More and more often, families are faced with the difficult choice of extending a loved one’s life only through the prolonged use of medical technology. Having that choice has not always been the case.
Throughout much of recorded history, there was no such thing as statutes defining death.
“Technology changed all of that,” said William Colby, a noted lawyer who serves as general counsel for Truman Medical Centers.
Before joining TMC in 2009, Colby served as the family attorney in what became the high profile, right-to-die case of Nancy Cruzan, a rural Missouri woman with no brain function following an automobile accident. Cruzan was kept alive for a number of years by feeding tube.
Speaking at the UMKC School of Medicine Dean’s Visiting Professor Series, Colby talked about the nearly three-year battle the Cruzan family eventually waged to have the feeding tube removed. He shared his involvement in the first “right to die” case to reach the United States Supreme Court and the predicament families and physicians more often face today.
“A case that started ordinarily didn’t end ordinarily,” he said.
Instead, the Cruzan case prompted the passage of numerous state and federal laws on death and dying. More important, Colby said, it prompted discussions on a difficult topic for not only physicians and lawmakers, but also for families throughout society.
In many ways, discussions among family members and between families and doctors about the use of medical technology, such as feeding tubes, to prolong life are just beginning. “It wasn’t long ago in our culture that we didn’t ask any of these questions,” Colby said.
After graduating from law school, Colby served as a senior fellow with the National Hospice and Palliative Care Organization in Washington, D.C. In 1985, he joined a large law office in Kansas City, where within a few years he became the attorney for the Cruzan family.
Following that case, he wrote the book, Long Goodbye: The Deaths of Nancy Cruzan. Another of his books, Unplugged, Reclaiming our right to die in America, won the American Medical Writers Association Book of the Year Award, and was recognized among the Best Consumer Health Books by the Library Journal. It also received the Independent Publishers Gold Medal for books on aging.
Colby said three factors are working together today to prompt more discussions on death and dying: an aging baby boomer society, swiftly advancing medical technology and overwhelming costs to provide care.
Many laws regarding power of attorney and advance health care directives have been enacted since the Cruzan case. However, laws can only offer a limited amount of guidance for families of patients dealing with end-of-life issues, said Colby.
“Decision making should not be driven by law, but by what’s best for the patient.”