Editor’s Note: For now over 75 years, The Baylor Line has been publishing vivid storytelling from across the Baylor Family. I don’t think our archives full of deep, inspirational features should live solely on shelves, so we are bringing them back to life in BL Classics. This September 1976 Classic explores how a Baylor Law Review symposium on euthanasia found its way into one of the most consequential legal cases of the 20th century.
It appeared that the plug in the electric socket was all that stood between Karen Ann Quinlan and death.
But by her bedside waited a thousand questions, and no one could give the answers, if there were any.
Karen had been in a coma since April, 1975, her life apparently sustained only by a respirator.
Joseph and Julia Quinlan, determined that some answer be given their 22-year-old daughter, pressed the courts to rule that she be allowed to die with dignity.
When the New Jersey Supreme Court ruled in March, 1976, it cited the 1975 symposium edition of the Baylor Law Review published that winter on the subject of euthanasia (mercy killing). The court named Quinlan his daughter’s guardian and provided for an ethics committee that would give Karen her answer.
The court said that if the family and attending physicians decided that “there is no reasonable possibility” of Karen’s coming out of the coma and that the life- support apparatus should be removed, they should consult with the ethics committee of the hospital where Karen was a patient.
If the committee agreed that there was no “reasonable possibility” of Karen’s coming out of the coma, the respirator could be withdrawn without civil or criminal liability on the part of any person, the court said.
In May the respirator was turned off. Surprisingly, Karen continued to breathe unassisted and was still breathing on her own at publication time.
The ethics committee was a suggestion made by Dr. Karen Williams Teel in her Baylor Law Review article, “The Physician’s Dilemma, A Doctor’s View: What the Law Should Be.”
Dr. Teel, director of pediatric education at Brackenridge Hospital in Austin, Texas, and the Central Texas Medical Foundation, describes in her article pitiful newborns who have little hope for what most people would call a meaningful life. The Quinlan case and its controversy may have seemed abstract to many, but not to Dr. Teel.
Her familiarity with such questions lends weight to her suggestion of an ethics committee composed of physicians, social workers, attorneys and theologians that would “allow the responsibility of these judgments to be shared.”
She also suggests “that we begin to discuss as objectively as possible the distinction between active and passive euthanasia; in what circumstances we might view these actions appropriate; and what the relative dangers might be.”
Dr. Teel does not take a stand for or against euthanasia but says the questions that have surrounded Karen Quinlan and countless others must be considered and answered.
Advances in medical science have made euthanasia a practical question and infinitely more complex than when, for most people, it was merely a topic for student debaters.
The complexity of the question is evident in that no one can agree on the basic points:
1. How is death defined?
2. When does death occur?
3. What kind of voice should a person have about the type and extent of treatment used to sustain his life?
4. When the patient cannot voice an opinion, who is responsible for deciding when life should be maintained and at what cost?
5. By what process should such decisions be made?
These questions and others were examined in the Baylor Law Review issue by ten attorneys, physicians and philosophers and six honor students of the Baylor Law School. The publication is a product of the Law School’s symposium on death held in October, 1974.
There is no one conclusion reached because the purpose of the symposium was “not to proselytize an answer” but to “clearly formulate questions and present areas to investigate,” according to W. Frank Newton, associate professor of law at Baylor.
“What makes the court’s citation of this source important is that this is a potentially significant area,” Newton said.
“The Quinlan case was the first highly publicized case of its kind. This decision is not the last word. What is so pleasing to us is that the court found our work helpful in giving their answer.”
The following are summaries of some of the articles in the symposium issue:
“Bill of Rights of the Dying Patient” by John D. Bonnet, M.D., senior physician, Department of Medicine, Section of Hematology-Oncology at Scott and White Clinic in Temple, Texas.
As part of his ten-part Bill of Rights, Dr. Bonnet in sists die patient be told what disease he has, what to ex pect from treatment and how much treatment will cost, both financially and physically.
“The patient and his family usually have conflicting apprehensions about death. The patient fears dying more than he fears death while his family fears the death more than the dying,” Dr. Bonnet says.
He believes the “Rights” should “serve as guidelines for prolonging . . . life. Hopefully, physicians will be able to cure more fequently and relieve more often, but certainly the goal in the use of life-sustaining measures should be to comfort always.”
“Medical Death ” by Sheff D. Olinger, M.D., director, Department of Neurology and director, Stroke Unit and E.E.G. Department of the Baylor University Medical School in Dallas.
Dr. Olinger draws the distinction between “cerebral death” and the term usually used by laymen, “brain death.”
The brain, he says, is composed of several parts, one of which is the cerebrum.
“The personal, identifiable life of an individual human can be equated with the living function of . . . the cerebrum,” Dr. Olinger says. “Cerebral function is manifested in consciousness, awareness, memory, anticipation, recognition, and emotions.”
Other parts of the brain may sustain circulation and respiration “in the absence of the cerebrum without consciousness or awareness. When all the brain has lost its function, there is no spontaneous respiration, and usually no effective circulation,” Dr. Olinger says.
“Cerebral death,” he says, “expresses the medical concept which is equated with death of the individual person.”
“The Family Deals With Death” by John R. Claypool, Th.D., pastor of the Broadway Baptist Church in Fort Worth, Texas, former chairman of the Christian Life Commission of the Southern Baptist Convention
Less than five years ago the Claypools’ ten-year-old daughter died of leukemia after her parents “actively decided,” along with her doctors, not to prolong life “as there was little human difference between the life she had and death.”
Dr. Claypool says, “ . . . the point was reached where the treatments were worse than the disease and the prospects for meaning and purpose in her life were not sufficient to justify things that were medically possible but humanely unbearable.”
He challenges the philosophy of vitalism, the “naive notion that life is always preferable to death under any circumstances,” and “the spirit of quietism; that is, the idea that we have no right to interfere with something as momentous as death.”
Dr. Claypool says the reluctance to interfere with the fatally ill is “an area where we all need to do some growing: because, in our “capacity to be co-creators with God,” we “can decide in large measure what we will become and how we will grow or atrophy in certain areas.”
For a patient to die with dignity, he believes, “death must become a much more open and deliberate process.”
Dr. Claypool says that “if one takes a median position (between vitalism and quietism), which is closer to the Christian perspective, then factors other than sheer survival or nature taking its course will have to be taken into consideration.”
“The Living Will, Coping With the Historical Event of Death” by Luis Kutner, LL.B.J.D., member of the Illinois and Indiana bars, nominated for the Nobel Peace Prize in 1972 and 1974.
The essence of the Living Will is Informed Consent of the person prior to the status of irreversability of dying or of being maimed,” Kutner says. Informed Consent is based on the right of privacy, he says.
Kutner briefly suggests provisions in the Living Will:
— “The document would provide that if the in dividual’s bodily state becomes completely vegetative and it is certain that he cannot regain his mental and physical capacities, medical treatment shall cease.”
— It should be notarized and attested to by at least two witnesses.
— The person should carry a copy of the will at all times and another trusted person should keep the original. “Personal possession of the document would create a strong presumption that he regards it as still binding,” Kutner says.
— A hospital committee would review each case.
— The person could revoke the will at any time.
He also emphasizes that the will could not authorize euthanasia and discusses possible complications associated with the Living Will.
“The Physician’s Criminal Liability for the Practice of Euthanasia” by Percy Forman, J.D., partner in the firm of Forman and DeGuerin in Houston.
“Despite evidence that euthanasia is widely practiced, at least by omission, there have been few prosecutions in this country,” Forman says. “Perhaps from the viewpoint of the terminally ill who desire a premature death, the practice is just. . . . But from the perspective of euthanasia victims unwilling or unable to give consent to the premature termination of their lives, the practice of not dealing with the perpetrators as the law provides might be viewed as inadequate protection of life by state action — arguably a violation of both due process and equal protection.”
Forman says that, although “there have been no convictions in Texas for voluntary euthanasia, we end where we began — euthanasia is a euphemism for criminal homicide.”
