Nancy Beth Cruzan: In No Voice At All To speak of death is difficult. To listen may be harder still. "I wouldn't want to live like that." The sentiment too often prompts denial, tension, and flight. Even physicians, duty-bound to speak and hear of this, will often run. Nancy Beth Cruzan did speak of death. She indicated she would not want to continue her life if she could not live "halfway normally." [1] Several times she said that if faced with life as a "vegetable," she would not want to live. [2] She also said, among other things, that "death is sometimes not the worst situation you can be in' when compared to being 'sent to the point of death and then stabilized' without hope of `ever really getting better.'" [3] Now, as Cruzan v. Harmon goes to the United States Supreme Court, the question is whether any will hear her, will honor instead of ignore the words she uttered. So far, in the highest court of Missouri, her words have fallen on deaf ears. She clearly is not living "halfway normally," yet that court has condemned her to years of constant, invasive treatment. The voice of Nancy Cruzan has been entirely lost. [4] Lost, too, are the protection and knowledge that her family can bring to bear. Nancy's parents, her legal guardians, claim that her prior statements and everything they know of her leave them convinced she would not want continued life-support. But the Missouri Court has rejected family decisionmaking, preferring to leave the physicians and health care institution free to inflict unwanted invasive treatment. Finally, the Missouri court has stripped Nancy not only of her voice and relationships, but also specifically of her body. What is immediately at issue in this case is how Nancy's body will be touched, handled, invaded. There is no neutral, "safe" decision; she either sustains bodily invasion and years in a vegetative state, or she does not. Yet the limits Nancy herself indicated on when she would wish to be touched and the limits her family discerns have been entirely disregarded. Will the Supreme Court command Missouri to hear the voice of this woman, honor her relationships, and allow Nancy and her family to order unwelcome intruders out of her body? In framing the problem this way, I focus not on the doctrinal reasons; many briefs and articles already do that I take a different tack here, arguing that the world offered by Cruzan is a world in which those hovering on the edge of life would be rendered voiceless and alone, would be stripped of the most fundamental interests. The Missouri decision demands that people speak of dying as if they were lawyers writing contracts, and makes the feelingful confession to loved ones irrelevant. Instead of acknowledging both the way people actually discuss the prospect of death and the reality of their relationships, Cruzan pursues an exceedingly formalistic and abstract rights analysis that would disempower not only Nancy Cruzan, but most of the rest of us as well. The Loss of Voice The opinion the Supreme Court now sits to review ignores Nancy's statements. The Missouri court dismisses them as "unreliable," [5] and instead treats her as someone about whom nothing is known, as a blank slate, voiceless: [W]e choose to err on the side of life, respecting the rights of incompetent persons who may wish to live despite a severely diminished quality of life. [6] The court thus ignores the fact that Nancy Cruzan has opted out of this category. She herself expressed that she would not want to continue her life unless she could live "halfway normally." What would the court demand before it would hear Nancy's voice, and find what she said sufficient guide to her preferences? Here further illumination comes from New York, because Nancy Cruzan, sadly, is not the only woman muted. Mary O'Connor also gave voice to her wishes. [7] Yet when a series of strokes left her severely demented and her daughters sought to block artificial nutrition and hydration in keeping with her wishes, the New York court objected that her statements were too general, that they might have been borne of feeling rather than thought, and that she might have changed her mind. …