- 6 weeks ago
The complex legal and moral issues surrounding the case of Nancy Cruzan, the subject of what would become the Supreme Court's first right to die case.
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00:00Funding for Frontline is provided by this station and other public television stations nationwide,
00:07and by the Corporation for Public Broadcasting.
00:11Tonight on Frontline, a father's agonizing decision to withdraw life support from his child.
00:17There have been times that I've thought, how can you murder your own child?
00:23Nancy Cruzan is irreversibly brain damaged,
00:26and her family wants to disconnect the medical technology which keeps her alive.
00:31If the decision's wrong, if we're playing God, then I'll have to live with that, and I'm willing to.
00:42Tonight, let my daughter die.
00:45From the network of public television stations, a presentation of KCTS Seattle, WMET New York, WPBT Miami, WTVS Detroit, and WGBH Boston.
01:07This is Frontline, with Judy Woodruff.
01:14Good evening.
01:16In recent years, in hospital rooms across America, more and more families have faced an agonizing decision.
01:24When is modern medical technology simply too much medicine?
01:30When should their mother or father, husband or wife, son or daughter, simply be allowed to die?
01:37In case after case, from Karen Ann Quinlan to Baby Doe,
01:43human morality, medical ethics, and the law have grappled with the central question.
01:49Who has the right to decide?
01:52The family, the doctor, or the state?
01:56Tonight, we take you to the newest frontier of this dilemma,
02:00with the very personal story of one American family's confrontation with life and death.
02:09Our program was produced by Elizabeth Arledge.
02:12It is called, Let My Daughter Die.
02:19In the southwest corner of Missouri, there's a small town called Mount Vernon.
02:32It's not a place where you'd expect great controversy.
02:36And not a place where a major legal and ethical precedent would seem likely to be set.
02:53But on the fourth floor of the hospital on the hill, life and death decisions are faced each day.
03:13This is called a chronic care ward.
03:15Most of the patients here have severe brain damage.
03:18They need medical technology to keep them alive.
03:21Open your eyes.
03:23Open your eyes, Debbie.
03:25Open your eyes.
03:27In room 425, Debbie Piper.
03:31She's 34.
03:32Her mother, Helen, lives at the hospital with her.
03:35Debbie's brain was damaged when multiple sclerosis paralyzed her breathing.
03:39She has oxygen pumped into her lungs through the blue tube in her throat.
03:43She says she won't never get any better.
03:46That should progress even weaker and weaker all the time.
03:54In room 428, Lodema Moore is 45.
03:58She's been here four years with brain damage from encephalitis and seizures.
04:03Her parents visit four times each week.
04:06But don't think she knows they're here.
04:08I feel that we get very little, if anything, through to her.
04:14It is following out what the doctors has told us.
04:17This is going to be just continuous breaking down of the brain
04:21and losing more of her memory and things of that sort.
04:29Wake up. Wake up.
04:30You're not that sleepy. There you go.
04:33Room 422. Sharon Terry was born with Down syndrome.
04:37She's 31 and was healthy until last year when seizures damaged her brain.
04:43They say that she'll never be any better, but she could outlive us.
04:48Or she could get some kind of an infection and we just take her.
04:53There's very little hope for improvement in any of the brain-damaged patients here.
04:58So their relatives can only wait for the end.
05:06In room 430, the Cruzan family.
05:09Joe Cruzan is a construction worker.
05:12His wife, Joyce, is a secretary for the local school system.
05:17Their daughter, Nancy, was in a car accident five years ago.
05:21Every week they drive 90 miles to visit her.
05:29You're just going to sleep right through all of this, aren't you?
05:33Today we have a film on stress management.
05:39Once a month, there's a support group meeting for relatives of the patients on the fourth floor.
05:44On this Saturday in July, they'd come together to talk about living with a loved one on life support.
05:52I know the stress that you have in your lives is tremendous, all of you.
05:57This film is more on meeting the everyday stresses of life.
06:01But those we all have, whether or not we have an added burden to bear.
06:05Today was supposed to be a routine meeting.
06:13There had been cookies, lemonade, and a film on how to cope with stress.
06:18No one was expecting the announcement Joe Cruzan was about to make.
06:30Do you think I'd be out of place if I touched a little bit on our...
06:36Not at all. That's what this period is for.
06:39I'm here to support it.
06:40Well, probably most of you know that or have heard that...
06:45That...
06:58We have...
07:02Well, I didn't think this would happen this way.
07:07Joyce and I have begun a procedure to...
07:11To have the life support for Nancy withdrawn.
07:17We've asked the hospital to do it and they are not...
07:21Able to without some kind of a...
07:25A court order, which we understand.
07:28So, what we're going to have to do is go through a legal procedure to get...
07:34Uh...
07:35Permission to withdraw the life support, which in Nancy's case is...
07:40Hydration and nutrition.
07:42Rather than...
07:44A respirator.
07:45A respirator.
07:46As far as being able to give you a reason why we...
07:58Why we're doing this, I...
08:00The only thing I could say that...
08:02Is...
08:03Is...
08:04If you knew...
08:06Uh...
08:08Nancy the way we did...
08:13I'm sure it wasn't this way...
08:16That...
08:17You would understand why...
08:19We feel like...
08:21We are doing what she would have us to do.
08:24The events which led to the Kruzan's decision began the night after Nancy's accident.
08:48Joe got a copy of the police report and came to the accident site...
08:52To try to figure out what had happened to his daughter.
09:05Well...
09:09She, uh...
09:14Was going east.
09:15And she went off on this side of the road about 300 feet down from that mailbox.
09:24Joe brought us here.
09:26It was the first time he'd been back in four and a half years.
09:29No one knows for sure how the accident happened.
09:32The best guess is that Nancy might have fallen asleep at the wheel.
09:36It was a January night and the roads were icy.
09:38Her car swerved across the road and flipped over several times.
09:42It was an old car with no seat belts.
09:45And Nancy was thrown out face down into the snow.
09:48I imagine the car came to rest right about in...
09:53Oh...
09:55Along in here.
09:57It was upside down.
09:58It was on this side of the lane.
10:02And, uh...
10:04Nancy was lying face down on the other side about...
10:09Well, just on the other side of the lane and about 20 feet down from the car that way.
10:15They said it was approximately 35 feet from the car.
10:18Probably lying there just about where the lane curves.
10:21I would like to have been here that night.
10:28I would like to have known what happened.
10:30I've gone through this in my mind thousands of times trying to picture when she came out of the car.
10:36And I don't know why.
10:38But just...
10:40Of course, I know why I'd like to have been here that night.
10:43I would have stopped it.
10:45But, uh...
10:47Trying to visualize what happened.
10:48About four and a half years, kind of...
11:07I'm ready to leave, though.
11:18Nancy was Joe and Joyce's second child.
11:30She was born and raised in the same little town, Carterville, Missouri, where Joe had grown up.
11:36Her family remembers her as a special kid from the very beginning.
11:40Almost everything the kid did was funny.
11:42She was, uh...
11:45Kind of impish.
11:46And everybody teased her a lot because she egged it on.
11:50She had a lot of friends.
11:51She got along well with her peers.
11:53Um...
11:54She never saw a stranger.
11:56She was...
11:58Uh...
11:59A lot more outgoing than...
12:01Than I ever was or than the other kids ever were.
12:04Nancy was, uh...
12:07Um...
12:08Kind of a cut-up.
12:10And...
12:11The wit in the family, actually.
12:13Sometimes I think she worked to embarrass me.
12:16That was her main goal in life when we were younger.
12:19Was to...
12:21To give me a hard time.
12:23She was a twirler.
12:25She was, uh...
12:27In her junior year in high school, she was co-captain.
12:29And I was...
12:31We'd go to parades everywhere and I'd take pictures of her.
12:35And I'm kind of emotional in particular with music.
12:39Marching band music.
12:41And my...
12:43You know, my eyes would fill up.
12:44I couldn't hardly see through the camera.
12:47And she had fun.
12:49She...
12:51And I think she enjoyed life as much as anybody I ever have been around.
12:56They all say she was the center of the family.
12:59Especially close to her sister Christy.
13:02And Christy's two daughters, Miranda and Angie.
13:05She was ornery and she was funny to be around.
13:08And she was a good aunt.
13:10She's just the greatest aunt anybody could ever have in the whole world.
13:15And she's funny.
13:17She'll let you do anything, but to where you won't get hurt.
13:19One of the stories the family still tells about Nancy and what she meant to the two kids is the day they all got together to paint the ceiling in Joe and Joyce's living room.
13:31My dad had some scaffolding up in the middle of the living room to make it easier for us.
13:36I was on the girls continuously to stay out of the way, don't get in the way, we're trying to paint.
13:42And, of course, Nancy was on me to leave them alone.
13:47They were not hurting anything.
13:49Well, they all decided to send me up to the Dairy Queen to get lunch for us.
13:53And while I was gone, Nancy got them up on the scaffolding.
13:57And Miranda turned to Nancy and told her that she was the best aunt in the world.
14:02In fact, she was better than Jesus Christ.
14:04She was a second mother to them.
14:07We had talked that if anything ever happened to me that I would want Nancy to take them and raise them.
14:15Because she would raise them the way that I would and love them as much as I did.
14:23This picture was taken Sunday, January 9th, 1983.
14:27It was the last time anyone in the family would ever speak to Nancy.
14:31Two days before her accident in the early morning hours of January 11th.
14:37It was, uh, 2.25 on a Tuesday morning.
14:42I, uh, I'd been divorced since October of the previous year.
14:49And I didn't sleep very well at nights and a lot of times I would sleep on the sofa.
14:53I would go to sleep watching television or whatever.
14:58And the phone rang.
15:00Well, I remember that, um, our mom got us up and we had to go over to our grandma's but nobody would tell us what was going on.
15:08Of course, Christy came over here and brought her girls and took them up to my mother's and we left them there.
15:12And then Joyce and Christy and I went on to, to Freeman Hospital in Joplin.
15:20There was a head injury and that was really all I knew.
15:26Um, I, I, I don't, I just felt like it couldn't be.
15:34There had to be some mistake.
15:36We were in the emergency room area, waiting area right there and, and you could hear the conversation between the hospital and the ambulance.
15:47And one of the things I remember is that the, I heard the guy in the ambulance say that we are, uh, have an ETA of about three minutes and we're running full bore, which was wide open.
16:01And then when they brought Nancy in.
16:04She had no shirt on and she was all bloody and I couldn't see her face very well.
16:13I thought, you know, I thought that's, that's not Nancy.
16:18I knew it couldn't be her because this person on this stretcher was, it was not Nancy until I saw her socks.
16:27And, uh, I thought, I kept waiting for him to bring Nancy and I thought, what's going on here?
16:34And, but it was Nancy.
16:40When medics found her in the field, she had no pulse, respiration or blood pressure.
16:51She was dead.
16:52But medical technology intervened.
16:55They worked on her for 47 minutes in the freezing temperature, got her heart beating and rushed her to this hospital where Joe, Joyce and Christie were waiting.
17:04They put in all kinds of things and did all kinds of x-rays trying to determine what state she was in.
17:13And, um, they had to do some surgery to stop some bleeding.
17:18So much of it is kind of a blur.
17:22Uh, I remember shaking and crying and people wanting to comfort me, my parents.
17:30And I didn't want anybody to touch me.
17:32I wanted to be left alone.
17:35I wanted her there.
17:38And we waited.
17:39She was in surgery quite a while.
17:41And when the nurse finally came out and said she's going to be all right.
17:47When the nurse came out and said that she was going to be all right, I, I turned, I believe, to Joyce and I said, I feel like I can breathe again.
17:56And this was like 5 o'clock in the morning.
18:00But she wasn't all right.
18:02She had stopped breathing for at least 20 minutes before she was brought back.
18:06And the lack of oxygen during that critical time had severely damaged her brain.
18:11For three weeks she was in a deep coma.
18:14Then she opened her eyes.
18:16But her family discovered that the brain damage had left her unable to speak, see, or respond in any way.
18:23She was in a permanent form of coma called persistent vegetative state.
18:28Nancy was 25 when the accident happened.
18:38Now, five years later, it's her 30th birthday.
18:42Well, it's not far now.
18:49Well, it's far away.
18:50Happy birthday.
18:51Hi.
18:52Happy birthday, Steve.
18:53Hi.
18:54She's asleep.
18:55Hi.
18:56Hi.
18:57Hi.
18:58Hi.
18:59Hi.
19:00Hi.
19:01Hi.
19:02Hi.
19:03Hi.
19:04Hi.
19:05Hi.
19:06Hi.
19:07Hi.
19:08Hi.
19:09Hi.
19:10Hi. Happy birthday. Big 3-0. Hi, Nancy. Oh, we have presents. Oh, I've got one Jack made. Is there another little thing that looks like that? Yeah, I don't know.
19:30It might be another one. See what Rand made for you? Big old kitty cat. Oh, and look, he's got a little mouse to kick around. Aren't they neat? Ah, we found birthday cards. You haven't even got to read them yet or anything. That's all right. I'll read them to you.
19:51I have yours, too. Uh-huh. Some pretty dogwood flowers. The loving thoughts that words can't say. Dear Nancy, are always, are being thought of you today. Happy birthday, Grandma Jack and Grandpa Les. Honey, this card says just how we feel. We spent some time this evening just remembering. Love you. Isn't that nice?
20:21Ah-ha. Here's a special one. It's got a little chipmunk and a little bird and pretty flowers to a very special ant. To lovingly tell you, it's certainly true. Ants just don't come any nicer than you. Happy birthday with love. Angie and Randa and lots of X's and O's.
20:51You made out pretty good, huh? I'll get them all hung up on the window so that they'll be there. Everybody will know it's your birthday. Do you want me to hang a big 3-0 up there, too?
21:02For five years, they've hoped for improvement, but they say they've never seen any conscious response from Nancy. Her neurologist, Dr. Hish Mazou, says the damage she sustained will never allow her to recover.
21:16The brain has two parts, like a mushroom. You know, the base is called the stem of the brain, and the mushroom itself is called the cortex of the brain, or the hemispheres.
21:25According to Mazou, Nancy's brain stem still works. It controls involuntary functions, like heartbeat and breathing. But her cortex, which controls conscious thoughts and actions, was severely damaged by oxygen deprivation. Brain cells don't regenerate, so the damage is permanent.
21:43If a brain cell dies, then that's it, you know, it doesn't come back. And I think when you have anoxia or lack of oxygen, once the damage is there, that's it, it doesn't recover. It's permanent, and that's no recovery whatsoever. No matter what you do medically, you can't reverse it.
21:58Nancy's eyes open, but will not track objects across the room. Her body will sometimes jump if she's startled by a noise. She will grimace if she's in pain.
22:10But doctors say there's no way to know if her brain is actually interpreting the noise or the pain. They think her reactions are reflexes. Dr. James Davis takes care of Nancy at the Missouri Rehabilitation Hospital.
22:25I don't know what's going on in her head when I talk to her. They do apparently hear something, but only they could say for certain whether they're understanding what's going on. It's possible that she would feel discomfort, but I don't know the answer to that question. It's possible she might not feel discomfort.
22:51The family tried everything they could think of to wake her up. They played music, talked to her, showed her pictures, all the usual stimuli for coma patients.
23:01And we would sit sometimes and hold hands and touch her and will strength to her body from ours. I mean, it just had to work because, you know, it just couldn't be this way.
23:14And frankly, I mean, we begged her, pleaded, you know, tried to bribe her, this kind of thing, you know, we'll do anything, anything. Just, you know, just respond. Just, you've got to. We need you. You can't do this.
23:32Trade places. Right. I begged her. I told her I would give her my car. I would do anything if she would just come back because I needed her so. But it was never to be.
23:47It was Nancy's two nieces, Miranda and Angie, who held on to hope the longest. They were six and seven at the time of the accident, 12 and 13 now.
23:59I think it was just a couple of years ago that we really realized that Nancy wasn't going to get any better and that she wasn't, I mean, that this had happened and, you know, all the stuff wasn't, I mean, it wasn't going to get any better.
24:13What's it like when you go visit her, when you go to the hospital and see her?
24:17It's hard, but I remember one time.
24:22It is an experience that nobody wants to know.
24:46It's like you don't, you don't want your mother to die.
24:54You think, oh, that'll never happen and it won't happen until it does.
24:58Dude, that's just nature, I guess.
25:01I guess she was so good, God wanted her early.
25:16The pain of Nancy's situation affected the entire family.
25:23Christy had serious health problems.
25:25Joe and Joyce felt the strain on their marriage.
25:28Finally, they went to see a psychologist, Barbara Carter.
25:32The way they describe Nancy, she seems to be kind of the glue between all the family members.
25:40She was the one that made the effort to keep the family members connected to each other.
25:46And after Nancy's accident, they've had a hard time finding their places again.
25:53Anybody want to scream? Grandpa?
25:57I think in a lot of ways, Nancy was a lot like Joe.
26:01And there was a real strong bond there.
26:04And he has a real hard time letting go.
26:07Joe is very much a doer.
26:10And he doesn't know what to do with emotions if you can't do something, if you can't make it better.
26:16I think the helplessness has gotten to Joe more than anything.
26:20Joyce doesn't talk about it as much.
26:23She feels it, but she's not as verbal.
26:26She's not as likely to talk to anybody and everyone about it.
26:31Nancy and Christy seem to be very close.
26:34And when Christy talks about Nancy, you can feel the loss, feel the emptiness there.
26:42She had always turned to Nancy for her support, and Nancy wasn't there anymore.
26:47The Kurzans gave us their consent to talk to Barbara Carter about their difficulties
26:53and about the emotional limbo of having a daughter between life and death.
26:58You go through lots of different grieving processes with this situation.
27:03This isn't one where there's a beginning and an end, where the burial can be the start of stages in that grief.
27:12This is an ongoing process, and they're different.
27:16They go through the entire grief stage maybe once a month, depending on what's going on with Nancy.
27:22But they can never get it done.
27:24You know, they can never go through the stages and go on with the recovery, because Nancy's still here.
27:32Back at the hospital, Nancy's life is unchanged.
27:42I've got a hand in.
27:44I've got a hand in.
27:45I've got a hand in.
27:46I've got a hand in.
27:47What are you having today?
27:49A steak?
27:50I smell like.
27:51Oh, she sure responds to that noise.
27:52Yes, she does.
27:53For the Kurzans to withdraw Nancy's life support, they have to do something most people would never expect.
28:09Nancy does not have a breathing machine or a kidney machine or anything else that takes over a normal body function.
28:18But she can't swallow, so a tube has been surgically implanted in her stomach.
28:23Three times a day, she's fed water and liquid protein through this tube.
28:28Usually, feeding like this is used temporarily on people who will eventually recover their ability to eat.
28:35But in Nancy's case, this tube feeding is the only medical technology which keeps her alive.
28:41These things are so crazy to get on.
28:47Okay.
28:48See, I drained this out and then she doesn't get air in the tube in her stomach.
29:04And then she's ready for her supper.
29:24Nancy could live this way indefinitely.
29:50She's young and relatively healthy.
29:53She could outlive her parents.
29:55So the only thing her family can do to hasten her death is to disconnect the tube feeding.
30:01That means Nancy would die of starvation.
30:05But as shocking as that may seem, they believe it's what Nancy would want.
30:10She has no dignity whatsoever there, and she was a very, very proud, independent person.
30:19And you would see what was left there, and you wondered why.
30:24Why?
30:25What's the purpose in this?
30:27I don't remember the first time it was brought up or brought up with Christy,
30:32but I remember Christy saying, I know exactly.
30:35If we could call Nancy up and ask her, I know what she'd say.
30:40And there's no doubt in my mind that if someone could bring her back and say,
30:46Nancy, do you want to continue this way or not?
30:54She would say, look, I realize it's hard on everyone else, but let me go.
31:03I've got other things to do.
31:05I've got other places to go.
31:08So turn me loose.
31:18The day after the Kruzans announced their decision, Joe came to visit Nancy.
31:27You know, I'll talk to you soon about this life support.
31:32It's supposed to go to Kansas City Wednesday and meet with an attorney up there,
31:43so maybe we can get something started on it.
31:47I don't know whether you know what I'm talking about or not.
32:03If you do, I don't want you to be scared.
32:15I don't want you to be scared.
32:16You know, I don't want you to be scared.
32:17You know, I don't want you to be scared.
32:18It's not that long.
32:19We'll be here with you all.
32:21Well, I'm hanging with you.
32:22uh
32:38this is
32:52Four days later, Joe and Joyce come to Kansas City to meet with a lawyer.
33:22They can't afford one on their own, so they've been referred by the American Civil Liberties Union to a firm which will assign a lawyer to argue their case for free.
33:38Joe? Yes, Bill Colby. Good to meet you.
33:41Nice to meet you. Come on in.
33:45Bill Colby is a lawyer with the prestigious firm of Shook, Hardy, and Bacon. He's never had a case like this before.
33:52But Joe and Joyce will now place Nancy's fate in his hands.
33:58What I thought we'd do this morning, other than just get acquainted, was just to get a little bit of a factual background.
34:06I guess maybe a good first place to start. It's not really the beginning, but if you could tell me a little bit about Nancy's current medical condition.
34:17They go over the facts and the law.
34:21In 1976, the Karen Ann Quinlan case was the first time life support was allowed to be withdrawn.
34:27But the issue then was a respirator.
34:30Stopping tube feeding is just now being argued in courtrooms across the country,
34:35and only a handful of cases have been brought.
34:39But in Missouri, there's a state law which specifically forbids stopping feeding under any circumstances.
34:45So the Kruzan case will be a test to try to overturn that law.
34:50Colby says the precedents in other states are all in favor of removing feeding tubes from people like Nancy.
34:56Every court in the country that has addressed this issue has concluded that they have either a constitutional right to privacy,
35:07a common law right to be free from bodily invasion, or both,
35:12that would allow them to have that tube removed and allow them to die with dignity.
35:18It's only because medical science has advanced far enough to keep them alive,
35:24but not far enough to give them any kind of life that they're caught in this situation.
35:28Our long constitutional history says you can't do that.
35:34You've got to let a person be free of that kind of bodily invasion if they want to be.
35:42But in the state capitol, officials are strongly opposed to Colby's argument.
35:48The attorney general says it's simply a matter of the law
35:51and that the state of Missouri draws the line at starvation.
35:55There is a distinction between nutrition and hydration and a more active type of life support.
36:03This is the distinction, for instance, between a respirator,
36:07which is frequently referred to as an artificial or active type of life support,
36:13and nutrition and hydration,
36:16which apparently the legislature has deemed to be that minimum basic nourishment
36:21which is going to be provided in this state.
36:25We believe the legislature has spoken
36:27and that the public policy that they have articulated
36:30is one which would not allow this family to do what they're seeking to do.
36:34The Kruzan's decision was not a matter of money.
36:47The state of Missouri pays for Nancy's care.
36:51It costs about $130,000 a year to keep her alive.
36:55Once a day, nurses move her from her bed to a chair and back.
37:09This keeps her lungs from filling up with fluid.
37:11Her arms and legs are permanently contracted from the brain damage
37:24and can't be straightened.
37:25See if she's here on this side.
37:26Get a nice thing.
37:34Oohh.
37:40Chin up.
37:41I'll go pay that.
37:47You got it?
37:48Mm-hmm.
37:55The last scan of her brain showed she's becoming increasingly hydrocephalic as more brain cells die and are replaced by water.
38:07Miracle recoveries in patients who've been like Nancy for more than a couple of years are unknown.
38:13But as long as she's cared for and fed, doctors say she could live till she's 60 or 70 years old.
38:25In October 1987, the Kruzans brought Bill Colby to the hospital.
38:32They wanted him to see Nancy before they started their lawsuit.
38:54How you doing?
38:55You look like you need your hair brushed.
39:03Nancy, we brought a fellow by the name of Bill Colby up with us.
39:08He's the one that's going to represent us in this thing that we've talked about.
39:15And Nancy?
39:19I don't think she's real impressed.
39:22Is this how she appears each time you come?
39:25Yeah, this is it.
39:33Does her faceful expression ever change?
39:37You know, not unless there's pain or something like that.
39:42She's gained some weight.
39:51That's what Christy said.
39:53They give her a real high protein, vitamin, you know.
39:59It helps to keep their skin from breaking down.
40:01Is it possible to see the tube without...
40:08Is it possible to see the tube without...
40:10Is it possible to see the tube without...
40:11Yeah.
40:12It's...
40:13It's...
40:13It's...
40:13It's a...
40:13Okay.
40:14It's a...
40:14It's a...
40:18It's a...
40:20It's a...
40:20It's a...
40:21I appreciate you taking the time.
40:37I know it's taking you some time to come up here and back.
40:40And...
40:40But it was important to us.
40:43I'm glad to do it.
40:45It certainly helps me understand better the position that you're in.
40:54The choices you have to make.
40:55Take care.
41:03See you.
41:04Okay.
41:07I...
41:08I'd never seen a person in a persistent vegetative state before.
41:14I knew from talking with Joe and Joyce that she wasn't in a completely still closed-eyed,
41:25comatose state, and that she had certain reflexive brainstem functions.
41:32That in the abstract, thinking of it medically is one thing.
41:35To...
41:35To...
41:35To walk in and see her with...
41:38With eyes open, her eyes blinking, it just made me realize more what a difficult, difficult
41:51thing it is for the Cruzeans to be going through this, and for all the people with family members
42:01in a persistent vegetative state.
42:02There are an estimated 10,000 Americans like Nancy.
42:11Only five have died after courts have allowed their feeding tubes to be disconnected.
42:18Death by starvation and dehydration can take anywhere from three to 15 days.
42:24Doctors don't know if Nancy would suffer.
42:35But unlike Karen Ann Quinlan, who lived nine years after her respirator was disconnected,
42:40there is no possibility that Nancy will live without the tube feedings.
42:45There have been times that, you know, I've thought, how can you murder your own child?
43:07Our decision was based on what we felt like that Nancy would want,
43:12and that's all we have to justify, that if the decision's wrong, if we're playing God,
43:22then I'll have to live with that, and I'm willing to.
43:33As the Cruzeans' decision became known, the hospital staff began to debate the ethics of death by starvation.
43:40It was the first time they'd ever faced the issue.
43:44Donald Lampkins is the hospital administrator.
43:47We know that we can unplug a machine that's been talked about in so many places.
43:53TV shows have shown that.
43:55That is nearly so hard for us to accept.
43:58But the fact that we starve somebody to death, we don't do that.
44:02That's beyond our ability to think, even at this point in Missouri.
44:06They're pushing for something that many people, and I think people even around them here today,
44:13are telling them, no, you can't do that, because we haven't faced that situation.
44:18Nobody has been willing to make that decision in a case like Nancy's.
44:24There are hard decisions about life support faced on this hall every day.
44:34Debbie Piper, for instance, does get life-sustaining oxygen.
44:38But when she stopped breathing completely and was put on a respirator,
44:42her mother Helen fought to unhook the machine, even though doctors said Debbie would die.
44:47But Debbie did start breathing on her own.
44:51And Helen says now she'll never let a machine breathe for her daughter again.
44:56I have it wrote up that she will not ever go back on a respirator,
45:01because something should go wrong.
45:03She's going to be strictly in the hands of God,
45:06and he's either going to heal her or he's going to take her home.
45:09But there'll be no more respirators for Debbie.
45:11Mr. and Mrs. Moore also faced the question of a respirator for Lodema.
45:23When she had the seizure,
45:26they wanted to know if we wanted to be put on the machine.
45:30And at first, I said, no, I didn't believe so,
45:35because I didn't feel like she'd want to live.
45:39She would look as a vegetable, more or less.
45:45But my husband couldn't feel the same way,
45:48so they did put her on the machine.
45:51I didn't accept it quite as readily as my wife.
45:55I wanted to be sure,
45:59and I felt like I couldn't live with it quite that soon.
46:03So I wanted to pursue every avenue,
46:08and we did.
46:11We told them that we didn't want to put her on a thing
46:13just to keep her alive,
46:15just make a live organism or such out of her.
46:19But as long as it's hope,
46:22if we want, you know, medication and stuff like that,
46:26we definitely don't want none of that taken away from us.
46:28Do you have hope that she might get better somehow, someday?
46:33Well, not too strong a hope
46:35that she'll ever be a lot better, no.
46:40It's not too hard to come visit her
46:41and see her like this.
46:43But despite the pain of seeing their children like this,
47:03none of these parents has made the same decision
47:05as the Prezans.
47:07I wouldn't want to hold back food or liquids.
47:12Never.
47:13I want to come out of this without a guilt complex.
47:18And I think I can do everything.
47:19I think nature will take care of that.
47:21Time will take care of it.
47:22We'll just keep the course.
47:25I couldn't do that
47:26because every time I'd think of sitting down to a meal,
47:31I'd think of my daughter laying up there
47:33not having anything to eat, you know,
47:35and that would bother me.
47:37You know, it would bother me a lot.
47:39When you take one's life,
47:40you can't give it back.
47:41You can't keep it.
47:42God-given.
47:47I'd be afraid of how I might feel later in later years.
47:52Would you regret it?
47:53You don't know, but I would hate to have that hanging over my head
47:58when there could be nothing I could do about it.
48:00I think the good Lord put her here,
48:04and we ought to take care of her.
48:13Nancy, let's turn you over.
48:16Many of the doctors and nurses
48:17are also likely to disagree with the Kruzans.
48:20Most did not want to speak on camera,
48:23but hospital administrator Don Lampkins says he's already heard objections.
48:28The first reaction, I think, will be,
48:31no, I don't want any part of it.
48:33We don't understand the feelings that the people who have been trained all their lives
48:40to keep somebody alive all at once take away the ability to live.
48:46In effect, we're saying you're killing people instead of keeping them alive.
48:53Some nurses, some doctors, I think, won't be able to do that.
48:56And I think we'll, if this were to become widespread,
49:01I think we would see doctors and nurses at various places willing to give up their jobs
49:07rather than to comply with the order.
49:10And for some, like Dr. Davis, it's more than a professional decision.
49:16I've lost a child myself,
49:19and the child suffered irreversible brain damage.
49:26And I knew at the time that the child was probably terminal.
49:32But to come out and say, let's not do anything,
49:39I don't believe I could have done that.
49:43The Kruzan's know that many of the people on this hall
49:46do not agree with their decision.
49:49But now they have to enter the legal arena
49:51and try to convince a judge to let their daughter die.
49:55January 20th, 1988,
50:02the night before the Kruzan's first scheduled legal appearance,
50:06Bill Colby has come down from Kansas City to prepare them for depositions.
50:11One way to think about what we're going to do tomorrow
50:14is that with the state's attorney coming in,
50:16they're kind of the people that are trying to stop or oppose what we're trying to do.
50:21This is our first chance to have you guys meet the person from the state
50:27who's going to be in charge of this.
50:29They've already filled out over 20 pages of written questions
50:33from the attorney general's office.
50:35Christy is especially nervous
50:37because one issue the state is focused on
50:39is two conversations she says she and Nancy had
50:43about whether they would want extraordinary life support.
50:46I'm sure he's going to ask you more about it.
50:49How many times did you talk?
50:51Where were you when you talked?
50:53What exactly did she say to you?
50:56How long did you talk for?
50:57What exactly do you remember about it?
51:01I mean, it'll be a chance to tell your story to some state official.
51:04Yeah, but isn't it somebody who's got preconceived ideas
51:07and who really isn't going to listen
51:10and maybe only listen to try to trip us up and screw it up?
51:13Well, I don't think so.
51:15And I think it's a chance to really make a good impression on him.
51:22They rehearsed and talked for three hours.
51:26The next day, in a small law office in Carthage, Missouri,
51:30the Kruzans were ready to meet their opposition.
51:35Christy hadn't slept all night.
51:36Joe got up at 1.30 in the morning to prepare notes.
51:46Just before they started,
51:48Colby and the Kruzans' family lawyer, Walt Williams,
51:51gave some last instructions.
51:53Kind of remember the theme we talked about last night,
51:56which is this is what Nancy would want to do
52:00and this is why we know she would want to do it.
52:03And that's kind of what we're aiming to get across to him.
52:08You guys are ready to go.
52:10Let's just, let's do it.
52:25Chris, this is Dave Moten.
52:28He's with Thad's office.
52:29He met Mel, her husband, the Kruzans.
52:33Robert Presson is the assistant attorney general
52:35who will argue against the Kruzans.
52:38Five other lawyers were also present.
52:42Raise your right hand, please.
52:43Do you solemnly swear that your testimony in this cause
52:45is to be the truth, the whole truth,
52:46and nothing but the truth, so help you God.
52:49Five of the six lawyers
52:50and everyone on the Kruzans' side of the case
52:53had consented to front-line filming the depositions,
52:56but the attorney general's office said cameras could not be present.
53:03So for five and a half hours,
53:05the Kruzans answered questions
53:06and the state investigated the implications
53:09of this landmark case.
53:11The bottom line is
53:13she is certainly alive now.
53:16We have a legal definition of death
53:18in the state of Missouri,
53:19and she does not meet any of those.
53:21On the other hand,
53:22the relief they have asked for in their petition
53:24would certainly lead to her death.
53:27And I think that in, you know,
53:29the simplest terms
53:30are the two major factors in the case,
53:32that she is alive now,
53:33and what they are asking for
53:35would lead to her death.
53:36The depositions were the first time
53:39the Kruzans had to publicly defend their decision.
53:44It was a long and emotional day.
53:48But, yeah, that went perfectly.
53:51It was also the beginning
53:53of a new chapter of their story.
53:55They'd be focusing more and more
53:56on lawyers and courts.
53:58That's where the decisions about Nancy
54:00would be made from now on.
54:02The courts, you know,
54:04they can postpone as much as they want.
54:08They can appeal, the attorneys, whatever.
54:12It's kind of a game,
54:13and yet you have to play the game.
54:15And it's, even though we don't like it,
54:20because we did love her
54:22and know how she felt,
54:26that's why we have to go through this.
54:28She'd do it for us in a heartbeat.
54:32Later that same night,
54:36Joe and Joyce came to the hospital
54:38for their weekly visit.
54:49A three-day trial is scheduled
54:55in a couple of months.
54:57If the Kruzans lose,
54:58they will appeal.
54:59If the state loses,
55:01there will also be an appeal.
55:03It will probably go all the way
55:04to the state Supreme Court.
55:06Nancy.
55:09Nancy.
55:11Look here.
55:12Look at me.
55:17Nancy.
55:20Well, we had quite a day today, Nancy.
55:23Nancy.
55:23Nancy.
55:23Nancy.
55:29We spent a day with the lawyers,
55:34taking depositions,
55:39and experienced.
55:43Proud of Christy.
55:43A final decision could take
55:55as long as three more years.
56:02My baby.
56:03The Kruzans trial begins next week
56:29in Carthage, Missouri.
56:32I'm Judy Woodruff.
56:33Good night.
56:34The Kruzans trial begins next week.
56:36The Kruzans trial begins next week.
56:36The Kruzans trial begins next week.
56:37The Kruzans trial begins next week.
56:38The Kruzans trial begins next week.
56:39The Kruzans trial begins next week.
56:40The Kruzans trial begins next week.
56:41The Kruzans trial begins next week.
56:42The Kruzans trial begins next week.
56:43The Kruzans trial begins next week.
56:44The Kruzans trial begins next week.
56:45The Kruzans trial begins next week.
56:46The Kruzans trial begins next week.
56:47The Kruzans trial begins next week.
56:48The Kruzans trial begins next week.
56:49The Kruzans trial begins next week.
56:50The Kruzans trial begins next week.
56:51The Kruzans trial begins next week.
56:52¶¶
57:22Frontline is produced for the Documentary Consortium by WGBH Boston, which is solely responsible for its content.
57:34Funding for Frontline was provided by this station and other public television stations nationwide, and by the Corporation for Public Broadcasting.
57:43Educational organizations may inquire about videocassettes by calling 1-800-424-7963.
58:01For a transcript of this program, please send $4 to Frontline, Box 322, Boston, Massachusetts, 02134.
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