Cruzan v. Director, Missouri Dept. of Health
497 U.S. 261 (1989)

  • Cruzan was involved in a car crash and ended up in a ‘persistent vegetative state’. Her parents asked the hospital to withdraw the feeding tube to let her die.
    • Cruzan was breathing on her own, but had no cognitive functions.
    • The hospital told the parents to get a court order.
  • Cruzan’s parents went to court and asked for an order to remove the feeding tube.
    • Cruzan’s parents argued that Cruzan had stated to her roommate that she didn’t want to be kept alive artificially.
  • The Trial Court granted the order to remove the feeding tube. Missouri appealed.
    • The Trial Court found that a person in Cruzan’s condition had a fundamental right to refuse or withdraw “death prolonging procedures.”
  • The Missouri Supreme Court reversed. Cruzan’s parents appealed.
    • The Missouri Supreme Court found that Cruzan’s out-of-court statements regarding her wishes were unreliable (aka hearsay) and insufficient to support her parents’ claim to exercise judgment on her behalf.
    • The Court found that there must be clear and convincing evidence of a person’s wishes before treatment can be withdrawn.
  • The US Supreme Court affirmed.
    • The US Supreme Court found that a competent person has a constitutionally protected right to refuse lifesaving treatment.
    • However, the Court found that an incompetent person cannot make an informed and voluntary choice, and requires a surrogate to make that choice for them.
    • The Court found that Missouri’s procedural requirement that there is clear and convincing evidence of the incompetent person’s wishes was not a violation of the person’s constitutional rights.