User:Kjsnguyen/new sandbox

The right to die movement in the US began with the case of Karen Quinlan in 1975 and continues to raise bioethical questions of one's quality of life and the legal process of death.

Karen Quinlan, 21, lost consciousness after attending a party in which she consumed alcohol and tranquilizers. She soon began to experience respiratory problems which then prevented oxygen from flowing to her brain thus damaging her cortex. This lead her to slip into a comatose state in which a respirator and a feeding tube was required to keep her alive and breathing

. Karen did not have a proxy, living will, or expressed her wishes if something ever happened to her to those around her made it difficult to decide what the next step should be taken. Her parents wanted their daughter to be removed from life support since they understood that their daughter would never wake up and that prolonging her life may be more damaging and it would not be of quality life. Karen Quinlan's father sought out the right to be Karen's legal guardian and petitioned for the removal of the respirator that was keeping her alive. The court, however, argued that the removal of the ventilator, which would lead to Karen's death, would be considered unlawful, unnatural, and unethical. Quinlan's lawyer's counterargument stated that the removal of the respiratory would allow Karen to have a natural death which is natural and ethical. The Quinlan's won the court case and was appointed as the legal guardians of their daughter. The respirator was removed in 1976, but Karen continued to live without the ventilator until 1985. This case to this day continues to raise bioethical questions of one's quality of life and the legal process of death. The Quinlan case brings up many important issues which are still being addressed til this day. One of the critical points that the Quinlan case brings up is the patient's right to deny or withdraw treatment. Cases, where the patient's denied or withdrew treatment, were unheard of during that period and it went against medical ethics in preserving one's life. Debates about allowing patients the right to self-determination was controversial, and it would be evaluated for the next couple of decades from state to state. It also brings up the question if family members and those who are close to the patient are allowed in the decision-making process. Since Karen had no written documentation, voiced her decision, or appointed a proxy, this caused a long legal battle between the Quinlan family and the state in determining Karen's best interest and determining if she would want to live or die. This had a significant influence on the use and establishment of advance directives, oral directives, the use of a proxy, and living wills

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Two other major cases that further propagate the right to die movement and the use of living wills, advance directives and use of a proxy were Nancy Cruzman and Terry Schiavo. In 1983, Nancy Cruzman suffered a car accident which left her permanently in a vegetative state. Her status as an adult and lack of an advance directive or proxy lead to a long legal battle for Nancy Cruzman's family in petitioning for the removal of her feeding tube which was keeping her alive since the accident. Nancy had mentioned to a friend that under no circumstances would she want to continue to live if she were ever in a vegetative state, but was not a strong enough case to remove the feeding tube. Eventually, the Cruzman family won the case and had their daughter's tube removed. This case brought great debate if the right to die should be approved from state to state or as a whole nation. Terri Schiavo is the most recent right to die case which occurred between 1990-2005. This case was more controversial because there was a disagreement between Terri's immediate family members and her husband whereas the Quinlan's and Cruzman's case, the family was able to make a unanimous decision on the state of their daughters. Terri suffered from a cardiac arrest which lead to her collapse and soon after began to have trouble breathing. The lack of oxygen to her brain caused irreversible brain damage, leaving her in a vegetative state and required a feeding tube and ventilator to keep her alive. Terri left no advance directive or had a discussion with her parents or husband about what she may have wanted if something were to happen to her. Soon after, her husband was appointed as her legal guardian. Years later, her husband decided to remove Terri's feeding tube since the chances of her waking up were slim to none. Terri's family, however, argued against this decision and brought this case to court. The case was very turbulent and occurred over some years and even involved the state and its' legislators before a decision was made. This brought out bioethical debates on discontinuation of Terri's life vs. allowing her to continue living in a permanent vegetative state. Those who were for preserving Terri's life stated that removing the tube would be ethically immoral since we do not know what she would have wanted. They challenged her physical and mental state and stated that she might have some consciousness; thus she deserves to continue living. Those for removing the tube argued for self determination and that her quality of life was diminished. The Schiavo case is the most recent and significant right to die case in which further many people's thought of having an advance directive or living will. It also further looks into other complications that can arise, such as family disagreements, which should have been accounted for when dealing with a right to die case.