Nancy Beth Cruzan (July 20, 1957–December 26, 1990) was a figure in the right-to-die movement. After an auto accident left her in a persistent vegetative state, her family fought in courts for three years, as far as the
U.S. Supreme Court, to have her feeding tube removed. The Court denied the family's request citing lack of evidence of Cruzan's wishes, but
the family ultimately prevailed by providing additional evidence. On December 14
1990, the tube was removed and she died 12 days later.
Car accident
On January 11 1983, she lost control of her old car that had
no seat belts, was thrown from it and landed face down in a water-filled ditch. Paramedics found her with no vital signs, but
they resuscitated her. After a couple weeks of remaining dormant within a coma, she was diagnoised as being in a persistent vegetative state (PVS). Surgeons inserted a feeding tube for her long-term care.
Her husband and parents waited for a more substantial recovery, but eventually, after four years, accepted that there was no
hope. In 1987 her parents asked to have Cruzan's feeding tube removed, but the hospital demanded a court order to that
effect.
Legal struggle to remove feeding tube
Cruzan's family's pursuit of that court order to have the feeding tube removed turned into a three-year, widely publicized
struggle. The trial court allowed the parents to discontinue tubal feeding, based on the testimony of a housemate of Cruzan who
relayed that Cruzan would not wish to continue her life on artificial support. The Missouri State Supreme Court reversed, ruling
that the lower court did not meet the clear and convincing evidence standard. The U.S.
Supreme Court affirmed the Missouri Supreme Court ruling in Cruzan v. Director, Missouri Department of Health, 497 US 261
(1990) [1].
The opinion of the Court states "for purposes of this case, we assume that the United States Constitution would grant a
competent person a constitutionally protected right to refuse lifesaving hydration and nutrition" (497 US at 279). (The Court
noted that "most state courts have based a right to refuse treatment on the common law right to informed consent ... or on both
that right and a constitutional privacy right" 497 US at 262). The Court also held that Missouri was able to require a standard
of "clear and convincing evidence" with regard to a person's wishes, and that "the State may properly decline to make judgments
about the 'quality' of a particular individual's life and simply assert an unqualified interest in the preservation of human life
to be weighed against the constitutionally protected interests of the individual" (497 US at 283).
After the US Supreme Court ruling, three close friends of Cruzan came forward with evidence that her wishes expressed when she
was competent were that she would want the tube removed. The lower court then ruled this was clear and convincing evidence, and
the decision was appealed.
Feeding tube removal and aftermath
Cruzan's feeding tube was taken out in December 1990. 15 members of Operation Rescue, including a nurse, appeared at the hospital to re-insert the feeding tube, but they
were arrested. Cruzan died 11 days later on December 26 1990.
Her father committed suicide in 1996 and her mother died in 1999. Nancy Cruzan had two sisters, Chris and Donna; Chris Cruzan
White ran the Cruzan Foundation, a program that assisted others with end-of-life decisions, but closed it in 2004.
Books about Cruzan
- Long Goodbye by William Colby (2003) ISBN 1-4019-0132-8
- "Comas: Quinlan and Cruzan," Classic Cases in Medical Ethics, 4th ed. Gregory E. Pence (2004) ISBN 0-07-282935-4
- The Right To Die"*
External links
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