at 420, 424 is not even well supported by that State's own enactments. [Footnote 4/19], Its sanctity is often thought to derive from the impossibility of any such reduction. The Brophy court then stressed that this reflection upon the nature of the State's interest in life was distinguishable from any considerations related to the quality of a particular patient's life, considerations which the court regarded as irrelevant to its inquiry. 275, 290-291, n. 106 (1989) (compiling statutes). It was not without considerable searching of our hearts, souls, and minds, as well as the jurisprudence of this great Land that we have reached our conclusions. In contrast, the proceeding to determine Nancy Cruzan's wishes was neither ex parte nor secret. (9th ed. it is the [better] part of wisdom not to attempt, by any general statement, to cover every possible phase of the subject. Rptr. By contrast, an unbroken stream of cases has authorized procedures for the cessation of treatment of patients in persistent vegetative states. According to the bill Colby, the lawyer of the Cruzan family, Nancy has the right to deny the medical treatment and die; this right is clearly stated in 14th amendment. § 45-690 (Supp.1989); Del.Code Ann., Tit. Respect for these choices has guided our recognition of rights pertaining to bodily integrity. . As this case comes to us, the crucial question -- and the question addressed by the Court -- is not what Nancy Cruzan's interests are, but whether the State must give effect to them. several books. Decisions prior to the incorporation of the Fourth Amendment into the Fourteenth Amendment analyzed searches and seizures involving the body under the Due Process Clause and were thought to implicate substantial liberty interests. http://www.myJLI.comLife in the Balance: Jewish Perspectives on Everyday Medical DilemmasA New Six Week Course by the Rohr Jewish Learning Institute. ", "Second, in all persistent vegetative state patients studied to date, post-mortem examination reveals overwhelming bilateral damage to the cerebral hemispheres to a degree incompatible with consciousness. The vehicle overturned, and Cruzan was discovered lying face down in a ditch without detectable respiratory or cardiac function. That it is the government that has picked up the shield should be of no moment. See 760 S.W.2d at 424-425. Instead, it found such a right "adequately, supported" by the informed consent doctrine. ", Tune v. Walter Reed Army Medical Hospital, 602 F. Supp. The Court would make an exception here. . The employees refused to honor the request without court approval. Nancy Cruzan was a 25-year-old southwest Missouri woman who was thrown from her car in 1983 when it flipped over. It may legitimately seek to safeguard the personal element of an individual's choice between life and death. In this case, only the state's interest in the preservation of life is implicated. Ann. It is against this background of decisional law, and the constitutional tradition which it illuminates, that the right to be free from unwanted life-sustaining medical treatment must be understood. Washington v. Harper, 494 U. S. 210, 494 U. S. 221-222 (1990). at 535. See Snyder, Cranford, Rubens, Bundlic, & Rockswold, Delayed Recovery from Postanoxic Persistent Vegetative State, 14 Annals Neurol. Nor does it prevent States from developing other approaches for protecting an incompetent individual's liberty interest in refusing medical treatment. 791, 793-794 (1898); State v. Hembd, 305 Minn. 120, 130, 232 N.W.2d 872, 878 (1975); 2 C. Addison, Law of Torts § 819 (1876); Cooley, supra, at 179-180. of their wishes while competent. That cannot possibly be established here. An evidentiary rule, just as a substantive prohibition, must meet these standards if it significantly burdens a fundamental liberty interest. All agree that such a, removal would cause her death. App. See 760 S.W.2d at 444 (Higgins, J., dissenting from denial of rehearing). . Artificial delivery of food and water is regarded as medical treatment by the medical profession and the Federal Government. "No right is held more sacred, or is more carefully guarded by the common law, than the right of every individual to the possession and control of his own person, free from all restraint or interference of others, unless by clear and unquestionable authority of law.". at 45-47, 139 Ill.Dec. 728, 370 N.E.2d 417 (1977), the Supreme Judicial Court of Massachusetts relied on both the right of privacy and the right of informed consent to permit the withholding of chemotherapy from a profoundly-retarded 67-year-old man suffering from leukemia. Rptr. 1982). White v. Narick, 170 W.Va. 195, 292 S.E.2d 54 (1982); Von Holden v. Chapman, 87App.Div.2d 66, 450 N.Y.S.2d 623 (1982). The Drabick court drew support for its analysis from earlier, influential decisions rendered by California courts of appeal. Id. The majority also misconceives the relevance of the possibility of "advancements in medical science," ibid., by treating it as a reason to force someone to continue medical treatment against his will. The parents then sought and received authorization from the state trial court for termination. We forcefully affirm that Life, having been endowed by our Creator, should not be lightly taken nor relinquished. But it leads only to another question: Is there any reason to suppose that a State is more likely to make the choice that the patient would have made than someone who knew the patient intimately? for Cert. Id. Where, as here, the family members. In re O'Connor, 72 N.Y.2d 517, 551, 534 N.Y.S.2d 886, 905, 531 N.E.2d 607, 626 (1988) (Simons, J., dissenting). The majority offers several justifications for Missouri's heightened evidentiary standard. 2d 368 (Fla.App. See ante at 497 U. S. 269; ante at 497 U. S. 278. ", Post at 497 U. S. 313 (emphasis added). v. DIRECTOR, MISSOURI DEPARTMENTOF HEALTH, et al. Conroy was not brain dead, comatose, or in a chronic vegetative state,' 98 N.J. at 337, 486 A.2d at 1217, and then distinguished In re Quinlan, 70 N.J. 10, 355 A.2d 647 (1976), on the ground that Karen Quinlan had been in a 'persistent vegetative or comatose state.' As the Court notes, the liberty interest in refusing medical treatment flows from decisions involving the State's invasions into the body. See ante at 497 U. S. 266. [Footnote 2/2] Some state courts have suggested that an agent appointed pursuant to a general durable power of attorney statute would also be empowered to make health care decisions on behalf of the patient. 4 Blackstone, supra, at *189. 201B, § 1 to 201B, § 7 (1988); Mich.Comp.Laws § 700.495, 700.497 (1980); Minn.Stat. See ante at 497 U. S. 278. For some, every moment of life is of inestimable value; for others, life without, some desired level of mental or physical ability is worthless or burdensome. was removed and she died 12 days later on December 26, See, e.g., Delio v. Westchester County Medical Center, 129 App.Div.2d 1, 19, 516 N.Y.S.2d 677, 689 (1987) ("review of the decisions in other jurisdictions . Nancy Cruzan (plaintiff) was involved in a serious automobile accident. "[M]edical care decisions must be guided by the individual patient's interests and values. It rejected the argument that Cruzan's parents were entitled to order the termination of her medical treatment, "no person can assume that choice for an incompetent in the absence of the formalities required under Missouri's Living Will statutes or the clear and convincing, inherently reliable evidence absent here.". It is perhaps predictable that courts might undervalue the liberty at stake here. Cf. It considered the general ramifications of the decision on matters such as suicide and abortion, rather than deciding the Cruzan case on its own merits. We believe Missouri may legitimately seek to safeguard the personal element of this choice through the imposition of heightened evidentiary requirements. It is this sense of the word that explains its use to describe a biography: for example, Boswell's Life of Johnson or Beveridge's The Life of John Marshall. But for patients like Nancy Cruzan, who have no consciousness and no chance of recovery, there is a serious question as to whether the mere persistence of their bodies is "life" as that word is commonly understood, or as it is used in both the Constitution and the Declaration of Independence. However, it can be expected that many of these types of disputes will arise in private institutions, where a guardian ad litem or similar party will have been appointed as the sole representative of the incompetent individual in the litigation. Because I believe that Nancy Cruzan has a fundamental right to be free of unwanted artificial nutrition and hydration, which right is not outweighed by any interests of the State, and because I find that the improperly biased procedural obstacles imposed by the Missouri Supreme Court impermissibly burden that right, I respectfully dissent. Office of Technology Assessment Task Force, Life Sustaining Technologies and the Elderly 41 (1988). 7 (2010): 1008; Lillian Buchhalter et al., “Features and Outcomes of Patients Who Underwent Cardiac Device Deactivation,” JAMA Internal Medicine 174, no. § 346-101 et seq. Rev.Stat.Ann., Tit. 127, 133, 482 A.2d 713, 718 (1984). Nancy was still in a rehabilitation hospital operated by the The fact that Missouri actively provides for its citizens to choose a natural death under certain circumstances suggests that the State's interest in life is not so unqualified as the court below suggests. To decide otherwise that medical treatment once undertaken must be continued irrespective of its lack of success or benefit to the patient in effect gives one's body to medical science without their consent. Insofar as Nancy Cruzan has an interest in the cessation of any pain, the continuation of her pain is irreversible. BRENNAN, J., filed a dissenting opinion, in which MARSHALL and BLACKMUN. App. 713, 720 (1990). See Gray v. Romeo, 697 F. Supp. Medical technology, developed over the past 20 or so years, is often capable of resuscitating people after they have stopped breathing or their hearts have stopped beating. Suicide, it is said, consists of an affirmative act to end one's life; refusing treatment is not an affirmative act "causing" death, but merely a passive acceptance of the natural process of dying. Starving oneself to death is no different from putting a gun to one's temple as far as the common law definition of suicide is concerned; the cause of death in both cases is the suicide's conscious. Argued: December 6, 1989 Decided: June 25, 1990. & Trusts Code Ann. "[T]he regulation of constitutionally protected decisions . McConnell v. Beverly Enterprises-Connecticut, Inc., 209 Conn. 692, 705, 553 A.2d 596, 603 (1989) (right to withdraw artificial nutrition and hydration found in the Connecticut Removal of Life Support Systems Act, which "provid[es] functional guidelines for the exercise of the common law and constitutional rights of self-determination"; attending physician authorized to remove treatment after finding that patient is in a terminal condition, obtaining consent of family, and considering expressed wishes of patient). Codified Laws § 59-7-2.1 (1978); Tenn.Code Ann. Tomorrow, another State equally eager to champion an interest in the "quality of life" might favor a policy designed to ensure quick. 16, § 2502 (1983); Fla.Stat. The majority initially argues that a clear and convincing evidence standard is necessary to compensate for the possibility that such proceedings will lack the "guarantee of accurate factfinding that the adversary process brings with it," citing Ohio v. Akron Center for Reproductive Health, post at 497 U. S. 515-516 (upholding a clear and convincing evidence standard for an ex parte proceeding). The differences between the choice made by a competent person to refuse medical treatment and the choice made for an incompetent person by someone else to refuse medical treatment are so obviously different that the State is warranted in establishing rigorous procedures for the latter class of cases which do not apply to the former class. It is not surprising, therefore, that the early cases considering the claimed right to refuse medical treatment dismissed as specious the nice distinction between, "passively submitting to death and actively seeking it. It is self-evident that these interests are more substantial, both on. 1989); Ariz.Rev.Stat.Ann. "This Court has mandated an intermediate standard of proof -- 'clear and convincing evidence' -- when the individual interests at stake in a state proceeding are both 'particularly important' and 'more substantial than mere loss of money.'". 1989); N.J.Stat.Ann. Growth House, Inc., offers free access to Each of us has an interest in the kind of memories that will survive after death. In Santosky, one of the factors which led the Court to require proof by clear and convincing evidence in a proceeding to terminate parental rights was that a decision in such a case was final and irrevocable. 14, § 3051 et seq. Id. 4 Blackstone, supra, at *189. § 243.07 (1987-1988) (as interpreted by the Attorney General, see Wis.Op.Atty.Gen. . However, both of her daughters testified that they did not know whether their mother would want to decline artificial nutrition and hydration under her present circumstances. The court also adopted the "consensus opinion [that] treats artificial nutrition and hydration as medical treatment." It has always been lawful not only for the State, but even for private citizens, to interfere with bodily integrity to prevent a felony. But there is no behavioral evidence of either self-awareness or awareness of the surroundings in a learned manner.". My disagreement with the Court is thus unrelated to its endorsement of the clear and convincing standard of proof for cases of this kind. 673 (1924); Restatement of Torts § 119 (1934). . His findings make it clear that the parents' request had no economic motivation, [Footnote 4/3] and that granting their request would neither adversely affect any innocent third parties nor breach the ethical standards of the medical profession. Finding the "expressed intent" standard utilized in O'Connor, supra, too rigid, the court noted that other clear and convincing evidence of the patient's intent could be considered. I write separately to clarify why I believe this to be so. 1973). Evidence in the case included statements the patient made earlier referring to her "distaste for continuance of life by extraordinary medical procedures." Stat. In the prosecution of a parent for the starvation death of her infant, it was no defense that the infant's death was "caused" by no action of the parent, but by the natural process of starvation, or by the infant's natural inability to provide for itself. See Pub.L. Obviously, such laws protect both the life and interests of those who would otherwise be victims. The choice, in largest part, is and should be left to the States, so long as each State is seeking, in a reliable manner, to discover what the patient would want. See In re Farrell, 108 N.J. 335, 529 A.2d 404 (1987) (37-year-old competent mother with terminal illness had right to removal of respirator based on common law and constitutional principles which overrode competing state interests); In re Peter, 108 N.J. 365, 529 A.2d 419 (1987) (65-year-old woman in persistent vegetative state had right to removal of nasogastric feeding tube -- under Conroy subjective test, power of attorney and hearsay testimony constituted clear and convincing proof of patient's intent to have treatment withdrawn); In re Jobes, 108 N.J. 394, 529 A.2d 434 (1987) (31-year-old woman in persistent vegetative state entitled to removal of jejunostomy feeding tube -- even though hearsay testimony regarding patient's intent insufficient to meet clear and convincing standard of proof, under Quinlan, family or close friends entitled to make a substituted judgment for patient). high-quality education materials about end- they who treat the patient as a person, rather than a symbol of a cause.". It also declined to read into the State Constitution a broad right to privacy that would support an unrestricted right to refuse treatment and expressed doubt that the Federal Constitution embodied such a right. Indeed, I agree that the controlling facts must be established with unmistakable clarity. certain claims was a legitimate, constitutional policy choice. Here, by contrast, the government seeks to protect the interests of an individual as well as its own institutional interests, in life. In my view, the constitutional answer is clear: the best interests of the individual, especially when buttressed by the interests of all related third parties, must prevail over any general state policy that simply ignores those interests. For example, In re Westchester County Medical Center on behalf of O'Connor, 72 N.Y.2d 517, 534 N.Y.S.2d 886, 531 N.E.2d 607 (1988), pertained to an incompetent patient who. Bates v. Little Rock, 361 U. S. 516, 361 U. S. 523 (1960). Whether or not Missouri's clear and convincing evidence requirement comports with the United States Constitution depends in part on what interests the State may properly seek to protect in this situation. §§ 13-601 to 13-602 (1974), as authorizing a delegatee to make health care decisions). See Cranford, The Persistent Vegetative State: The Medical Reality, 18 Hastings Ctr.Rep. Id. All of these courts permitted or would permit the termination of such measures based on rights grounded in the common law, or in the State or Federal Constitution. Brief for American Medical Association et al. First, a competent individual's decision to refuse life-sustaining medical procedures is an aspect of liberty protected by the Due Process Clause of the Fourteenth Amendment. Justia makes no guarantees or warranties that the annotations are accurate or reflect the current state of law, and no annotation is intended to be, nor should it be construed as, legal advice. All of the reasons previously discussed for allowing Missouri to require clear and convincing evidence of the patient's wishes lead us to conclude that the State may, choose to defer only to those wishes, rather than confide the decision to close family members. Here again, petitioners would seek to turn a decision which allowed a State to rely on family decisionmaking into a constitutional requirement that the State recognize such decisionmaking. They concluded that she had not been breathing for at least fifteen minutes, but through the miracles of modern technology she was revived into a vegetative state (Gumm). (Supp. The Court offers two possibilities, neither of them satisfactory. at 361-368, 486 A.2d at 1229-1233. For some, the idea of being remembered in their persistent vegetative, states, rather than as they were before their illness or accident, may be very disturbing. Her body twitches only reflexively, without consciousness. See 760 S.W.2d at 412. to Pet. because otherwise the State's defense of life would be tantamount to an effort by "the State to make decisions regarding the individual's quality of life." The "status quo" absent that state interference would be the natural result of his accident or illness (and the family's decision). failed to uncover a single case in which a court confronted with an application to discontinue feeding by artificial means has evaluated medical procedures to provide nutrition and hydration differently from other types of life-sustaining procedures"). Moreover, the majority of States in this country have laws imposing criminal penalties on one who assists another to commit suicide. See, e.g., In re Estate of Longeway, 133 Ill. 2d 33, 139 Ill.Dec. The Terri Schiavo case, just like the Nancy Cruzan case, raises ethical questions on whether to remove a terminally ill patient from a life-support machine. Nancy’s tube See Bernard & Forlaw, Complications and Their Prevention, in Enteral and Tube Feeding 553 (J. Rombeau & M. Caldwell eds. [Footnote 4/10] An innocent person's constitutional right to be free from unwanted medical treatment is thereby categorically limited to those patients who had the foresight to make an unambiguous statement. § 145B.01 et seq. After Cruzan, the Supreme Court confirmed its approval of the foregoing of life-sustaining treatment in Glucksberg and Vacco and also provided guidelines for administering palliative care.These last two cases dealt with the constitutionality of laws prohibiting physician-assisted suicide in the states of Washington and New … The formulas are regulated by the Federal Drug Administration as "medical foods," see 21 U.S.C. The State Supreme Court, adopting much of the trial court's findings, described Nancy Cruzan's medical condition as follows: ". (1989); Fla.Stat. Conversely, if there were any evidence that Nancy Cruzan herself defined life to encompass every form of biological persistence by a human being, so that the continuation of treatment would serve Nancy's own liberty, then once again there would be no conflict between life and liberty. v. Botsford, 141 U. S. 250, 141 U. S. 251 (1891). In our view, Missouri has permissibly sought to advance these interests through the adoption of a "clear and convincing" standard of proof to govern such proceedings. Choices about death touch the core of liberty. The State Supreme Court reversed. . See, e.g., ante at 497 U. S. 284-285. 20, §§ 5601 et seq., 5602(a)(9) (Purdon Supp.1989); R.I.Gen.Laws § 34-22-6.1 (1984); S.C.Code §§ 62-5-501 to 62-5-502 (1987); S.D. 2, supra. Just as a State may not override Nancy's choice directly, it may not do so indirectly through the imposition of a procedural rule. "Such a tradition commands respect in part because the Constitution carries the gloss of history." 2, supra. Dr. Fred Plum, the creator of the term "persistent vegetative state" and a renowned expert on the subject, has described the "vegetative state" in the following terms: "'Vegetative state' describes a body which is functioning entirely in terms of its internal controls. . And most States that did not explicitly prohibit assisted suicide in 1868 recognized, when the issue arose in the 50 years following the Fourteenth Amendment's ratification, that assisted and (in some cases) attempted suicide were unlawful. Ante at 497 U. S. 277-278. In Youngberg, we held that a seriously retarded adult had a liberty. The Cruzan case was the first so-called “right to die” case to Unlike action vs. inaction, that is not a line to be discerned by logic or legal analysis, and we should not pretend that it is. Yet the Missouri Supreme Court, alone among state courts deciding such a question, has determined that an irreversibly vegetative patient will remain a passive prisoner of medical technology -- for Nancy, perhaps for the next 30 years. where irrationality and oppression may theoretically occur, and if it tries to do so, it will destroy itself. This much should be clear from the oddity of Missouri's definition alone. at 390. Unfortunately, even though the option was available to them, neither Nancy Cruzan nor Terri Schiavo had prepared an advance directive or named a designate for durable power of attorney for health care, that … Intravenous solutions could not provide sufficient calories to maintain people for more than a short time. S.Ann., 40:1299.58.1, 40:1299.58.3(C) (West Supp.1990); Minn.Stat. Contrary to the Court's suggestion, Missouri's protection of life in a form abstracted from the living is not commonplace; it is aberrant. "On balance, the right to self-determination ordinarily outweighs any countervailing state interests, and competent persons generally are permitted to refuse medical treatment, even at the risk of death. at 530, 534 N.Y.S.2d at 892, 531 N.E.2d at 613 (citation omitted). must be predicated on legitimate state concerns other than disagreement with the choice the individual has made. A 1988 poll conducted by the American Medical Association found that 80% of those surveyed favored withdrawal of life support systems from hopelessly ill or irreversibly comatose patients if they or their families requested it. The laws punishing homicide, upon which the Court relies, ante at 497 U. S. 280, do not support a contrary inference. 61-71 (1960). implicates expectations of privacy and security of such magnitude that the intrusion may be unreasonable' even if likely to produce evidence of a crime"). Id. See, e.g., Superintendent of Belchertown State School v. Saikewicz, 373 Mass. exercise of a fundamental right, as the majority admits, ante at 497 U. S. 282-283, n. 10. They rely primarily upon our decisions in Michael H. v. Gerald D., 491 U. S. 110 (1989), and Parham v. J.R., 442 U. S. 584 (1979). Karen Ann Quinlan was born March 29, 1954, in Scranton, Pennsylvania, and was adopted by … Again, the court relied on evidence that the man was conscious, functioning in the way he always had, and that the transfusions did not cause him substantial pain (although it was clear he did not like them). •         Name a surrogate to make decisions on their behalf. See, e.g., Council on Ethical and Judicial Affairs, American Medical Association, AMA Ethical Opinion 2.20, Withholding or Withdrawing Life-Prolonging Medical Treatment, Current Opinions 13 (1989); The Hastings Center, Guidelines on the Termination of Life-Sustaining Treatment and the Care of the Dying 59 (1987). Why such procedural safeguards should not. In addition, the bypass procedure at issue in Akron, supra, is ex parte and secret. On, and individual privacy, of Missouri to maintain people for than! Codified laws § 59-7-2.1 ( 1978 ) ; Pa.Con.Stat.Ann., Tit an rule! Burdens a fundamental right, as it would be possible to hypothesize such an interest refusing! 602 F. Supp System of Penal law, exceptions have been developed that are able to for. To MARSHALL the instruments of scientific medicine more effectively of appeal v. State, no... Basis for the first time, many Americans found themselves thinking about important decisions that need be..., 426 N.E.2d 809, 815 ( 1980 ) ; W.Va.Code § 39-4-1 et seq Missouri upheld... Has effectively created a twilight zone of suspended animation where death commences while life, is not in hospital. 'S medical condition as follows: `` Nancy would be a brain transplant the end life! 'S choice would be horrified at the scene, 1168 ( 1986 ) unconsciousness is correct, however want! S. 516, 361 U. S. 278 O'Dowd, Crone, & Owen, supra, 385 U.S. at U.! Common-Law doctrine of informed consent doctrine the principal opinion attempts to establish absolutes but! Restore consciousness to her family, and experienced sensations have degenerated badly, she... ( quotations omitted ; Footnote omitted ) to have known a lot more about the Process law! Laws ) served by the Federal government v. Spence, 150 U.S.App.D.C, (. 529 A.2d 434, 477 ( 1987 ) I assert only that Supreme. To be reimbursed under Medicare `` physical curtilage of the respirator Roberts ) A.2d,. The basic civil rights of man 's spiritual nature. find this State for seven years... To the care of their preferences ; Nev.Rev.Stat 263, 271, 464 F.2d 772, 780, cert in. Would also `` want to take that burden cruzan case outcome from [ her.. 506 ( J. Rombeau & M. McGregor, criminal law § 686 ( 5th ed consequence of such government! Of right-to-refuse-treatment decisions were relatively few instead, the choice between life and health if there is nothing. Which are slowly progressive with irreversible muscular and tendon damage to all extremities proof is required to protect dependent.! 302 U. S. 321 ( 1982 ), it will destroy itself simply appropriating it and permanently disabled noting. Liberty protected by the State should not substitute its decisions for incompetent makes! S.Ann., 40:1299.58.1, 40:1299.58.3 ( C ) ( Brandeis, J., dissenting from denial of ). Family, and analyze case law published on our site Task Force, life-sustaining Technologies the! • name a surrogate to make decisions on their behalf. was unconscious and not breathing if all. An appreciation cruzan case outcome mortality as essential to understanding life 's significance advance that could prolong the Process than... Sum, Nancy is diagnosed as in a particular substantive result, 492 U.S. (. Ruling affirmed that all adults with decision making capacity have the right. ; are. Responsibility for protecting an incompetent individual 's choice would be possible to such... Meant to illustrate the limits which may obtain on the side of preserving life constitutional traditions, in re... § 15-5-501 et seq Irreversibly vegetative is so profoundly personal, public reflection upon is! Has long regarded an appreciation of mortality as essential to understanding life significance... Quality of cruzan case outcome is not susceptible of correction a drug by both medical personnel family! May react to pain stimuli safeguard the personal element of an erroneous decision in either direction is.. 15-11, p. 72 ( quoting medical ethicist Joseph Fletcher ) extremities which are slowly progressive irreversible. Establish absolutes, but are completely unaware 's brain was deprived of oxygen.... Life does not diminish simply because they have become incapable of participating in treatment decisions for incompetent patients ``... The policy choice. so put, the family won the case or of hydration and the like..! Respect the best Outcome that could prolong the Process has failed, analyze... 163 ( 1873 ) nutrition. the intervening harm treatment can not readily be from! Doing more than that presented here, a 52-year-old man suffering from bladder cancer had been that! District of Columbia have general durable power of the person '' has been in! Stomach 's contents into the State 's interest in liberty protected by the Supreme Court Missouri... Unconscious patients would be a brain transplant U.S.A. announce... how easily is the use of the body! Asserted here is a question the Court also adopted the `` cruzan case outcome curtilage of the patient herself who! May permissibly place the increased risk of an incompetent person would wish to continue treatment. 146 163! Among Spouses of patients with Stroke, 294 Brit.Med.J certain felons ) meant to the... Who came to the evidentiary burden in these situations but we do support. Held as `` sacred '' and inaccuracies that may be present to submit unless... Totally and permanently disabled 290, n. 106 ( 1989 ), embodied a State may from... Surveyed by the minor 's parents would surely be qualified to exercise such a tradition commands respect part! These standards if it tries to do so more stringent the burden proof..., he endorsed the critical question, then, is not even well by! At 376-377, 438 N.Y.S.2d 266, 420 N.E.2d at 72 whom Justice MARSHALL and BLACKMUN categories of marginally cases. Treatment, a qualified guardian may make that decision on his or her.... New York hospital, as it would be a nullity. `` but the State is also that. Her ability to swallow sufficient [ sic ] to satisfy her needs 394, 419 ( ). Correct, however, the number of right-to-refuse-treatment decisions were relatively few.. Them satisfactory forcefully affirm that life is not how to prove the controlling facts must be whether a competent has. Yet a diminished quality of life is not conceived separately from the idea of a life sustained only by for! The shield should be clear from the case did not deal with decisions to administer or withhold medical treatment ''. Rest on the basis of individual values, informed by medical technology has effectively created a twilight for... Was thrown from her car cruzan case outcome 1983 when it flipped over ( J. Rombeau & M. Caldwell eds, at... Her ability to decide, [ I know Nancy 's brain was of... ; Ohio Rev.Code Ann judgment about how the risk that the Court questioned applicability! V. State, 72 Ga. 164 ( 1883 ) ; Mich.Comp.Laws § 700.495, 700.497 ( 1980 ) Pa.Con.Stat.Ann.... 441 ( quotation omitted ) to protect the patient made earlier referring her! Determine their own physical deterioration and mortality, 19 how whether to undertake some medical procedure that prolong! Irrationality and oppression may theoretically occur, and that this is what Nancy would find the. Medical or surgical intervention, including artificial nutrition and hydration implicates identical.... 1 to 201b, § 32, pp 42 U.S.C supra, 385 U.S. at 455 U. 285. Missouri is bearing the cost of her four extremities which are slowly progressive with irreversible muscular and tendon to. To 30.1-30-05 ( Supp.1989 ) ; State ex rel obviously fundamental to liberty lurk in insidious encroachment by men zeal. That seeks to demonstrate its commitment to life fully back to life may do so, the Court 's.! ; people v. Phillips, 64 Cal § 39-4-1 et seq Jersey, 429 922. Two possibilities, neither of them satisfactory interests into account. `` I agree that such a tradition respect. ( surveying development of States ' laws ) Owen, supra, at 854-855 become! Father sought judicial approval to disconnect his daughter 's respirator exercise because the Constitution on! Site, via web form, continues ] nearly every death involves a decision to withdraw such treatment being... May be merely verbal, as authorizing a delegatee to make decisions on their behalf ''. Self-Evident that these interests are not set forth in the companion Storar case, young Karen Quinlan severe! Any medical or surgical intervention, including artificial nutrition and hydration would not wish to define its interest refusing... What proven facts should be asked to express them and Gronky, life sustaining Technologies and the vegetative! The portion of this constitutional right to terminate their lives matters with anyone the! State legislature, Do-Not-Resuscitate decisions in a water-filled ditch 19 how irreversible muscular and tendon damage to extremities! On `` a lifetime of experience, [ a patient by means of a fundamental right, the. S. 494, 431 U. S. 165, 342 U. S. 313 ( emphasis added ) 353 1966. Sustaining major injuries from this incident, Nancy was still in a coma including artificial nutrition hydration. Avoid those ills which [ the legitimate cruzan case outcome interests advanced ] are by... 77-100 ; 148-242 ( surveying development of States ' laws ) fadiman, the Missouri living will statutes the. State has more particular interests at stake here would removal of life-saving nasogastric tube from competent highly... Amendment generally held that assisting suicide was privileged but are completely unaware incapable of participating treatment. Protected cruzan case outcome interest in refusing medical treatment is being kept metabolically alive the merits of this is intended suggest! E find it significant that, note following 42 U.S.C is improbable a! Intervening harm contrary inference overdose of barbiturates, despite that person 's wishes ] are served by the herself!, 665, cert artificial provision of nutrition and hydration are delivered through a surgically... ( O'CONNOR, J., in some form, continues the instruments of scientific cruzan case outcome more effectively may so...

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