Do Women Have a Right to Die?
On a mid-April evening in 1975, 21-year-old Karen Ann Quinlan was celebrating the birthday of a friend at a bar when she ingested a combination of Valium and alcohol that — ten years later — would prove fatal. For days prior, Quinlan had cut off her food intake in an attempt to lose weight; now, as she rapidly began feeling the effects of combining drugs and a starvation diet, her friends decided to take her home. Shortly thereafter, Quinlan lost consciousness and stopped breathing. The doctors who examined her upon admission to the hospital noted that she was feverish, exhibited low blood oxygen levels, and failed to respond to pain stimuli. Her arms were drawn over her chest, her fingers flexed, while her legs stuck stiffly out with pointed toes — a position known as “decorticate posture” that signals severe and possibly irreversible damage to the brain.
Quinlan had entered a persistent vegetative state from which she would never recover. But when her parents asked the doctors to turn off their daughter’s ventilator and let her die, the hospital staff refused, citing fears that to do so would be tantamount to homicide. The New Jersey Supreme Court would eventually side with the family and against the hospital, ruling that the constitutional right to privacy for a patient in a persistent vegetative state allowed for the cessation of life support and establishing that physicians were not legally culpable for complying with such requests. Today, In re Quinlan is widely remembered as a landmark decision for the right-to-die movement. But the Quinlan case — and the storm of press coverage surrounding it — is notable for something else as well: it would inaugurate an era in which the battle for the right to refuse treatment would largely be fought in the right-wing media over the bodies of white women.
In the decades following the Quinlan ruling, a number of high-profile cases in the United States have shaped the jurisprudence and popular perception of the removal of life support. The case of Nancy Cruzan, who entered a persistent vegetative state at the age of 25 after a serious car accident, would make it all the way to the Supreme Court and lead to a spike in public interest in living wills. More recently, Brittany Maynard made headlines when she announced in a viral video that she intended to commit assisted suicide after being diagnosed with Stage IV brain cancer that left her prone to seizures and “stroke-like symptoms.” Arguably the most well-known right-to-die case in recent years, however, is that of Terri Schiavo, whose collapse in 1990 for unknown reasons would trigger a legal battle that lasted over a decade and would embroil both Jeb and George W. Bush until her feeding tube was finally removed in 2005.
All of these cases were accompanied by frenzied media coverage, particularly among conservative outlets, that helped launch their plaintiffs into America’s public consciousness and add fuel to the so-called “right to life” countermovement. A study examining penetration of the Schiavo story found that 92 percent of participants (100 percent of those with what the authors called “adequate literacy”) had heard about it, and at the time of writing, there are six separate lengthy Wikipedia articles related to Schiavo (ranging from “Terri Schiavo Timeline” to “Government Involvement in the Terri Schiavo Case”). Needless to say, these women are hardly the only patients to have had their families opt to end care where there was no hope for recovery, or even to seek legal redress when such requests were refused. Yet, they disproportionately constitute those at the forefront of the national conversation around the right to die. In interrogating why that might be and in examining how these cases were framed by public outlets and political groups, we necessarily raise questions about whose lives are valued in America and why.
Photographs of patients like Quinlan, Cruzan, and Schiavo often capture them pre-coma. For instance, the only widely circulated image of Quinlan is a high school portrait, while Cruzan is most often shown beaming at the camera in an eye-catching red shirt and gold necklace. Images like these portray their subjects as slim, beautiful, and full of life while obfuscating their later state. These photographs are often altered as well: conservative websites that post images of Schiavo tend to crop out her hands, which had been contorted from neuronal damage, while others photoshop out her wheelchair headrest (compare this image from the Christian Broadcasting Network with this image from the New York Daily News).
In other instances, the manipulation is emotional rather than technological. Portraits of Schiavo popular with right-wing websites and news outlets show her appearing to smile and make deliberate eye contact with her mother under beatific lighting. Without context, it resembles a family photo like any other, albeit one with strong angelic overtones. It should be noted, of course, that the deliberate actions and facial recognition heavily implied by the photo are impossible for a patient with the kind of massive brain damage suffered by Schiavo (an EEG performed on her in 2002 found no brain activity).
When mobilized by conservative media outlets, these representational strategies attempt to argue against a right to die by effectively obscuring the medical realities of the women they depict. Yet, compassion begins by acknowledging the position of the other, not denying it. Though claiming to advocate on behalf of those with disabilities, these representations merely further an ableist narrative, implying that these women are only deserving of empathy if the audience perceives them as able-bodied and of sound mind but for some reason “trapped.” What’s more, by erasing the deeply impaired nature of cognitive functioning and awareness in a persistent vegetative state, anti-euthanasia activists mobilize sexist tropes that infantilize women and portray them as virtuous but helpless victims requiring protection. Equally noteworthy is the relative dearth of media attention towards non-white patients — the lack of vigorous "right to life" defenses of such individuals is indicative of the different value that American society places upon white and non-white lives.
Textual representations of these patients also play upon similar ideas, even down to the cutesy habit of referring to these women by their first names. A 2008 analysis of the media’s reporting on Schiavo found that 21 percent of the articles used in the study erroneously included hope that Schiavo “might improve,” frequently describing conscious-seeming behaviors such as laughter and smiling, both of which are linked to the portrayal of these patients as having regressed to a state of innocent girlhood. Commenting on the Maynard case, a blogger for the National Right to Life dismisses Maynard, whom he describes as “a beautiful young woman about to be cut down in the prime of her life,” as being “clearly upset by the changes in her appearance. She is barely taking in more than prescription medications but has, as she tells us, gained over 25 pounds.” The NRL also criticizes Maynard’s choice for increasing the suffering of her family, implying that a woman must put her domestic responsibilities above her own right to self-determination. By lamenting that the pro-assisted suicide group Compassion & Choices (formerly The Hemlock Society) is “exploit[ing] her tragedy for its own malevolent purposes,” the NRL further erodes Maynard’s agency, casting her as easily manipulated and lacking proper guidance.
Arguments for a right to die are often framed in abstract philosophical or legalistic terms, yet opponents tend to ground their claims in appeals to pathos that are ultimately moored to sexist tropes that cast (young, white, photogenic) plaintiffs as helpless “Sleeping Beauties” in need of protection. If we understand the right to die as a feminist issue, then, we can refocus on how the debate plays out in the real world and more effectively counter the arguments of conservatives who seek to preserve a “right to life” at the expense of any right to bodily autonomy.