ROANOKE TIMES

                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: MONDAY, June 25, 1990                   TAG: 9006250250
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A/1   EDITION: EVENING 
SOURCE: Associated Press
DATELINE: WASHINGTON                                LENGTH: Medium


REMOVAL OF LIFE SUPPORT BARRED

The Supreme Court, in its first ruling in a "right-to-die" case, said today states may bar the removal of life-sustaining treatment from patients in irreversible coma-like conditions.

By a 5-4 vote, the justices blocked the parents of a permanently unconscious Missouri woman, Nancy Cruzan, from ordering the removal of tubes that provide her with food and water.

The court said Cruzan's rights were not violated by allowing the state's interest in preserving life to outweigh her parents' wishes.

But the court, indirectly supporting so-called "living will" laws, said the Constitution guarantees a competent person a right to refuse medical treatment. That issue was not presented squarely in the Cruzan case since she is incompetent to decide her future, the court said.

The parents, Joe and Joyce Cruzan, left a message on the answering machine at their Cartersville, Mo., home that the family will have no reaction until they have had time to analyze the ruling.

But Dick Kurtenbach, who has worked with the Cruzans as head of the Kansas City, Mo., office of the American Civil Liberties Union, commented:

"When we looked at it realistically, and with the recent history of the court, this is not that surprising.

"I'm sure the family is going to be extremely disappointed."

Doctors have said Cruzan, 32, could live for 30 more years in her current "persistent vegetative" condition.

Chief Justice William Rehnquist, writing for the court, said Missouri may require "clear and convincing" proof that Cruzan wants to die before allowing the withdrawal of life-sustaining treatment. Such evidence is lacking in her case, he said.

The chief justice also said that "not all incompetent patients will have loved ones available to serve as surrogate decision makers. A state is entitled to guard against potential abuses in such situations."

"In sum, we conclude that a state may apply a clear and convincing evidence standard in proceedings where a guardian seeks to discontinue nutrition and hydration of a person diagnosed to be in a persistent vegetative state," Rehnquist said.

He was joined by Justices Byron White, Sandra Day O'Connor, Antonin Scalia and Anthony Kennedy.

Dissenting were Justices William Brennan, Thurgood Marshall, Harry Blackmun and John Paul Stevens.

Brennan, in an opinion joined by Marshall and Blackmun, said, "Nancy Cruzan is entitled to choose to die with dignity."

Missouri and the Supreme Court "have displaced Nancy's own assessment of the processes associated with dying," Brennan said.

"They have discarded evidence of her will, ignored her values, and deprived her of the right to a decision as closely approximating her own choice as humanly possible."

But Brennan said he is heartened that the court tentatively concluded that in some cases a competent person must be allowed to choose death.



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