Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making

By David J. Rothman | Go to book overview

CHAPTER 11
New Rules for the Bedside

THE culmination of the decade-long process of bringing strangers to the bedside came in the case of Karen Ann Quinlan. Its impact on opinion and policy outweighed even that of the scandals in human experimentation and the death of a newborn at Johns Hopkins. After Quinlan there was no disputing the fact that medical decision making was in the public domain and that a profession that had once ruled was now being ruled.

The bare facts of the case are well known and easily summarized. On the night of 15 April 1975, Karen Ann Quinlan, age twenty-two, was brought into a New Jersey hospital emergency room in a coma whose etiology was never fully explained and from which she never emerged. After several months of hoping against hope, her parents recognized that she would not recover, and they asked her doctors and the hospital, St. Clair's, to remove her from the respirator that had been assisting her breathing. Joseph and Julia Quinlan, practicing Catholics, had sought church guidance on the issue and had been told that respirator care was "extraordinary" and that returning Karen to her "natural state" (that is, taking her off the machine, even if she would then die) was a morally correct action. Although the Quinlans believed that their decision was in accord with the sentiments of Karen's doctors, the hospital denied their request. St. Clair's staff would

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Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making
Table of contents

Table of contents

  • Title Page *
  • Contents vii
  • Acknowledgments ix
  • Introduction - Making the Invisible Visible 1
  • Chapter 1 - The Nobility of the Material 15
  • Chapter 2 - Research at War 30
  • Chapter 3 - The Gilded Age of Research 51
  • Chapter 4 - The Doctor as Whistle-Blower 70
  • Chapter 5 - New Rules for the Laboratory 85
  • Chapter 6 - Bedside Ethics 101
  • Chapter 7 - The Doctor as Stranger 127
  • Chapter 8 - Life through Death 148
  • Chapter 9 - Commissioning Ethics 168
  • Chapter 10 - No One to Trust 190
  • Chapter 11 - New Rules for the Bedside 222
  • Epilogue 247
  • Appendix A - Citations to Henry Beecher's 1966 Article 263
  • Notes 266
  • Index 293
  • About the Author *
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