Cruzans appealed to the United States Supreme Court. But the Supreme Court affirmed the lower ruling, finding the evidentiary standard constitutional, ruling that such a strict standard was properly in keeping with the state’s obligation to protect the lives of its citizens. Since no clear and convincing evidence had been offered at trial that removing food and fluids was what Nancy would have wanted—as opposed to what her parents wanted for her—Missouri could properly require her life support to continue.
What at first appeared a resounding victory for those who opposed Nancy’s dehydration soon turned to ashes. First, it became clear that the Supreme Court, by implication, had agreed that tube-supplied food and water was a medical treatment that could be withdrawn. The Cruzans went back to court in front of the same trial judge who had originally ordered Nancy dehydrated. This time there was testimony from two of Nancy’s former coworkers of a few vague conversations with Nancy that she would not want to live in a coma. Nancy’s exact words could not be described, and whether she made the statement or simply agreed with someone else’s opinion could not be proven. But that sparse testimony was all the judge needed to rationalize doing what he had wanted to do all along. Once again, he ordered Nancy dehydrated. This time Missouri did not appeal the decision and none of the many opponents of Nancy’s killing had legal standing to enter the case. Nancy Cruzan died on December 26, 1990, twelve days after the removal of her feeding tube.
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