Advance Directives: How Two Tragic Accidents Impacted the Law 

Have you ever been hospitalized unexpectedly? Unfortunately throughout the course of our lives many of us will find ourselves in this situation. It’s hard enough to think about the possibility of being unexpectedly hospitalized – but what happens if you enter the hospital while unconscious? 

Every day thousands of people enter emergency rooms while unconscious and suffering from a serious medical condition. Whether it’s caused by an accident, an allergic reaction or something else entirely, it raises a vital question – if you’re unconscious, who will make decisions about your medical care? It doesn’t matter if you are young or old, healthy or sick, everyone should have a plan to address this situation. 

What happens if you don’t have a plan? This question entered the national spotlight in the 1970s and then again in the 1990s, both times when two young women tragically fell ill and were hospitalized while unconscious. With new medical procedures that could keep people in this condition artificially alive, new legal questions arose that needed to be answered. Read on to learn more about the family fights that ensued, the court battles, and the ultimate resolution to these two tragic events.

A Young Girl from New Jersey Falls into a Coma

Karen Ann Quinlan was a young woman whose unfortunate situation completely changed how we think about making medical decisions on the behalf of others. She was born in Scranton, Pennsylvania on March 29, 1954 and was adopted by a loving family in New Jersey. Quinlan was an active child and enjoyed playing sports with her siblings. After graduating from high school, she held a few different jobs and enjoyed spending time with her friends. She moved out of her family home at 21.

On April 15, 1975, just days after moving to a new apartment, Quinlan consumed a mix of drugs while also being on a diet. She fainted and was rushed to the hospital, but not before falling into a coma due to a lack of oxygen. Quinlan did not have any written plan describing how she would want to be treated if this situation ever occurred. When the doctor informed her family that she was now in a persistent vegetative state that she may never awaken from, they were left to try and decipher her wishes regarding the continuation of her treatment.

A few months after this situation occurred, Quinlan’s parents requested that her ventilation tube be removed so their daughter could pass away naturally. Unfortunately, the legality of this move was not clear, and the hospital refused to do so, fearing it would face a homicide charge.  

This refusal led to nine months of legal challenges by the family while they were still grieving for their daughter’s condition. Her father sued the State of New Jersey to try and remove her from the ventilator. When rejected, he went to the New Jersey Supreme Court which ultimately ruled in his favor. 

At only 21, Quinlan had never thought of creating instructions to prepare for a situation like the one she tragically ended up in. Her family was forced to endure a series of legal challenges all while suffering through the loss of a once-vibrant child.  In the end, Karen Ann Quinlan passed away in 1985 due to pneumonia, nine years after the ventilator was removed.

The Quinlan Tragedy Gives Rise to a Legal Solution

When Quinlan fell ill in the 1970s, medical technology was in a state of rapid advancement. The use of feeding tubes and ventilators meant that patients who were previously diagnosed as terminal were now capable of living on for years, albeit often in a vegetative state. Unfortunately, prior to Quinlan, most people and institutions – including hospitals and courts – had not contemplated a situation where one’s family must essentially decide whether to end a treatment that was keeping a loved one alive. 

The situation surrounding Quinlan’s tragedy led the legal community to begin enacting “right to die” laws, which allow a person to designate circumstances under which they would no longer want to receive treatment. California was the first state to respond to the Quinlan case with these laws, but most states followed shortly after. Currently all 50 states have a law in place that allows someone to create an advance directive, which would include a “living will,” that lays out their wishes should they ever find themselves unconscious and in need of medical treatment.

Although living wills have been legal for decades now, most people still do not have one. Many of us think that we don’t need to contemplate things like serious medical diagnoses until we are older, but Quinlan was a young and healthy woman when she fell ill. The difficult decisions and legal battles her family faced could’ve been avoided if she had created an advance directive, and a living will that specified whether or not she would want to remain on a ventilator tube if no recovery is possible. These are difficult things to think about, but a qualified attorney can guide you through the process of creating an advance directive and living will to accurately reflect your wishes should you ever end up in a similar situation.

Sadly, the Quinlan case did little to spur people into taking action. A few decades later the Schiavo case once again brought this issue into the national spotlight.

Terri Schiavo’s Story Captivates the Nation

Theresa Marie (Terri) Schiavo represents another sad turn of events where proper planning could have saved her family a great deal of struggle and heartbreak. Her story quickly became national news and captivated people across the country as it played out on live television. 

Terri was born in Philadelphia, Pennsylvania on December 3, 1963. She struggled with obesity as a young child and into adulthood and often resorted to different dieting methods. She met Michael Schiavo in college and the couple moved close to Terri’s parents in Florida after they were married.

On February 25, 1990, Terri went into cardiac arrest most likely due to severe dieting. Although she was later resuscitated, she suffered from brain damage due to a lack of oxygen. After being in a coma for two months, it was determined that she would remain in a persistent vegetative state. 

Like Quinlan, Terri did not have an advance directive so there were no instructions from her on what to do about her medical care. An advance directive would have also allowed her to name a healthcare proxy – a specific person to make medical treatment decisions on her behalf. Without a designated proxy it was left to the courts to appoint a guardian on her behalf, and they chose her husband, Michael. 

After eight years in this vegetative state, Michael petitioned to remove her feeding tube. He claimed that she had previously told him she would not want to live on a machine. However, her parents vehemently opposed this claim and the two parties went back and forth arguing over what Terri’s true wishes would be in this situation. This story was further complicated by the fact that Terri’s estate would go to Michael if she passed away, or to her parents if Michael decided to divorce her. 

Although Michael originally won in the first trial regarding his wife’s feeding tube, Terri’s parents continued to fight him in court, requesting assisted feeding and questioning Michael’s guardianship again. In 2003, 13 years after Terri first went into a coma, her parents’ final appeals were denied and her feeding tube was removed. This was after 15 years of receiving medical treatment to preserve her life. Theresa Marie Schiavo passed away in 2005 at 41 years old.

This case is yet another example of the importance of creating an advance directive containing both a healthcare proxy designation and a living will. In this situation, having an advance directive would have given specific directions to Terri’s family and the doctors involved with her care. The court battle would have been avoided entirely, and if she truly did not want the treatment, she would have avoided years of living in a vegetative state. 

If you’re worried about how your healthcare will be handled in a similar situation, it’s best to speak with an experienced attorney who will assist you in creating an advance directive that ensures your wishes regarding treatment will be met, whether or not you are conscious when these decisions are made.

Why Is This Still a Problem?

Advance directives are the best way to prepare for a situation where one is incapacitated but requires decisions to be made about their medical treatment. Creating such a document will save one’s family from the difficult choice of whether to remove someone from life support. It will also keep the family out of any court battles over such decisions. Clearly, the Quinlan and Schiavo cases show the need for an advance directive, regardless of one’s age or health.

Unfortunately, there are many who still lack this legal preparation. In 2015, Bobbi Kristina Brown, the daughter of singer and actress Whitney Houston, was found unresponsive in a tub of water. She was placed in a medically-induced coma and on life support. After much heartbreak, her father and aunt, who were acting as her guardians, decided to remove her from life support once they realized she would be unable to recover. She died after six months of being in a coma, at the age of 22.

Brown demonstrates an even more recent case where an advance directive would’ve helped everyone involved. Brown had inherited substantial assets from her famous mother, complicating issues about whether or not to continue keeping her alive. Her family, like so many others, were left in the unfortunate situation of having to determine her wishes while undergoing the terrible tragedy of her medical condition. An estate planning attorney would’ve cleared up these issues in advance by guiding Brown through the process of choosing a proxy and creating a living will to answer any questions the family may have had about how to proceed given her state.

You Can Avoid This Situation

It’s been over 40 years since the Quinlan case first raised the issue of whether or not to remove someone from life support. Yet it is clear that there is still a majority of people without advance directives. According to a collection of studies, only 36.7% of Americans have created a living will. No one wants to imagine themselves or their families in the position faced by the Browns, Schiavos, and Quinlans. Unfortunately, the reality is that – as these cases demonstrate – it’s a possibility anyone can face at any time. 

Every state has a law allowing for this type of document, so everyone, no matter their age, should look to create an advance directive describing their medical wishes and preferences. If you are interested in drafting an advance directive, contact Rosenblum Law. Our skilled attorneys can assist you in creating a document that clearly dictates your wishes should you ever be unable to make these decisions for yourself. Call us at 888-883-5529 for a free consultation today.

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