing exceptions. In: Südwest Presse . February 28, 2014, accessed October 14, 2014 . 
19. ↑ Sylke Geißendörfer: The self-determination of the incapable of decision-making at the limits of the law: on the debate about "passive euthanasia" through waiver of treatment, custodial approval procedure, living wills and their statutory regulation options . LIT Verlag, Berlin 2009, ISBN 978-3-643-10049-8 , pp. 293 ( limited preview in Google Book search).
20. ↑ Barbara Häcker: The ethical problems of euthanasia: a critical analysis . In: Philosophy in Context . tape 5 . LIT Verlag, Hamburg 2008, ISBN 978-3-8258-8951-7 , p. 21 ( limited preview in Google Book search).
21. ↑ Karen Ann Quinlan. In: Find a grave. June 11, 2002, accessed October 12, 2014 . 
22. ↑ Sylke Geißendörfer: The self-determination of the incapable of decision-making at the limits of the law: on the debate about "passive euthanasia" through waiver of treatment, custodial approval procedure, living wills and their statutory regulation options . LIT Verlag, Berlin 2009, ISBN 978-3-643-10049-8 , pp. 291 ( limited preview in Google Book search).
23. ↑ Sylke Geißendörfer: The self-determination of the incapable of decision-making at the limits of the law: on the debate about "passive euthanasia" through waiver of treatment, custodial approval procedure, living wills and their statutory regulation options . LIT Verlag, Berlin 2009, ISBN 978-3-643-10049-8 , pp. 294 ( limited preview in Google Book search).
24. ↑ Kabel1 Filmlexikon , accessed on October 13, 2014
25. ↑ IMDb: Condemned to Life
26. ^ IMDb: Girlfriend in a Coma

→ at the beginning of the individual proofs