Case-based clinical ethics education

The Right to Die

When can patients or families say enough is enough?

Karen Anne Quinlan - the Right to Die as per the wishes of family vs refusal by her providers based on medicolegal concerns

Here’s the New York Times article written on the similarly controversial case of Karen Ann Quinlan:

https://www.nytimes.com/1985/06/12/nyregion/karen-ann-quinlan-31-dies-focus-of-76-right-to-die-case.html

A 21 year-old woman suffered irreversible brain damage leading to a persistent vegetative state with no hope of recovery following a night combining tranquilizers and alcohol complicated by a period of at least 30 minutes when she wasn’t breathing.After a year of being ventilator-dependent with no hope of recovery, and with the support of Catholic clergy, her parents requested that the ventilator be removed and their daughter be allowed to pass away.However, her doctors resisted this request fearing a malpractice lawsuit despite the parents signing paperwork backing up their request. This was a seminal case regarding the constitutional right to die and “judicious neglect” i.e. doctors can respect the wishes of family members of the terminally ill to withdraw extraordinary life support measures.


Terri Schiavo - the Right to Die (husband’s wishes) vs Maintaining in Persistent Vegetative State via Artificial Nutrition and Hydration (family’s wishes)

Watch this video, Terri Schiavo Documentary: The Case’s Enduring Legacy

Terri Schiavo suffered anoxic brain injury due to lack of oxygen to her brain for a period of seven minutes.  Perhaps one of the most litigated cases in our history (a.k.a. “The Roe vs Wade of Euthanasia”), with the debate between her husband, who wanted to stop artificial nutrition and hydration based on what he knew of her wishes and after being told his wife had no chance of recovery, vs the Schindler family including her parents and brother who wished to maintain her in her persistent vegetative state.  The feeding tube was removed when Michael Schiavo’s wishes were upheld.  Governor Jeb Bush was allowed to replace it.  It was subsequently again removed.  President Bush signed a bill to replace it, but a federal judge did not uphold this order based on doubting that the order would stand in court.  On March 31, 2005, her feeding tube was removed.  An autopsy showed that the brain damage was extensive and irreversible.  Family including Terri’s brother noted the lack of hope for recovery didn’t affect their desire to care for Terri.


Brittany Maynard - a 29 year old diagnosed with stage 4 brain cancer and her husband become proponents of Death with Dignity

Watch this segment from the Today show on Brittany Maynard and her husband Dan Diaz about the right to die, with Megyn Kelly:

A 29-year old was diagnosed with stage 4 terminal brain cancer and was given a 6-month life expectancy.  She moved from California to Oregon, which allowed for euthanasia.  Both Brittany and her husband became advocates for death with dignity laws, taking her own life on November 1, 2014.  Dan talks about being a proponent for Death with Dignity and Medical Aid in Dying as a devout Catholic, framing Brittany’s two options as being dying under her control, vs suffering with pain, nausea/vomiting, and most frightening for her, with grand mal seizures.


References:

McFadden, Robert D. (1985, June 12). Karen Ann Quinlan, 31, Dies; Focus of ‘76 Right to Die Case. Retrieved from https://www.nytimes.com/1985/06/12/nyregion/karen-ann-quinlan-31-dies-focus-of-76-right-to-die-case.html

The New York Times. (2014, April 21). Terri Schiavo Documentary: The Case’s Enduring Legacy - Retro Report - The New York Times. Retrieved from https://www.youtube.com/watch?v=O-rQ3tIabvM

Today. (2018, June 1). Brittany Maynard’s Husband Tells Megyn Kelly About Her Decision To Die. Retrieved from https://www.youtube.com/watch?v=itihpltdVec