Our right to death: how medical breakthroughs challenge easy answers about suicide.

• Author: Sirius, R.U.
• Position: Unplugged: Reclaiming Our Right to Die in America - Book review

Unplugged: Reclaiming Our Right to Die in America, by William H. Colby, New York: AMACOM, 272 pages, $24.95

IF YOU BELIEVE every person should have control of his or her mind and body, it probably seems easy to leap to a quick, smug opinion about "our right to die in America." Of course individuals have a right to die, the standard individualist position goes; the decision to end a terminal illness with the assistance of a physician should be left to the doctor and the patient.

William H. Colby's new book complicates such straightforward conclusions. Unplugged: Reclaiming Our Right to Die in America shows us ethical gray areas that are not easily elided. More important, it reminds us that advances in medical technology have radically altered our relationship to the most familiar Shakespearean question: "To be, or not to be?" Roll over, Aristotle, and tell Ayn Rand the news: There is now a middle ground regarding whether and when a human being still exists. Colby fights his intellectual battles on that middle ground.

Colby is a lawyer who has worked with right to die issues primarily as they relate to the persistent vegetative state, the condition wherein a person's body is kept alive long after consciousness is gone. He has been on both sides of the issue, working with families that did and that did not want feeding tubes removed from their loved ones, always supporting their choices over the choices favored by the state. But as we witnessed last year in the case of Terri Schiavo, trying to decipher choice when the person at issue is brain-dead can lead to a complicated mess. If the individual whose life is at stake cannot make life-and-death decisions, who is best qualified to do so?

In 1956 Paul Zoll, a physician at Beth Israel Hospital in Boston, used an AC defibrillator to shock a stopped heart back to life. That development set in motion a complicated, twisting series of events that has redefined the moment of death for all of us. By 1970 respirators were keeping people breathing, "alive" but unconscious.

That made Karen Ann Quinlan a cause celebre in 1976. The New Jersey woman had been brain-dead for a year but kept breathing, apparently with the help of a respirator. Her parents, who wanted the respirator unplugged, took their case to the New Jersey supreme Court and won. The respirator was unplugged, but Quinlan unexpectedly kept breathing. She remained unconscious but alive for nine more years.

In 1987 the case of Nancy Cruzan gave an eerie new meaning to the phrase legal...