At the time the court considered her father's position to become guardian, Karen was in a profound and allegedly irreversible coma and Physical debility.
The court spent significant time discussing Joseph Quinlan's religious belief and moral character because these were the basis of the decision whether or not to take Karen out of Life support. Joseph Quinlan would not allow for that action unless it was in line with ethical beliefs supported by his religion. The Bishop felt that because there was no other available medical procedure to treat Karen and because the life support was not actually treating but rather supporting her, discontinuance of treatment was the right thing to do.
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The court agreed that each individual has the freedom to exercise their right to religion and practice it in their own way.
The court did not think cruel and unusual punishment applied in this case because despite Karen's situation being cruel, it was caused by the accident of fate and nature and not in any way a type of punishment
The court agreed to Karen having an independent right of choice. However, this right is ordinarily based on her competency and capability to assert it. Given her incapability and incompetency, the rights were granted to be asserted on her behalf by the guardian. The court believed that in Karen's situation, the guardian and family are the closest and best bet of determining and asserting her rights and she would also feel that way if she had the decision.
The states' interest in the case is with regards to protecting the life of Karen while in the hospital. Discontinuing her treatment in life support would impact a faster death which amounts to a homicide on the guardians and hospital part. The state's interest is to ensure this does not happen until it is completely necessary.
The court decided that ultimately should the time come when it has been ascertained that no available medical practice can help bring Karen out of the comatose state to cognitive sapient state then the hospital through consultation with the hospital ethics committee will discontinue Karen's support and discharge her to the care of her guardian without any civil or criminal liability.
