Between Life and Death

One night last April, Karen Ann Quinlan, 21, went to bed saying she was not feeling well. She never woke up. Stricken with a still undiagnosed malady (perhaps the result of mistakenly mixing a tranquilizer and drinks), she has remained in a coma ever since. One side of her permanently damaged brain shows almost no sign of functioning while the other gives off only slight but steady signals visible on an electroencephalogram. Last week, unwittingly, Karen Ann became the focus of the continuing legal-medical-ethical controversy over how to define death.

In Limbo. For her adoptive parents, the anguish is already five months old. For a while, Julia Ann Quinlan prayed for Karen's recovery, then that "God would take her." Joseph Quinlan, a section supervisor at Warner-Lambert, a pharmaceutical company, found it harder to give up, but "finally, I had to." Karen's neurologist declared she had "extensive cerebral damage" and saw "no hope." Nonetheless a respirator and other medical aid promised to hold her almost indefinitely in her limbo between life and death. The Quinlans realized they would have to take an affirmative step to allow Karen to die.

They were bolstered by long soul-searching talks with their other two children and their Roman Catholic parish priest. Father Thomas Trapasso advised them that there was "no moral obligation to use extraordinary means to sustain life when there is no realistic hope of some recovery." But when the Quinlans asked doctors to let their daughter die, the doctors refused. Karen was not a minor, they said, and they might be held responsible for her death.

By now committed to his course, Karen's father concluded that "the courts would be the only way to get her off the machine"; he asked a judge in Morristown, N.J., to give him the right to authorize turning off the respirator. Last week the judge responded by asking the county prosecutor to show cause why he should not be barred from prosecuting if the machine were stopped. The judge also appointed a public defender to protect the unconscious girl's legal rights. But what are they? Is Karen Ann Quinlan alive or dead?

The American Bar Association has suggested that death should now be legally redefined as the "irreversible cessation of total brain function." Only a few states--not including New Jersey --have passed such a law. Nor can lawyers in the case, after days of research, find a single court precedent. Though there are nominally three sides in the court action, all seem united in a desire to take this case on through the appeals courts to get a full and thoughtful legal resolution of the many issues. Her mother finds comfort in that, believing that God kept Karen alive "so that others could be helped."

Fetal Position. For now, the hospital is absorbing the medical cost, already more than $100,000. Meanwhile Karen's body is slowly curling into the fetal position, and she has lost 60 lbs. Though she does not respond, the Quinlans visit twice a day, and Mrs. Quinlan talks quietly to her. "I don't believe I could go to bed without saying something to her," she says. "Just like saying good night, you know, to your other children."

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