Ethics

Quinlan, her father requested to remove the ventilator when she was in persistent vegetative state. She is the first case in the Westlaw database to mention the phrase “persistent vegetative state”. Although some points of law in this case have been subsequently modified in later cases, the Quinlan case is of great historical importance and is still cited by courts. Joseph Charles Fox had been a Brother in the Membership of the Society of Mary, a religious congregation in the Roman Catholic Church, since 1912, when Fox was 16 years of age. At age 83 in 1979, Brother Fox lapsed into a persistent vegetative state following a routine surgical operation for a hernia. Father Philip K. Eichner, a priest of the Roman Catholic Church, and Director of the Society of Mary at Chaminade, filed a petition in court on 22 Oct 1979 to become a “committee of the person” and then to discontinue life support from Brother Fox. The district Attorney opposed discontinuation of life support. Brother Fox died before the Court of Appeals released their decision, they authorized Father Eichner to terminate the respirator. The court concluded that "the common-law right of bodily self-determination permits a competent adult to refuse life sustaining medical treatment" where, as here, that right outweighed the State's interest in having the treatment continue. Bertha Colyer was a 69-year-old woman who had sustained a cardiac arrest. She suffered massive brain damage. She was placed on a mechanical ventilator and remained in a comatose, unresponsive state. The Washington court said that “her prognosis for any sort of meaningful existence was zero”. Colyer’s husband, who was her legal guardian, asked the court for permission to remove the ventilator. Although the patient had never explicitly stated her preferences regarding such an act, her husband inferred that this would have been her decision, had she been able to decide. The court reached the same conclusion as Quinlan’s case. Colyer died peacefully soon after the life support systems were removed. Claire Conroy was an 84-year-old patient in a nursing home. She suffered from severe organic brain syndrome, necrotic decumbitus ulcers, urinary tract infection, arteriosclerotic heart disease, hypertension, and diabetes mellitus. She was unable to speak or move, though from her fetal position she sometimes followed people with her eyes. Nurses were not able to feed her by hand, so a nasogastric tube was inserted and several times a day a nutrient formula, vitamins, and medicine were poured through the tube. Her only surviving relative, her nephew and legal guardian, requested the Superior Court of Essex County, New Jersey, to allow the nasogastric tube to be removed and thus allow Claire Conroy to die. The Superior Court granted the request, but the Appellate Division of New Jersey decided to review the decision of the Appellate Court even though Claire Conroy had died because of the relevance for other people in nursing homes and hospitals who are in somewhat the same condition. The New Jersey Supreme Court reaffirmed its decision in Quinlan that there was no civil and no criminal liability for good faith attempts to make end-of-life decisions. On the other hand, the New Jersey Supreme Court noted the absence in the trial record of factual findings of what Claire Conroy would have wanted. However, the New Jersey Supreme Court did not remand the case to the trial court because Conroy had already died. Elizabeth Bouvia admitted herself into the psychiatric ward of Riverside General Hospital in Riverside, California. She was almost totally paralysed by cerebral palsy and had severe degenerative arthritis, which caused her great pain. Even though she was severely disabled, she was definitely a person and she had an estimated 15 to 20 years of life remaining. However, she believed her quality of life was so poor and she requested to die. Bouvia appealed the lower court ruling and lost. Eventually, she appealed again and this time the court ruled in her favour. After the court case, she decided that she would live. The Los Angeles Times on May 11, 2008 reported that Bouvia was still alive. Terri Schiavo’s case is similar situation with Quinlan and Fox. She had been in a persistent vegetative state since February 1990. Her husband petitioned the probate court in Florida to allow her feeding tube to be removed after six years of waiting for her to recover. The difference is Terri’s parents were against this decision. They fought in court for nine years, intended to keep the feeding tube in Terri. The court ruled to remove the feeding tube approximately 4075 days after she initially became unconscious.