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October 16, 1987

By No Extraordinary Means: The Choice to Forgo Life-Sustaining Food and Water

Author Affiliations

University of Chicago Pritzker School of Medicine

University of Chicago Pritzker School of Medicine


edited by Joanne Lynn (Medical Ethics Series), 272 pp, $25, Bloomington, Ind, Indiana University Press, 1986.

JAMA. 1987;258(15):2134-2135. doi:10.1001/jama.1987.03400150126047

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


Nineteen eighty-six was the tenth anniversary of the landmark decision by the New Jersey Supreme Court regarding Karen Ann Quinlan's right to privacy. In this decision, the court decided that the then-22-year-old woman be removed from the mechanical ventilator that was thought to be sustaining her life and be allowed to die naturally. The decision was based on the extremely poor prognosis for any recovery of sapient function and on Karen's verbal remarks to her parents about the meaning of her quality of life.

However, she did not die then, nor did she regain sapient life. She went on to live another eight years in a nursing home, curled in a fetal position, being nourished by a tube into her stomach. The part of her brain that controlled her breathing was clearly not as damaged as the physicians thought, and thus she did not require mechanical ventilation to support her