Bringing An End to Limbo

By Jill Smolowe

The cruel ordeal of Nancy Cruzan is finally drawing to an end. Last week probate judge Charles Teel Jr. ruled that the Missouri Rehabilitation Center could disconnect the feeding tube that has kept the woman alive since 1983, when a car crash left her in an irreversible coma. Since state officials have promised to abide by the ruling, the decision ends a legal battle that took the woman's parents all the way to the Supreme Court in their quest to "allow Nancy the dignity of death."

In a written statement, Joe Cruzan said that because of his daughter's travail, "I suspect hundreds of thousands of people can rest free, knowing that when death beckons they can meet it face to face with dignity, free from the fear of unwanted and useless medical treatment." At week's end he and his wife Joyce had decided to instruct the hospital in Mount Vernon, Mo., to remove the tube. Nancy, 33, is expected to die within two weeks of that action.

During the seven years the woman has lain in a vegetative state, her case has become a bellwether for right-to-die advocates across the U.S. They argue that decisions about whether to withhold food, water and medical treatment from hopeless and helpless patients should be left to families or guardians. While many states embrace such guidelines, Missouri law demands "clear and convincing evidence" of a patient's intent, such as a living will, before countenancing a decision.

Because Nancy had left no such document, her parents had to prove that she would have wanted the tube disconnected. When the case was first heard in 1988, Judge Teel weighed the testimony of friends and family, then granted permission to remove the life-sustaining apparatus. Four months later, however, the Missouri Supreme Court reversed the ruling, arguing that "vague and unreliable" recollections were insufficient proof of Nancy's intent. Last June the U.S. Supreme Court upheld a state's right to demand clear and convincing evidence in the matter, then returned the Cruzan case to the Missouri courts.

On Nov. 1, Teel heard new evidence. This time the Cruzan family's lawyer produced three witnesses who recounted specific conversations in which Nancy stated that she would not want to live "like a vegetable." Teel reaffirmed his decision.

Right-to-die groups hailed the move. "It's a belated victory," said Derek Humphry of the Hemlock Society. "She should have been allowed to die in the first year of her condition." Nancy Myers of the National Right to Life Committee countered that the ruling "represents a serious decline in how our society values human life." While the Cruzans' legal odyssey is ending, their struggle has persuaded many Americans to seek to avoid the same fate. Since the Supreme Court decision, right-to-die advocates report that inquiries about living wills have surged 500-fold.

With reporting by Andrea Sachs/New York