In the Arms of Others: A Cultural History of the Right to Die in America. By Peter G. Filene. Ivan R. Dee, 282 pages, $27.50. 

The “right to die.” Even for a topic as unpredictable as death, Americans have coined a take-charge slogan. “Autonomy-the personal right to come and go and do-is ingrained in our value system, even in our law,” says Peter Filene, professor of history. 

“We talk about the right to die when we choose, on the terms we choose,” he says. “It just doesn’t work that way.” 

Filene argues that it’s a “cultural illusion” that each of us is independent. Even when we’re healthy, he says, we can’t be separated from our relationships. And especially when we’re dying, we often end up “in the arms of others,” relying on family, friends, or doctors to carry out our wishes. Sometimes, even when those wishes seem clear, granting them isn’t easy. 

The parents of Karen Ann Quinlan decided what they thought was best for their daughter, but it took more than 10 years and two court cases for it to happen. Quinlan had fallen into a coma after drinking at least three gin and tonics and taking a valium. Later, she progressed into a deeper coma-a persistent vegetative state. She had some brain activity but stayed unconscious and breathed only with the help of a respirator. 

Three months later, doctors predicted that Karen would never regain consciousness. After consulting their priest, Karen’s parents decided to disconnect the respirator. 

Her doctors refused. The resulting court case attracted endless publicity and became, Filene says, a symbol of the “right to die.” Her parents won the right to act in Karen’s stead only after an appeal to the New Jersey Supreme Court. Even then, her doctors weaned her off the respirator instead of removing it immediately. She lingered for ten years, in a nursing home, and died in 1985. 

The Quinlan case is the best known, but there are dozens of others that involved equally heart-wrenching decisions. Telling the stories of the people behind these cases helped Filene, a “freshman” to the right-to-die debate, grasp his topic. “These issues were so difficult, but as soon as I started telling the story of one of the innumerable characters that popped up, the issues became real,” he says. 

So along with court decisions and newspaper headlines from the Quinlan case, Filene also includes the story of a mass the Quinlans held at their home to mark Karen Ann’s 22nd birthday, while she lay in a hospital miles away, connected to tubes, grimacing, her legs contorted. 

“These aren’t questions in the library,” Filene says. “These are human questions that people have to answer in the rush of what’s happening to them, then and there.”