Comparing Rasouli, Wawrzyniak, and Quinlan

Comparing the Wawrzyniak and Rasouli cases in recent posts reminded me of a similar comparison one might draw -- between the Superior Court and Supreme Court opinions in the famous Quinlan case.  In his November 1975, Judge Muir concluded that "the determination whether or not Karen Ann Quinlan be removed from the respirator is to be left to the treating physician.  It is a medical decision . . .   The nature, extent, and duration of care . . . is the responsibility of a physician"  

In contrast, the following March, the New Jersey Supreme Court cogently refused to grant that much deference to physicians.  First, there appeared to be significant variability in the relevant standards (some engaged in the practice of "judicious neglect" and "refused to treat the hopeless and dying as if they were curable").  Therefore, the standards lacked "such internal consistency and rationality . . . as should warrant their constituting an ineluctable bar the the effectuation of substantive relief for plaintiff."  Furthermore, the court was concerned that physician judgments (regarding the standard of care) might be "contaminated" by "self-interest or self-protection.

In short, one common theme in Wawrzyniak, Rasouli, and Quinlan is that the standard of care is not wholly determined by physicians.  It is also, in part, determined by societal norms manifested in legislative or common law.