Karen Ann Quinlan was twenty-one years old on the night she went into a coma. After mixing valium and alcohol, Quinlan stopped breathing, and by the time she arrived at the hospital, she had gone thirty minutes with no oxygen to the brain. Barely alive, she was put on a respirator and feeding tube as she steadily slipped into a deeper coma.
Over the following three months, Karen Ann lost weight and shriveled into a fetal position only to sleep, wake and spasm. Her parents, Joseph and Julia Quinlan, along with their priest decided to stop life support, but the doctors refused. Joseph and Julia petitioned the court for the right to remove life support, and their case, In the Matter of Karen Quinlan, sparked a national debate about the government's role in life and death.
The Quinlan family's story and trial is the setting for Jill Lepore's paper, Dead or Alive: Matters of life and death and the American body politic. Lepore, the Kemper Professor of American History at Harvard University and a staff writer for The New Yorker, discussed the paper at the Public Law & Legal Theory Workshop on November 12, 2010, with faculty and students.
The American Tradition: Political Paranoia
Among the many topics highlighted in the paper is the trend towards political paranoia and conspiracy fears surrounding life and death. At the time of the Quinlan case, a majority of Americans believed the decision to continue life support rested with the family members. After Quinlan and Roe v. Wade, a new fear sprouted, namely the fear that the government, courts and politicians are conspiring to refuse medical care and euthanize the disabled, sick, old and unwanted members of society.
Lepore explains how the life and death fascination transitioned into domestic policy issues that have captured public attention since the 1970s: abortion, capital punishment, contraception and health care. It is now commonplace for political parties to sling accusations that evoke difficult questions about life and death.
The Right to Life, Liberty and Property
According to Lepore, the American Revolution was focused on liberty. The Patriots feared and equally profited from conspiracy theories about British tyranny stifling all natural rights to liberty. The loyalists also tried to show that they actually were the liberty bearers and argued that the Patriots were invoking liberty only to gain power. At the time of the Boston Tea Party, the paranoia had reached its peak after the British government imposed a tax on tea that was viewed as oppressive and restraining liberty.
In the nineteenth century, property became the heart of American politics and paranoia. Although slavery had been a sensitive subject for some time, the paranoia sprang up just before the Civil War. In Dred Scott, the Supreme Court voiced its fear that allowing slaves a safe haven in the north might give third parties an incentive to deprive Southern citizens of their right to property. John Brown did just that after kidnapping and releasing slaves in 1859.
In the 1960s, the locus of death moved. People no longer died in their beds at home, but spent the remainder of their life at a hospital. Death became known as a struggle with hospitals, doctors and insurance companies. As medicine and technology improved, death became less acceptable and became, also, the next American obsession.
The Right to Die
At trial, the Quinlans were unable to establish a Constitutional right to die. The family appealed, however, and the New Jersey Supreme Court reversed. The Court held that a family may remove life support when there is no reasonable possibility of recovery. After the Quinlans asked the doctors to remove the respirator, the doctors slowly weaned Karen Ann off until she breathed by herself. Karen Ann lived for another nine years before dying of pneumonia.
One commenter drew a connection between the current obsession with life and death and the conspiracy theories surrounding President Obama's birth place. Another noted that some opposition and concerns about abortion and ending life support may reflect a legitimate and good faith concern about the threats of industrialized medicine in modern society. Lepore argued in response that the paranoia may not be generated by individuals' difficult choices or beliefs, but rather by the political parties' exploitation of the current uncertainty surrounding life and death to further a political agenda.