Euthanasia Simulation

PART 3

In 1983, 25 year-old Nancy Cruzan, a Missouri resident, was transported to a hospital in an unconscious state after her car accidentally overturned. Because her brain had been anoxic for more than ten minutes, she fell into a coma. To aid in her recovery, physicians implanted gastronomy and hydration tubes into her. Nancy was later transferred to a state hospital.

It became apparent that Nancy had virtually no chance of coming out of the persistent vegetative state into which she had lapsed. Her parents, who had been appointed as her co-guardians, believed that their self-respecting and independent daughter would not have wanted to continue her life under these circumstances. Nancy's parents asked employees of the state hospital to terminate the artificial nutrition and hydration procedures. The employees refused to honor the request without court approval.

The parents filed a declaratory judgment action in a Missouri trial court. The Cruzans were seeking judicial authorization of their request. The trial court entered an order directing hospital employees to carry out the parents' request. The State of Missouri appealed and the Supreme Court of Missouri reversed the trial court's decision. The supreme court held that the state had an interest in preserving life, and that before medical life-support could be withdrawn from an incompetent patient, there must be "clear and convincing" evidence of the patient's wishes. Later in 1990, the United States Supreme Court affirmed the Missouri Supreme Court decision. The U.S. Supreme Court held that the state could require such "clear and convincing" evidence. The U.S. Supreme Court went on to say that withdrawing a feeding tube was no different from withdrawing any other kind of life-sustaining medical support including a respirator.

The U.S. Supreme Court decision, while not in favor of Nancy's parents, meant that the Cruzans could authorize the termination of nutrition and hydration procedures provided that there was clear and convincing evidence of what their daughter would have wanted should she fall into a persistent vegetative state.

Later, three witnesses who knew Nancy very well came forward to testify in a rehearing of the case in a lower court. The witnesses remembered Nancy telling them that she absolutely would not want to continue her life as a "vegetable" hooked up to a machine. The court accepted the witnesses' statements as clear and convincing evidence. The court ordered the cessation of Nancy's nutrition and hydration. In December 1990, more than 7 years after her accident, Nancy was removed from her life-support system. She breathed her last breath 12 days later.

In this case, the withdrawal of nutrition and hydration procedures was permitted in order to end the life of a patient in a persistent vegetative state. The removal of nutrition and hydration support results in a patient dying from starvation and dehydration. There is no consensus among professionals as to whether a patient in a persistent vegetative state actually suffers from hunger and thirst.

Finally, Nancy did not precisely express her wishes as to how she wanted to die, e.g., being starved to death.