Abstract

KIE: The parents of Nancy Cruzan, a Missouri woman in a persistent vegetative state, petitioned to be allowed to order the termination of her artificially administered hydration and nutrition. A state trial court's authorization of the termination was reversed by the Missouri Supreme Court, which ruled that no one may order an end to life sustaining treatment for an incompetent patient in the absence of a valid living will or clear and convincing evidence of the patient's wishes. Cruzan was appealed to the U.S. Supreme Court, which affirmed (5-4) the Missouri decision, on the grounds that an incompetent person does not have the same constitutionally protected right as a competent person to refuse life sustaining treatment. In such cases a state may, but is not required to, recognize a family's decision making role, and may require clear and convincing proof of a patient's determination to forgo hydration and nutrition.