The Right to Live or Die : Cruzan Case Is a Flash Point for Both Anti-Abortion, Right-to-Die Groups

They arrived with their pup tents, their placards and their shared conviction.

Before it ended, close to 100 people would come to the small southwest Missouri town of Mt. Vernon for what they said was a single purpose--to save a life.

They came from Atlanta, Chicago, Kenosha, and Miami, from St. Louis and Kansas City, just as they crisscrossed the country for Operation Rescue to “stop the killing” at abortion clinics.

But this time was different. This time, they said, they came to save Nancy Cruzan.

“Nancy Cruzan had a right to life just as much as those unborn babies in the womb do,” said protester Patrick Mahoney, an anti-abortion leader and founder of the Center for Christian Activism in Florida. “The Nancy Cruzan case is to the right-to-die movement what Roe v. Wade was to the right-to-life movement. As it was at the beginning of the right-to-life movement, we are witnessing the mobilization of people committed to protecting the innocents.”

There is much disagreement, however, about who should protect the rights of those who cannot speak for themselves.

Traditionally, families and their physicians make life and death decisions, alone. But the Nancy Cruzan case has attracted an array of strangers--a variety of interest groups, each with its own definition of individual or societal rights.

Anti-abortion groups, from the radical Operation Rescue to the more mainstream Right-to-Life, oppose euthanasia, but disagree about how the battle should be waged. They have been joined in their fight by groups who lobby on behalf of the disabled.

Civil liberties groups talk about protecting individual privacy from state intrusion. Right-to-die groups argue that how a life ends is the most personal of human choices.

For the first time, the Nancy Cruzan case has brought them all to the same battlefield.

“We’ve never seen anything like this before in the right-to-die movement,” said Derek Humphry, founder of the National Hemlock Society, a right-to-die group. “The fact that these anti-abortionists have switched their guns and pointed them at people who are at the end of their lives is not good news for anybody.”

Until her old Nash Rambler slipped off an icy country road eight years ago, Nancy Cruzan had been an outgoing 25-year-old who worked the night shift in a cheese factory and loved the outdoors. Since nearly suffocating in that accident--she didn’t breathe for at least 13 minutes--she lived in what her doctors said was a “persistent vegetative state,” a form of permanent unconsciousness.

Although she could breathe on her own, she showed no awareness of herself nor her surroundings. Her face was red and bloated; her arms and legs severely contracted.

Last Dec. 26, 12 days after the removal of her feeding tubes, and following a protracted legal battle that ended with a landmark ruling by the U.S. Supreme Court, Nancy Cruzan died.

Operation Rescue is one of many groups that took an interest in her case and in another prompted by the Cruzan family’s court victories. This week, a hearing may be scheduled to decide whether the father of 20-year-old Christine Busalacchi has the right to move her to Minnesota, where her feeding tube could be removed with less legal strife. For the last three years, Busalacchi, also the victim of an auto accident, has been a patient at the Missouri Rehabilitation Center--in a room not far from Cruzan’s.

As Joe and Joyce Cruzan were asking judges to let them end their daughter’s feedings, and thus her life, the National Right-to-Life Committee and the Society for the Right to Die faced off in and out of court over what should be done for Nancy Cruzan. And as disabled-rights groups argued for the preciousness of all life, the Hemlock Society issued strong statements about death as the ultimate personal choice.

Inside the hospital, the Cruzan family prayed for an end to their daughter’s suffering. Outside, demonstrators waved signs pleading “Feed Nancy.”

Food and water, said Operation Rescue leaders, was all they wanted for Cruzan. “We don’t consider that artificial life support. Everybody needs food and water to live,” Mahoney said. “For people living on heart-lung machines or respirators, we won’t object to their being taken off the life-support systems. And if the patient dies, OK. But if we know of a case where they are blatantly trying to kill someone, by withholding food and water as they’ve done with Nancy Cruzan, then Operation Rescue will be there.”

Joseph Foreman, an Operation Rescue founder who led an attempt to “rescue” Cruzan a week before she died, has promised more--and more dramatic--attempts to save patients like Cruzan.

“We’ll be looking at physically removing people from the hospital, taking them to a safe place where they can be kept alive,” said Foreman.

He says he foresees “a whole underground network of people caring not for terminally diseased people but for people who happen to be completely helpless, like Nancy.”

He says skilled medical help is available within the ranks of Operation Rescue to care for patients such as Cruzan or Busalacchi.

For the National Right to Life Committee and several national groups that lobby for the rights of the disabled, the Cruzan case represents “the ultimate discrimination against the handicapped.” In and out of court, they argued that ending Cruzan’s feedings risked “death by starvation (for) hundreds of thousands of severely disabled people who need assistance to eat.”

“It’s not new at all for us to be involved in a case such as Nancy’s,” said David O’Steen, Right-to-Life executive director. “This group was formed to oppose infanticide, abortion and euthanasia.”

Although Right-to-Life was not represented outside the hospital where Cruzan died, O’Steen said the organization will continue to attempt to use legislation, political action and education “to see that medically dependent people are fed.”

Groups such as the Nursing Home Action Group, the Assn. for Retarded Citizens and the United Handicapped Federation filed their own court briefs “on behalf of Ms. Cruzan’s right to receive food and fluids.”

After her death, the groups issued a joint statement decrying Cruzan’s death as “both tragedy and travesty . . . a tragic end to a difficult case.”

But to groups on the other side, such as the Society for the Right to Die and the Hemlock Society, the intervention of right-to-life organizations in decisions about how and when life ends is a grievous invasion of privacy.

“This is an awful turnaround. We’ve never seen anything like this in the right-to-die movement,” said the Hemlock Society’s Humphry. Based in Eugene, Oregon, the society represents 40,000 members who believe not only in the right to end life-sustaining medical treatment, but also in a person’s right to assisted suicide.

“I think a new war has truly broken out. We in the right-to-die movement have had an easy ride for the past 10 years,” Humphry said. “Fine. We can cope. We are ready. We have the arguments, the literature, the money.

“We were shocked by what we saw in Nancy Cruzan’s final days. We’ve been debating these issues with the Right-to-Life Committee since the start of this. But we were slugging it out on ethical terms. We’ve never seen anything like this action by Operation Rescue.”

Evan Collins is president of the Society for the Right to Die, the largest of such national groups and one that has avoided the issue of assisted suicide. He said the battle with right-to-life forces may already be in its final stages: “No matter what may be done or threatened, right-to-die is mainstream now. They (Operation Rescue) are the fringe element, not us.

“Since the Nancy Cruzan case became public, we have received hundreds and hundreds of thousands of requests for living wills. People do not want to go on living in shells, they do not want to live for as long as our advanced medical technology can keep them going.

“While the other side may argue that this case will lead to more people being (removed) from life-support systems, I worry that we’ll see more patients refusing even temporary life support for fear it will never end.”

On June 25, the U.S Supreme Court issued its first ruling on a right-to-die case. The high court ruled that a person whose wishes are clearly known has a constitutionally protected right to reject life-sustaining treatment. Justices also said the state has the right to prevent the removal of life support when the person’s wishes are unknown.

Following the Supreme Court ruling, a Missouri judge heard testimony in October from three friends who said that Nancy Cruzan had told them she would not want to be force-fed or kept alive in a vegatative state. The judge said their testimony satisfied the demands of the Supreme Court and on Dec. 14 he ruled that Cruzan’s family could have the feeding halted.

While the Supreme Court’s first right-to-die ruling had several dimensions, according to Ramona Ripston, executive director of the America Civil Liberties Union of Southern California, “perhaps the most important for each of us worried about how our life may end is that how you died, to a certain extent, is a personal decision to be made among members of the family.”

The ACLU filed a friend-of-the-court brief in the Cruzan case. But unlike other third-party litigants, it argued that the decision to forgo life-sustaining treatment is an American liberty, guaranteed by constitutional rights.

“There is a right to privacy here that supersedes all else,” Ripston said. “People should have the liberty to decide just how to live and how to die when there is no hope they’re going to recover. This is not in conflict with the Bill of Rights. This is what the Bill of Rights is all about. In the Cruzan case, it was the state of Missouri who wanted to keep this woman alive. And that is not a decision for governments.”

The difficulties, both legal and moral, of the Cruzan case have not been lost on many who have followed the case.

“It’s a case with a lot of questions, but few easy answers,” said Thad McCanse, the Missouri attorney appointed in 1987 as Nancy Cruzan’s legal advocate. “I decided that no interest of hers was being served by keeping her in limbo. She had no future, no signs of peace or contentment.

“Yet I struggled too with this. Although the protesters chose to ignore this fact, I was the only person who could’ve stopped this (termination of feeding). It hasn’t been easy. I asked myself many, many times, ‘What right do I have?’ But I have no doubt in my mind, this was the right thing to do for Nancy.”

For Eileene Winters of Van Nuys, whose 27-year-old son Andy has been in a vegetative state for 11 years, the right thing remains elusive: “I have walked in the shoes of the Cruzans with every step. And I passionately approve of their right to allow Nancy to die. And I am horrified that people tried to stop them from making that very personal family decision.

“But as much as I believe in the right to die, could I make that final, awful decision for my child? I don’t know if I would have the strength. The Cruzans have helped to open the door of escape for the families of the 10,000 lost souls in America who hover in that twilight zone between life and death. If I found the key to unlock that door, would I ever have the strength to use it? I don’t know.”