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You can download a free discussion guide for the book in Microsoft Word format (37 KB). The discussion guide was developed for book clubs and classroom use. It includes discussion questions covering the Cruzan case, plus questions designed to stimulate thinking about your own wishes. There's also a list of suggested resources for further study. Listen to interviews with author Bill Colby done for Growth House Radio.
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Published by Hay House, Inc.
Publication date: 2002
416 pp.
ISBN: 1401900119 (hard cover)
In 1987 Nancy Cruzan had a car accident that left her in a persistent vegetative state, a severely unresponsive type of brain impairment. When it became clear that Nancy's situation was hopeless, her family wanted to discontinue the use of artificial feeding tubes. Colby, then a young lawyer, took the case on a pro bono basis, little realizing that he would soon find himself at the center of a national debate on the right to die.
The Cruzan family began their legal action in a probate court in a small Missouri town, but soon found themselves before the Missouri State Supreme Court, and then the U.S. Supreme Court. Along the way we see brief appearances by figures that later gained national prominence, including Missouri governor John Ashcroft, whose state officials opposed the Cruzan family, and U.S. Solicitor General Kevin Starr, who argued the case for the U.S. government. The landmark Supreme Court decision established that health care consumers have a clear right to determine their treatment, including the right to refuse treatment. Following this ruling the Cruzan family returned to state courts to provide evidence on what Nancy's wishes would have been, following the new standards. They eventually established that Nancy would not have wanted her body to have been kept alive by artificial means after her mind was gone. Nancy died peacefully following the removal of artificial feeding tubes, some seven years after she lapsed into a persistent vegetative state.
The Cruzan case drew national attention, and the family was put under a media microscope throughout the long process. Attorney Colby paints a deeply human portrait of a family suffering the loss of a daughter, but unable to gain closure due to intrusive medical care. But no one can easily be blamed here. The medical staff that insisted on the artificial feeding do so out of a sense of ethical duty and a respect for life. Today we have the benefit of clear ethics guidelines from leading medical associations stating that removal of artifical life support in such cases is appropriate and consistent with human dignity. But at the time these issues were not as well defined. The Cruzan debate was instrumental in leading to the policy formulations that today guide medical decisionmaking in similar situations.
Author Bill Colby was the lawyer for the family of Nancy Cruzan, the only right-to-die case ever to come before the U.S. Supreme Court. Written with the drive of a novel, this absorbing memoir is a page-turner that lets us follow the Cruzan family during their agonizing struggle with removal of a feeding tube for their permanently-comatose daughter. Colby's clear narrative gives a no-nonsense introduction to troubling ethical questions of brain death, artificial nutrition and hydration, and medical interventions that can prolong physical existence long after the mind is gone.
