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Friday, September 16, 2005

Here's a story

Yesterday was another fine day for me. I had the great pleasure of meeting Bill Colby. No, not the old CIA director. The Bill Colby I'm talking about is currently a fellow at something called the Center for Practical Bioethics. He used to be a partner at a big-bucks Kansas City law firm. While at that firm, he took on a pro bono case that the old guys said would last a half-day. Instead, it lasted years. It changed lives, including Colby's. You might even say the case took one or two lives, depending on your perspective. It was the case of Nancy Cruzan.

Nancy Cruzan, aged 25, crashed her car in a bad accident near her Carthage, Missouri home on Jan. 11, 1983. The emergency responders were able to get her heart and lungs working, but she had lain without oxygen for a long time before they got there, and much of her brain was destroyed. She was left in a persistent vegetative state. Her bodily functions worked -- sort of -- but her existence could not reasonably be called consciousness. Her eyes were open; she had some limited reflex reactions; but, in the word that used to suffice in a less sensitive time, she was a vegetable -- kept alive only by a feeding tube. If Terry Schiavo is still fresh in your mind, you get the picture.

Colby's book, Long Goodbye, is about Nancy's family, and how they spent more than three years fighting to have the feeding tube removed. Once they realized that their daughter and sister was wihout a meaningful life, and that she could be sustained that way for three or four decades, they searched their souls and determined that that wouldn't be right. But the medical authorities in Missou refused to pull the tube at the family's request. If the family wanted to let Nancy die, they would have to invoke the legal system to order the state to allow them to do it.

The case went all the way to the U.S. Supreme Court -- the Court's only major right-to-die case so far -- with young Colby, then in his early 30s, suddenly thrust into the limelight. The family lost in the High Court, by a 5-4 vote, but eventually "won" in a new trial in a local court, and they had their daughter's feeding tube removed. She died around three hours after Christmas Day in 1990.

There are very few visitors to this blog who wouldn't benefit from reading Colby's book. If you care about the theory of the right to die, bioethics generally, the right to privacy, abortion, parental rights, the influence of law over agonizing personal decisions, or just the story of a bright young man in over his head, Long Goodbye has valuable messages for you. Heck, even John Ashcroft (then governor of Missouri) and Ken Starr (then U.S. solicitor general) make appearances.

I have at least a mild interest in all those subejcts, but what ultimately kept me up at night, sometimes stopping to dry my own tears as I read, was the story of a father and his daughter. Colby's work is really a story about Joe Cruzan, Nancy's father, more than anything else. At one point toward the end of Nancy's life (and Joe's), a stranger sent Joe a postcard that read in part:

I pray to God that someone would love me enough to fight to let me die.

In Nancy's case, her father did -- at enormous cost.

The book has several pages of photos, and by the time you're done with the text, you could care less about Ashcroft, Starr, or the nine justices of he Supreme Court. The only pictures that matter are those of the parents, Joe and Joyce, and of course, those of Nancy. God rest all of their souls.

If my own gut reaction is any indicator, this is a story that you clearly should take a look at.

Comments (5)

That's really an excellent book, and I'll second Jack Bog's advice on reading it. If anyone wants a cheap local copy, mine can be had for approximately the price of postage. I read the book last year, and it's still on the shelf (I have read it again since then). This is often a very difficult book to read, on an emotional level, but well worth the effort.

Nancy Cruzan's headstone includes a graphic illustration of an EKG tracing morphing into a "thank you" then into a flat line. I remember seeing a photo of it in a legal textbook. It is very powerful. Res ipsa loquitor.

Jack, when my mother was very sick and on a ventilator, they told us she would probably not recover and be able to breathe on her own. My family made the decision to remove the ventilator and move her to a private room where we could spend time with her. (The next day she did recover [miracle] and my family was able to share almost another 2 years with her. My question is what is different from removing someone from a ventilator and allowing them to pass as opposed to a feeding tube? I imagine there are people every day in the U.S. that make the decision to stop the machines that are sustaining our loved ones...what makes certain cases more prevalent? (Other than if they have a living will or DNR...which my mom did not.)

Part of the Cruzan case was the issue whether feeding tubes and ventilators were the legal equivalent. Under the hospital rules then, the family could remove a ventilator, but not a feeding tube.

The Cruzans waited several years before they gave up on Nancy's chance of recovery. It was nil.

If Nancy had had an advance medical directive, it would have been a lot simpler for everyone.

Yes - I met Colby a couple of years ago when he stopped in to talk at Stoel Rives.

The local angle, besides Oct. 5 at SCOTUS, is Compassion In Dying: Stories of Dignity and Choice by Barbara Roberts & Barbara Coombs Lee.

See http://tinyurl.com/cc266

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