THE COURT'S VERDICT
Shannon, Thomas A.
KAREN QUINLAN THE COURT'S VERDICT As has often happened during the course of the past year, Karen Quinlan hauntingly smiles at us from the front pages. This time the story says that the New Jersey...
...The Court said such attitudes are balanced efforts to implement a proper respect for the meaning of life and death...
...thomas a. shannon (Thomas A. Shannon is Assistant Professor of Social Ethics at the Worcester Polytechnic Institute...
...Requiescat in pace...
...There is a clear recognition that the cause of death will be the failure of the biological processes to maintain themselves not the removal of the respirator...
...Quintan's situation has been the lumping together of all sorts of unrelated issues, which has served only to further obfuscate an already murky situation...
...The Court relied on the old saw that the right to religious beliefs is absolute, but that religious actions are subject to governmental restraint...
...it is quite another matter to prove it...
...Continued reflection seems to be imperative...
...How is the value of life enhanced socially and individually by artificially maintaining the biological processes of unconscious dying patients...
...This ultimate sanctuary of the person appears to be one of the best Constitutional and ethical places to develop a strong argument for this position...
...The unfortunate part is that the decision did not stop there...
...Even though the case may end mercifully with Ms...
...Implicit in this is the recognition that while there is an obligation to cure the ill, there way be an obligation only to care for and comfort the dying...
...Quite properly the Court argues that this right is broad enough to cover a decision to decline medical treatment under certain conditions...
...One of the problems in the discussion of Ms...
...While applauding this conclusion with its clear implication of some kind of right to be left alone, one needs to raise the issue of exactly what the State's interest is...
...Now the Court from this particular perspective has not only apparently waffled on the euthanasia issue, but has done so by using the same reasons which justify abortion...
...Even though it is an obvious improvement over the first decision in its affirmation that removing a person from a respirator is basically not an act of criminal or unlawful homicide...
...It is one thin gto say that the public interest is at stake...
...The relation between optional religious actions, religious freedom and forced medication merits much more careful treatment than they have received in the literature and in court decisions...
...Secondly, the distinction begs the question of the relation of belief and action by implicitly suggesting that religious acts even if optional are only tenuously related to religious beliefs and may therefore by impeded without any violation of First Amendment rights...
...One note of comfort in the decision is that physicians now distinguish between curing the ill and comforting the dying...
...it went on to say that the right to privacy is broad enough to cover this decision, just as it is broad enough to cover a woman's decision to terminate her pregnancy under certain conditions...
...How far into one's life can the State reach...
...Quinlan and her family is over...
...While it is absolutely clear that the use of extraordinary or heroic treatment is a moral option within Roman Catholicism, it is by no means self-evident that the forcing of extraordinary treatment on individuals is not a violation of their religious freedom...
...While neither a necessary nor a correct reading of the decision, many may argue that this is the clear implication of it...
...The Court has opened itself unnecessarily to the possibility of a strong attack by extreme right-to-life groups who argue a moral domino theory with respect to the practice of abortion and euthanasia...
...However, it is profoundly strategic...
...and in its recognition of the distinction between caring and curing, nonetheless this most recent decision does raise some serious issues that need further investigation...
...The second problematic issue in this decision is that of the Constitutional right of privacy...
...This time the story says that the New Jersey Supreme Court decided her father may seek a physician willing to stop the respirator which has ruthlessly kept her from death for over a year...
...The time has come for a thorough re-evaluation of this issue...
...The distinction is more hypothetical than real...
...The Court properly distinguished between the unlawful taking of the life of another and a certain amount of self-determination in the act of asserted that the recognition of death's inevitability 1 infers the right to murdgr...
...Some will always be ideologically incapable of separating issues, but there is no good reason why these groups should be handed such opportunities on a silver platter...
...Now that it is clear that no further legal maneuvers will be attempted, this decision should be the penultimate chapter in one of the major tragedies of modem medical practice...
...One is the published report of the gratuitous dismissal of the issue of religious freedom...
...Many expressed relief at the first Quinlan decision because it was perceived as a way of stopping euthanasia-on-demand...
...Unfortunate as this may be, the ensuing unclarity and hostility will be the fault of the insensitive wording of the decision...
...We need to recognize that there is a real problem in adapting either too casual or too strict an approach to medical care...
...Put in much simpler terms, one can argue that the Court recognized that, in common experience, all of us will die regardless of the quality or quantity of various holding actions or medical machines...
...Much more careful thought needs to go into the famous distinction between religious belief and action than is evidenced here...
...Also the proper relations and the lack thereof between the right to life, the right to privacy, and abortion, and euthanasia need to be clearly stated with sound ethical and empirical reasoning...
...In spite of these generally positive elements in the recent Quinlan decision, there are also two very problematic issues...
...This case is by no means unique and developments within medicine and medical technology will continue...
...Also, since a Constitutional right is under discussion, all presumptions should favor that established right, unless clearly stated and strongly demonstrated vested state interests are brought forward and they were not...
...Based on the published reports of the new decision, the Court saw value in some issues posed by ethical commentators, although these issues are properly articulated within a legal and medical perspective...
...yet within this dilemma, the interests of the State with respect to the individual must be clearly enunciated and firmly argued...
...One may ask if the interest of the State may not better be articulated in terms of protecting the citizen from uncritical application of technology which may have the capacity to stabilize or maintain persons while neither curing them nor restoring them to reasonable health...
...The recognition of the Court that the act of turning off the respirator is not an act of either criminal or unlawful homicide is also a positive sign...
...A third encouraging note is the Court's recognition that there comes a time when individual rights overcome the State's interests...
...The clear suggestion is that the closer individuals come to their death, the weaker State's interests over them become...
...In spite of these continuing problems, most will be relieved to know that the needless agony of Ms...
...Sflch a distinction clearly removes this discussion from the categories of active or direct euthanasia and places it within the human experience of death as the fate of us all...
...Hoisting the flag of State's interests may stop a particular action, but in itself does not resolve the issue...
...Finally, the decision fails to take into account the basic rejection of the Reynold's principle of separation of beliefs and actions in recent cases such as Macintosh (1970) and Yoder (1972), The issue of religious freedom in such cases is a profoundly serious one to which the courts have not been very sympathetic...
...While I personally laud the Court for accepting this position, I also think it is a shame that this viewpoint, a tradition of Roman Catholic medical ethics and a principle well developed by Ramsey in 1970, has taken so long to sink into the consciousness of many and to be legally implemented...
...The problem here is not necessarily a substantive one...
...Quinlan's death, some issues have been raised by the Court which merit further investigation and evaluation...
Vol. 103 • May 1976 • No. 10
