Las Vegas Sun

March 28, 2024

Speaker addresses life — and the right to die

Each of the 45 people who listened to William Colby, a lawyer who represented the family of Nancy Cruzan in removing her feeding tube in 1990, had their own tragic stories about family members dying.

The audience members could relate to the anguish that families of Karen Ann Quinlan, Nancy Cruzan, Hugh Finn and Terri Schiavo went through. The families of those individuals unwittingly found themselves the focus of national debate and media attention, Nathan Adelson Hospice CEO and President Susan Drongowski said when she introduced Colby.

"These names are more than legal cases, since they belong to a cherished daughter, wife, husband or son, and friend to many," Drongowski said.

Hospice volunteers, widows and curious young couples came to hear Colby speak about the lives and deaths of Cruzan and Schiavo, each of whom made international news 15 years apart.

Cathleen Ernsberger, a Nathan Adelson Hospice volunteer, remembered the sense of tragedy her brother and his wife felt when their 10-month-old daughter caught a virus that doctors said she would overcome.

The baby did not survive the vomiting that led to bleeding in her brain and she died at the hospital, Ernsberger said, her eyes glistening with tears.

Another hospice volunteer, Sylvia Orestes, said she had a living will done in California before moving to Las Vegas seven years ago.

"I had it checked and renewed when I got here," Orestes said. "My family knows exactly what I want."

Nurse Margaret Richardson, who cares for the elderly and dying at Life Care Center Las Vegas, said that ending life is never an easy decision for the patient or families.

"It's rather disturbing sometimes," said Richardson, after 10 years of nursing.

Sometimes Richardson said that the center's staff cannot let go of a person that they have known and cared for over the years.

"It's a very personal decision on every level," Richardson said.

The black and white of laws is not easily applied to the gray, emotional decisions regarding the end of someone's life, Colby said.

Even with an advanced directive in hand, Colby said that unless family members and caregivers understand the patient's plan, emotional and legal battles can rage over the end of life as it did in both Cruzan's and Schiavo's case.

"I may be Pollyanna from Kansas, but I think Terri Schiavo has changed the way we die in this country," Colby said.

"That's the great gift these families give to the rest of us."

Technological and medical advances, plus the law, will keep the public discussion going, said Colby, who teaches bioethics at the Center for Practical Bioethics in Kansas City, Mo. as well as practicing law.

In fact, technology has driven the debate.

Breathing machines and heart pumps did not exist 15 years ago, so families wanted the most intensive level of care for their loved ones.

Two years ago a U.S. surgeon using robotic tools operated on a patient in France, Colby said.

"Technology has brought us to a point where there are no words to describe life and death," Colby said.

Even if Terri Schiavo had had a living will, her husband and her parents would still have battled in court, Colby said, "because they didn't talk."

The lack of deference by Congress to the court's decisions to remove Schiavo's feeding tube was unprecedented and an outgrowth of "the cruelty of the vegetative state and technology," Colby said.

The federal judge in the Schiavo case is a conservative Republican and a church-going Baptist who weighed all the evidence, and such decisions are never easy, Colby said.

Colby, author of "Long Goodbye: The Deaths of Nancy Cruzan," vividly recalled the similar struggle of the Cruzan family.

Colby, a father himself, said he cannot imagine what Nancy's parents, Joe and Joyce Cruzan, went through during three years of court battles that ended up in a Missouri state court after the U.S. Supreme Court sent the question of removing the 25-year-old's feeding tube back down the legal line.

It was an "unbelievable, horrific" decision the parents made after Nancy Cruzan was in a horrific car crash in 1987.

Authorities never discovered the cause of the accident. Paramedics got to Nancy on the side of a rural road in perhaps as long a 30 minutes, longer than the four- to six-minute time lapse it takes for the brain to die without oxygen.

The rescuers resuscitated her, because that is what they are trained to do, Colby said.

Three weeks after the accident, Nancy moved from a coma to an open-eyed vegetative state, similar to the way Schiavo appeared in the 2000 videotape, Colby said. Her eyes would move, they would stare, she would grimace, groan and her fingers curled so that her nails cut into her wrists. Her family gently unfurled her fingers and place pillows under them to prevent cuts on her wrists.

The family began talking about Nancy's future at dinners, Colby said. Doctors said she could live 30 years with the feeding tube and would die without it.

When they decided to remove the tube, the blue-collar, God-fearing Midwestern family found themselves between conservative state officials and their decision.

In the lengthy legal fight, Colby faced then Missouri Gov. John Ashcroft, former U.S. Solicitor Ken Starr and the U.S. Conference of Catholic Bishops, all opposing the family's wish to remove the feeding tube.

Nancy was moved to a rural state-run hospice along with dozens of protesters. Officials locked down the hospice with 32 policemen ringing its perimeter.

The family gathered in Nancy's room on Christmas day 1990. After midnight, mother Joyce asked nurses to leave her daughter alone. At 2:47 a.m. on Dec. 26, 1990 Nancy Cruzan stopped breathing.

Steelworker father, Joe, called Colby and told him the news.

"What are you going to do?" Colby asked.

"I guess we'll just go home," Joe Cruzan said.

In Joe's world, the legal nightmare had taken forever, Colby said.

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