Book puts human face on right-to-die court battle

In the spring of 1987, a partner in the prestigious Kansas City firm of Shook, Hardy & Bacon asked one of its young lawyers to take on a pro bono case – one that big firms do for free. “It may not amount to much,” Bill Colby recalls being told, “probably no more than a half-day trial in probate court – but the issues look interesting.”

That brief conversation was Colby’s introduction to the case of Nancy Cruzan, the southwest Missouri woman in a persistent vegetative state whose family fought all the way to the U.S. Supreme Court and back again for the right to withdraw her feeding tube and end a life that the family felt was not worth living.

The case consumed Colby for more than three years, until Cruzan died in late 1990; the emotions and the issues still haunt him today. The story he tells in “Long Goodbye: The Deaths of Nancy Cruzan” puts a touchingly human face on a case that the public, if it remembers at all, is most likely to think of in legalistic terms.

The deaths of the title, of course, refer to Cruzan’s near-fatal car accident, which left her unable to respond to anyone; the realization by the family that she would never return to the vivacious woman she was; and the actual physical release that Colby and the Cruzans fought so hard to achieve.

Until doctors performed surgery on Cruzan to insert a gastrostomy tube, a few weeks after her accident in early 1983, the case was purely a medical one. But when Joe Cruzan, her father, and Paul Davis, her husband, signed consent forms for the operation, they had no idea they were entering a legal realm that would become agonizingly difficult to escape. As that battle continued, Joe Cruzan said, “I had no idea I was signing away anybody’s rights that day. I would have signed anything. We were just waiting for Nancy to wake up.”

She never did wake up, not after the surgery and not during the long months and years that followed. Colby and the Cruzans got an intensive education in law and medicine as they prepared the arguments needed to convince officials that the unresponsive woman lying in a bed in the Missouri Rehabilitation Center in Mount Vernon was not the Nancy Cruzan they had known, and, if she were able, she would say clearly and forcefully that she would not want to lie there to wither away.

The initial decision went in favor of the Cruzans’ desire to remove Nancy’s feeding tube, but the state of Missouri appealed and prevailed, both in the Missouri Supreme Court and in the U.S. Supreme Court. Still, Colby saw eight words in the high-court decision that turned the case around: “discovery of new evidence regarding the patient’s intent” could lead to a different outcome.

He found two women who had once worked with Nancy. They said she had unequivocally said she would never want to live the kind of life she was doomed to now. Colby brought the case back to a Missouri court, which once again sided with the Cruzans and said the tube could be removed. It came out Dec. 14, 1990, and Nancy died 12 days later.

Colby does a good job weaving together the medical, legal, political and public opinion aspects of a case that captured the attention of a nation. And for someone so wrapped up in the case, for the most part he manages to move the story along. He could have done an even better job without his extensive use of detail and transcripts, but that is a minor quibble. Overall, Colby presents a moving, thought-provoking account of a story whose details may now be hard to recall but whose issues and emotions are as timely as ever.