Kelsey Garrison

The right to die means asserting or advocating the right to refuse extraordinary medical measures to prolong one's life when one is terminally ill or irreversibly comatose. It includes suicide, passive euthanasia, assisted suicide, active euthanasia, palliative care, and physician-assisted suicide.

In 1983, Nancy Cruzan was in a car accident; she was twenty-five. Due to her injuries, she fell into an unconscious state for three weeks and was on life- support. She emerged from the coma after three weeks, but only displayed motor reflexes. She had no indications of cognitive function. Doctors said she could live many years in current state if she remained on life-support.

There was no chance of recovery. She remained in a vegetative state for five years. Her parents requested that she be taken off of life-support considering she was not going to get better. Hospital refused without court approval because it would result in Cruzan’s death.

The case was presented to the court. The court granted the request of Nancy’s parents to cut off life-support. The director of the Missouri Department of Health took the case on appeal to the Supreme Court. Missouri insisted on a high standard of proof of Cruzan’s wish to die.

The issue of law in question was did the Due Process Clause of the Fourteenth Amendment permit Cruzan's parents to refuse life-sustaining treatment on their daughter's behalf? The answer to this question as decided by the Supreme Court is no. They ruled in favor of Director.

The majority decision was written by William H. Rehnquist. The Court “held that while individuals enjoyed the right to refuse medical treatment under the Due Process Clause, incompetent persons were not able to exercise such rights.” There was no clear and convincing evidence that Nancy would want to terminate her life-support.

Under the fourteenth amendment, a competent adult can decline unwanted medical treatment. If the patient is incompetent, the state can refuse to allow the termination of medical procedures constitutionally except when there is clear and convincing evidence that the person would wish to refuse medical treatment. In Cruzan’s Case, her parents believed that an incompetent person should possess the same right as a competent person. The Court states that “incompetent persons are not able to make an informed choice.”

William J. Brennan, Jr. wrote the dissenting opinion. Thurgood Marshall and Harry A. Blackmun joined in on his dissent. He said that “no state interest could outweigh the rights of an individual in Nancy Cruzan's position.” He said, “The meaning and completion of her life should be controlled by persons who have her best interests at heart—not by a state legislature concerned only with the preservation of human life.”

On December 14, 1990, a Missouri circuit court ruled that evidence presented from three more friends constituted clear and convincing evidence that she would not want to continue to live in a vegetative state. The court granted Cruzan’s parents their request of the removal of her feeding tube. Within two hours of the ruling, the doctors removed her feeding tube. She died twelve days later on December 26, 1990.

“Case Brief: Cruzan v. Director, Missouri Department of Health, 497 U.S. 261." StudentJD. Accessed November 22, v. Director, Missouri Department of Health[Ch 6][Implied Fundamental Rights][substantial due process][Life Support][protects refusal of treatment].htm. “Court and the End of Life - The Case Of Nancy Cruzan." - Missouri, Supreme, Evidence, and Feeding. Accessed November 24, “Cruzan v. Director, MDH 497 U.S. 261 (1990)." Justia Law. Accessed November 24, “CRUZAN v. DIRECTOR, MISSOURI DEPT. OF HEALTH." Cruzan v. Director, Missouri Dept. of Health. Accessed November 22, /1989/1989_88_1503. “Cruzan v. Director, Missouri Dept. of Health (1990)." Infoplease. Accessed November 21, “Cruzan v. Director, Missouri Dept. of Health | Casebriefs." Casebriefs. Accessed November 21, law/constitutional-law-keyed-to-chemerinsky/fundamental-fights-under-due-process-and- equal-protection/cruzan-v-director-missouri-dept-of-health-2/2/.

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