The landmark case of Karen Ann Quinlan was the first to deal with the dilemma of withdrawing life-sustaining treatment from a patient who was not terminally ill but who was not really "alive." The decision to terminate life support, which was once a private matter between the patient's family and doctor, became an issue to be decided by the courts. The New Jersey Supreme Court…
Joseph Saikewicz was a mentally incompetent resident of the Belchertown State School of the Massachusetts Department of Mental Health. In April 1976 Saikewicz was diagnosed with acute myeloblastic monocytic leukemia. He was sixty-seven years old but had the mental age of about two years and eight months. The superintendent of the mental institution petitioned the court for a guardian ad litem (a t…
Not all the cases of patients seeking to terminate life support concern incompetent people. Abe Perlmutter, seventy-three years old, was suffering from amyotrophic lateral sclerosis (ALS; sometimes called Lou Gehrig's disease). ALS is always fatal after prolonged physical degeneration, but it does not affect mental functions. Perlmutter's 1978 request to have his respirator removed w…
Claire Conroy was an eighty-four-year-old nursing-home patient suffering from "serious and irreversible mental and physical impairments with a limited life expectancy." In March 1984 her nephew (her guardian and only living relative) petitioned the Superior Court of Essex County, New Jersey, for removal of her nasogastric feeding tube. Conroy's guardian ad litem, appointed by …
Historically, physicians have been free from prosecution for terminating life support. A precedent was set in 1983, however, when two doctors were charged with murder and conspiracy to commit murder after agreeing to requests from a patient's family to discontinue life support (Barber v. Superior Court of the State of California, 195 Cal.Rptr. 484 [Cal.App. 2 Dist. 1983]). The two physician…
In 1983 Paul E. Brophy, Sr., suffered an aneurysm (a blood-filled sac formed by dilation of a blood vessel with a weak wall, which makes the vessel more prone to burst) that left him in a PVS. He was not brain dead, nor was he terminal. He had been a fireman and emergency medical technician and often expressed the opinion that he never wanted to be kept alive artificially. Patricia Brophy brought …
In 1980 twenty-four-year-old Nancy Ellen Jobes was in a car accident. At the time, she was four-and-a-half months pregnant. Doctors who treated her determined that her fetus was dead. During the surgery to remove the fetus, Jobes suffered loss of oxygen and blood flow to the brain. Never regaining consciousness, she was moved to the Lincoln Park Nursing Home several months later. The nursing home …
Throughout the history of right-to-die cases, there has been considerable debate about how to determine a patient's wishes. How clearly must a patient have expressed his or her wishes before becoming incompetent? Does a parent or other family member best represent the patient? Are casual conversations sufficient to reveal intentions, or must there be written instructions? Eighty-three-year-…
While O'Connor set a rigorous standard of proof for the state of New York, Cruzan was the first right-to-die case heard by the U.S. Supreme Court. It confirmed the legality of such strict standards for the entire country. In January 1983 twenty-five-year-old Nancy Beth Cruzan lost control of her car. A state trooper found her lying face-down in a ditch. She was in cardiac and respiratory ar…
Like Cruzan, the case of Terri Schiavo involved a young woman in a persistent vegetative state and the question of whether her nutrition and hydration could be discontinued. In 1990 Schiavo suffered a loss of potassium in her body due to an eating disorder. This physiological imbalance caused her heart to stop beating, which deprived her brain of oxygen and resulted in a coma. She underwent surger…
In January 1994 four Washington State doctors, three terminally ill patients, and the organization Compassion in Dying filed a suit in the U.S. District Court. The plaintiffs sought to have the Washington Revised Code 9A.36.060(1) (1994) declared unconstitutional. This Washington law states: "A person is guilty of promoting a suicide attempt when he knowingly causes or aids another person t…
U.S. Supreme Court justices John Paul Stevens and David Souter issued opinions encouraging individual states to enact legislation to permit physician-assisted suicide in selected cases. At the state level, more than thirty bills to legalize physician-assisted suicide have been introduced. As of February 2006, Oregon remained the only state with a law that legalizes the practice. The Oregon legisla…
In late 2001 Attorney General John Ashcroft reversed a decision made by his predecessor Janet Reno by asserting that the federal Controlled Substances Act could be used against Oregon physicians who helped patients commit suicide by prescribing lethal drugs. If that were the case, then the federal Drug Enforcement Administration (DEA) could disallow the prescription-writing privileges of any Orego…
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