Nancy Cruzan in China.

Nancy Cruzan in China Had the Cruzan family been in China when Nancy Cruzan suffered the accident that left her in a persistent vegetative state, and had China done to the Cruzans what Missouri has done to them, outrage would have rung throughout the United States. The commandeering of Nancy Cruzan's living body by the Chinese government would likely have been condemned by the White House, the State Department, and the Attorney General. Nancy's parents, who know and love her better than anyone on earth, would have been seen as her natural protectors, the state as an unpredictable predator. Most Americans would likely have found it easy to see that both her and Nancy's family's rights were being unconscionably violated, and have thanked God that we live in a free country where arbitrary governmental actions are restrained by a Constitution. Yet the post-Reagan Supreme Court's majority seems to believe that while personal constitutional rights exist, the Constitution should not protect them against government restrictions that are related to a legitimate state interest and are not completely "irrational." In the abortion context the struggle between the individual and the state can be misleadingly portrayed as one between the pregnant woman and the fetus. But there can be no mistake in the case of Nancy Cruzan. The choice is between the rights of Nancy Cruzan and her family, and the interests of the state. How did the state prevail? Why are we moving more and more toward a government that sees citizens merely as means to its own ends? Nancy Cruzan in Missouri Nancy Cruzan, like Karen Quinlan before her, is a young woman in a persistent vegetative state whose parents believe that she would not want to continue to live permanently unconscious. Unlike Ms. Quinlan, however, who required both a mechanical ventilator and tube feeding at the time her case was heard in court, Ms. Cruzan requires only the latter. The trial judge granted the Cruzans' petition to have tube feeding discontinued because he believed this is what Nancy wanted. The Supreme Court of Missouri, however, reversed on the grounds that the judge's decision was based only on the preponderance of the evidence (that is, it was more likely than not that Nancy wanted tube feeding discontinued), and not on a higher standard of proof, "clear and convincing" evidence, which the court said would have required Nancy herself to have expressed a specific decision about permanent comas and tube feeding before her accident. The Missouri Supreme Court determined that such evidence was required because Nancy was "not dead" and the state had an "unqualified interest" in her continued life. (1) In the absence of clear and convincing evidence of her own wishes, the state could insist that treatment continue indefinitely. The Cruzans appealed to the U.S. Supreme Court. (2) Before the Supreme Court Chief Justice William Rehnquist wrote the five-to-four majority opinion of the Court, mischaracterizing the case as one involving the "right to die" and the right to "cause death." Without deciding the central right to refuse treatment issue, he said, "for purposes of this case" the Court would "assume that the United States Constitution would grant a competent person a constitutionally protected right to refuse lifesaving hydration and nutrition." This right was implicit in previous Court decisions, based on the liberty interest delineated in the Fourteenth Amendment. The core of the case, however, involved determining what restrictions the state could impose on the exercise of the right to refuse treatment by surrogate decisionmakers acting on behalf of previously competent patients. In the Court's words, the narrow question was "whether the U.S. Constitution forbids a state from requiring clear and convincing evidence of a person's expressed decision while competent to have hydration and nutrition withdrawn in such a way as to cause death. …