Dr. Ronald E. Cranford, 65, a neurologist and brain injury expert died on Wednesday in Minneapolis. He had helped to establish clearer standards to determine whether a patient was in a deep coma or a vegetative state.
According to his family the cause of death was complications of kidney cancer.
Dr. Cranford had long been an advocate for the right of terminally ill patients to end their lives. He was a bioethicist interested in the moral quandaries brought about by advances in medical technology.
He was especially well known because of his participation in some of the most contentious brain-injury cases including that of Terri Schiavo. As a professor of neurology at the University of Minnesota he had examined Ms. Schiavo and her brain scan in 2002, before her case hit headlines because of the debate over the extent of her brain injuries as well as her husband's request to withdraw life support.
After reviewing Ms. Schiavo's brain scan Dr Cranford had concluded that she was in a permanent vegetative state the condition in which the patient's eyes would remain open, without any evidence of awareness of self others or the surrounding environment, and yet having sleep-wake cycles. and was unlikely to recover.
Dr. Joseph J. Fins, a professor of medicine and the chief of the division of medical ethics at Cornell cited Dr. Cranford's contribution in preparing a more accurate description of comas and the vegetative state,
In 1994, the description, 'Medical Aspects of the Persistent Vegetative State,' was published in two parts in The New England Journal of Medicine and became 'the definitive statement in the field,' Dr. Fins said.
Dr. Cranford played a vital role in the case of Nancy Cruzan, who was injured in an automobile accident in 1983 that had resulted in her being left in a coma.
According to Arthur L. Caplan, chairman of the department of medical ethics at the University of Pennsylvania, 'When families locked horns with hospitals, he squared off with state and federal officials for their rights. He was a defender of free choice and families' wishes, but thought it was pointless and futile ó and not a good use of society's resources ó to sustain a person who would not recover.'
In the 1980's, Dr. Cranford had lobbied for the formation of ethics committees within hospitals to consider questions raised by ever more effective life-support systems. Once considered to be unusual, ethics committees have since become commonplace in hospitals nationwide.
'Right now,' he told The New York Times in 1984, 'we are beginning to realize that our wonderful medical advances enable us to prolong the dying process. The first question is, Should we? And then come all the others: Who lives? Who dies? How do you decide? When do you decide? Who decides?'
Ronald Eugene Cranford hailed from Peoria, Ill. He earned his medical degree from the University of Illinois and as assistant professor of neurology at Minnesota in 1971.
From 1987 to 1988, he was president of the American Society of Law, Medicine and Ethics. He was a former president of the Minnesota Society of Neurological Sciences.
Dr. Cranford is survived by his wife of 19 years, Candy as well as his two daughters, Kristin Cranford of Long Beach, Calif., and Robyn Moder of Beverly Hills, Calif.; a son, Craig Losure of Glencoe, Minn.; a brother, Tom Cranford of Peoria; and two grandchildren.