S: Cruzan v. Missouri
FC: Cruzan v. Missouri | Supreme Court Case Project | Kristina Pham Ram Ramkumar
1: Table of Contents | Background Case Info Supreme Court Aftermath | 2-5 | 6-9 | 10-13 | 14-17
2: Background | January 11, 1983 - Nancy Beth Cruzan got into a car accident that left her in a "persistent vegetative state." | 1983 - Doctors believed that Cruzan's brain had been without oxygen for at least fourteen minutes. A person who goes without oxygen for more than six minutes suffers irreparable brain damage.
3: Background | 1983-1986 - Out of dedication, love, and hope, Nancy's parents drove the 80 miles round-trip to the rehabilitation center every week. | 1984 - Nurses observed that Nancy Cruzan responded to certain people. Once, when a valentine was read to her, she cried.
4: Background | 1986 - Doctors finally told the Cruzan family that Nancy's condition was permanent. | 1983-1986 - The rehab center held weekly support meetings for families in a similar situation, and the Cruzans were able to empathize with other families.
5: Background | mid-1986 - Her parents, Joe and Joyce Cruzan, asked the director of the Missouri Rehabilitation Center to remove the feeding and hydration tube. | mid-1986 - Donald Lamkins, the director of the center, refused the Cruzans' request to stop treatment because he was afraid of a murder charge against the center.
6: Case Information | A Missouri court found that Cruzan had a constitutional right to refuse medical treatment and that she would not have continued with the feeding tube. | The Court therefore ruled that the feeding tube could, in fact, be removed, allowing Nancy to die rather than continue surviving in PVS.
7: Case Information | The decision was appealed by Nancy's guardian ad litem, and so the case was brought to the Missouri Supreme Court. | Nancy's doctors were against this decision and were wary of being charged with assisted murder, as had taken place in an earlier medical case.
8: Case Information | The court questioned the right that an individual had the right to refuse life-saving medical treatment. | The state court reversed its previous decision calling the decision to remove the feeding tube constitutional, for two reasons.
9: Case Information | The State Supreme Court ruled that the parents had the burden of producing "clear and convincing evidence" that Nancy would have chosen to discontinue treatment. | It also ruled that Nancy's parents had failed to provide this evidence in this case, disallowing their decision to allow Nancy to die.
10: Supreme Court | But it also upheld with a 5-4 vote the right of the state to require "clear and convincing evidence." | The U.S. Supreme Court unanimously reversed the Missouri Court's decision on its first point.
11: Supreme Court | The Court began analysis by reviewing the law of "informed consent". It noted that physicians are obligated to obtain a patient's consent to treatment and the consequences of accepting/denying treatment. | It concluded that refusing medical treatment is a constitutional right for any individuals capable of making decisions on their own.
12: Supreme Court | The Supreme Court also noted that this right extends to medical treatment that could save or extend a person's life. | The Court then reversed its positions on cases such as "Jacobson v. Massachusetts" and "Vitek v. Jones".
13: Supreme Court | Nancy Cruzan had never made a living will that documented her wishes if she ever got in such an accident. Her friends and family could only generally testify whether or not Nancy would have wanted to continue in a vegetative state. | Thus, the Supreme Court upheld the Missouri Court's call for "clear and convincing" evidence" in such an event. It also stated that the Cruzans had not provided this evidence.
14: Aftermath | The trial court ruled that there was now "clear and convincing evidence" to support the removal of the feeding tube. | Later that year, the family found additional witnesses who testified that Nancy would have wanted her treatment terminated.
15: Aftermath | Nancy died on December 26th, 1990, more than seven years after the accident. | This case led the Supreme Court to revise its decisions on previous landmark cases having to do with medical treatments, such as smallpox vaccinations and mental treatments.
16: Aftermath | Lawsuits over Nancy's wished could have been avoided with such a living will and a durable power of attorney for medical care. | This case brought the importance of living wills to the spotlight.
17: Aftermath | The Court successfully upheld that refusing medical treatment on any grounds was a constitutional right, setting a precedent for cases such as the lawsuit involving Terri Schiavo . | A living will specifies any treatments you want and don't want. A power of attorney gives someone you trust the ability to make health care decisions for you.