Nancy Cruzan and the right to die
Article Abstract:
The recent case of Nancy Cruzan represents the first time that the United States Supreme Court has ruled on a case involving the right to die. Cruzan is a young woman who has been in a vegetative state since an auto accident in 1983. The only life support measure that she needs is a feeding tube. Based on their beliefs about what their daughter would have wanted, her parents went to court to have the feeding tube removed to allow her to die. In almost all cases decided in state courts regarding the right to die, the courts have upheld the right of a surrogate (such as a parent) to make this decision for a patient who is incompetent. In the Cruzan case, the Missouri trial judge reached the same conclusion. However, the Missouri Supreme Court reversed this ruling, stating that only the patient could make such a decision for herself. The US Supreme Court then ruled that Missouri could require presentation of convincing evidence of Cruzan's wishes before life support could be terminated; this effectively prevented removal of the feeding tube. It is important to note that this ruling does not determine the future outcome of all such cases in the nation; it ruled that the states could set and follow their own standards. This decision is consistent with the recent trend towards restricting the rights of individuals in deference to the state. In this case, the objective was to protect incompetent patients whose families might not have their best interests in mind. Sadly, there is every reason to believe that Cruzan's parents are loving and caring, and that they are correct in their assessment of what their daughter would want. One of the Justices, Sandra Day O'Connor, stated that all citizens should appoint a 'surrogate decision maker' to act on their behalf if they become incompetent; this might be more effective than a written living will, which may require interpretation. Finally, physicians will continue to deal with such dilemmas and should be aware that the Supreme Court decision in the Cruzan case does not legally bind them to render medical care to incompetent patients when the care is not desired or medically indicated. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1990
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Bioethicists' statement on the U.S. Supreme Court's Cruzan decision
Article Abstract:
This statement, written at the Second Annual Conference of Bioethicists held on July 1, 1990, addresses the implications of the United States Supreme Court decision regarding the Nancy Cruzan case. Cruzan has been in a vegetative state since an auto accident in 1983 and is being kept alive by food and water she receives through a tube. Her parents went to court to obtain permission to remove the feeding tube to allow her to die, because they believe she would want this. The Missouri Supreme Court denied her parents this permission. The case reached the US Supreme Court, which in June 1990 decided to uphold the ruling and to allow the state of Missouri to require that there be 'clear and convincing evidence' that the patient had expressly authorized disconnection of life support in such a situation before she was injured. In the Cruzan decision, the US Supreme Court did not require other states to adopt the standards used in Missouri, nor does the ruling prevent Missouri from later changing these standards. The decision also does not change the ethical standards, clinical practices, or laws that have evolved in the US which permit refusal of life-sustaining treatments. The bioethicists recommend that physicians continue to follow accepted ethical practices regarding refusal of life support measures unless their state courts explicitly require a change in conduct. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1990
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The bell tolls for a constitutional right to physician-assisted suicide
Article Abstract:
The US Supreme Court has stated that there is no constitutional right protecting physician-assisted suicide but the justices still believe more should be done to help the dying patient. The court overturned two appeals court decisions which ruled that laws against physician-assisted suicide are unconstitutional. These decisions were probably flawed to begin with, since suicide has not traditionally been treated as a fundamental right in the US. The justices also drew a distinction between assisted suicide and refusing or withdrawing life-saving treatment. Physicians can still prescribe painkillers to dying patients.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1997
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