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None of the medical experts held out any hope that Karen could ever recover. Dr. Julius Korein, a neurologist at Bellevue Hospital in Manhattan, said it most dramatically when he likened Karen to a child without a brain. Karen, he made clear, is not in a "locked-in" syndrome—i.e., a state in which she sees, hears or understands but cannot communicate. She is, said Korein, a vegetable. His description was so disturbing that Mrs. Quinlan, who had maintained her composure throughout the proceedings, slipped quietly from the room.
And yet Diamond insisted that the machine could not be turned off, for "no physician will ever interrupt a device that is performing lifesaving functions." The experts agreed that despite the seriousness of Karen's condition, she meets none of the accepted criteria for determining death. She has not suffered "brain death," the legal measure of death in eight states—though not New Jersey. An electroencephalograph shows that there is still brain activity. She has, on occasion, breathed spontaneously, for up to half an hour, though most experts doubt that she could do so much longer without the aid of the respirator.
The lawyers in the case have already set forth their widely divergent arguments. Paul Armstrong, the attorney who represents the Quinlans, acknowledges that there is no question about Karen's being alive. But he insists that her parents as guardians have a responsibility to look after her best interests. They also have a constitutional right to end her medical treatment on the basis of guarantees of religious freedom, protection against cruel and unusual punishment and the right to privacy as spelled out in the First, Eighth and Fourteenth Amendments. "The court," said Armstrong, "certainly can determine, given the form of existence for Karen, that it would be for her best interest to remove the respirator."
Daniel Coburn, a part-time public defender who represents Karen, disagrees. Although he has retreated slightly from his earlier claim that Karen could recover, he still insists that the court must protect her constitutional "right to life." New Jersey Deputy Attorney General David S. Baime takes a similar stand. Says he: "Although one has the right to hold religious beliefs, one does not have the right to practice them to the detriment of the state, society or the particular person."
Attorneys representing the hospital and the doctors involved in the case take yet another tack. The hospital's lawyer, Theodore Einhorn, urges the court to leave the patient to her doctors, who are best qualified to decide how to treat her. Ralph Porzio, counsel for Morse and Javed, agrees. If the court authorizes an action that may end Karen's life, he says, "hundreds of thousands of people who are confined to institutions for the chronically ill" will be affected. They "may be in a condition similar to Karen's and you can terminate their lives."