Topeka ? With Terri Schiavo’s case on their minds and advocates for the disabled providing support, legislators have moved to make it more difficult in Kansas for court-appointed guardians to withhold food and water from people under their care.

The state House approved a bill Friday that would have district courts review guardians’ attempts to remove feeding tubes if people under their care have left no instructions. The 95-29 vote sent the measure to the Senate, where its future is uncertain.

Kansas is not alone. Legislators in at least six other states — Alabama, Hawaii, Kentucky, Nevada, South Dakota and Schiavo’s home state of Florida — have proposals dealing with such situations, according to the National Conference of State Legislatures.

Schiavo’s case, a 15-year court battle between her parents and her husband, led state and federal officials to try to prolong her life. But courts, including the U.S. Supreme Court, have sided with her husband, who sought successfully to have her feeding tube removed.

Advocates for the disabled said Friday that most cases in which a family member or guardian seeks to withhold life-sustaining treatment don’t reach the courts or the public’s attention. And, they said, the disabled remain vulnerable to having such treatment ended without their consent.

“Society can look at us as the canaries in the coal mine — except that we don’t see ourselves as expendable,” said Diane Coleman, president of Not Dead Yet, an Illinois group advocating for the disabled and opposing euthanasia and assisted suicide.

Cruzan lawyer critical

But Bill Colby, a Prairie Village attorney, was critical of the Kansas measure. Colby represented Nancy Cruzan, a southwest Missouri woman who died in 1990 after an eight-year legal battle that led to the U.S. Supreme Court’s first and only ruling on so-called right-to-die issues.

“A bill that virtually prohibits incapacitated people from exercising the right to refuse medical treatment may well violate the Constitution,” Colby said.

How it would work

Wade Carpenter, 8, left, and Aaron Nestor, 6, kneel and pray during a Good Friday service outside the Woodside Hospice in Pinellas Park, Fla., where Terri Schiavo resides. As Schiavo's body continued its slow shutdown Friday after a week of no food and water, her parents held out hope for unlikely help from Gov. Jeb Bush, and pressed the federal courts to have their daughter's feeding tube reconnected.

The Kansas bill would apply when courts appoint legal guardians for people who are incapacitated, disabled or unable to make some decisions for themselves. Guardians would be required to obtain permission from a judge or jury to withhold food and water if the people in their care had no living wills or legal documents specifying their wishes. Also, people with guardians would have their own attorneys.

A 2002 state law says a guardian can withhold life-sustaining treatment if two doctors, two medical ethics committees, or one of each, certify that a person’s life won’t be prolonged without artificial means, or that a person is in a vegetative state.

While some Kansas legislators said existing law still favors prolonging life, Coleman called it “extreme” in failing to protect people under a guardian’s care.

Numbers unclear

Kirk Lowry, an attorney for the Disability Rights Center of Kansas, said it’s difficult to say how many Schiavo-like cases occur, because records for guardianship cases are sealed and because there’s no judicial review once a guardian obtains the necessary documents to withhold food and water.

Lowry said judges have told him cases in Kansas were “not uncommon.”

“The Terri Schiavo thing is just the tip of the iceberg,” Lowry said. “Usually, the family agrees and there is no dispute, and the person is dead.”

Some senators are receptive to the House proposal, but some are skeptical.

“That’s a fairly major policy change,” said Sen. Jim Barnett, R-Emporia, a doctor. “I’d want to have a full and thorough hearing before acting on that.”

Gov. Kathleen Sebelius hasn’t taken a position publicly.

“We really haven’t had a chance to review it,” spokeswoman Nicole Corcoran said.