The Case of Nancy Cruzan

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The Case of Nancy Cruzan Importance The case of Nancy Cruzan has become one of the landmark cases for withdrawal of artificial nutrition and hydration because of important ethical issues the case brings to light. At the time of the case, the United States Supreme Court had already established the right of an individual to refuse medical treatment. This issue therefore is not novel to the Cruzan case. Furthermore, there was not any controversy over who was the appropriate decision maker for Nancy Cruzan. The significant issue that the Cruzan case did bring to the table of medical ethics regarded whether or not a substituted decision make could choose to withdraw artificial hydration and nutrition on behalf of another individual. Legal Implications Because the Missouri Supreme Court ruled against the removal of Nancy Cruzan’s artificial hydration and nutrition on the grounds that “clear and convincing” evidence of Nancy’s wishes was not provided, the Cruzan family appealed the decision to the United States Supreme Court arguing that Nancy was being deprived of her right to refuse medical treatment. The Supreme Court ruling affirmed that competent patients have the right to refuse unwanted medical treatment, but also noted that incompetent patients are not capable of exercising this right. Consequently, states may establish their own safe-guards to govern cases in which a substituted decision maker wishes to refuse treatment for an incompetent patient. This ruling therefore upheld the decision of Missouri’s Supreme Court. The major implication of this decision is that each state decides the type of evidence required to withhold or withdraw medical treatment from an incompetent patient. The state ... ... middle of paper ... ...d how these determinations effect a physician’s approach to various types of critically ill patients? These types of questions come in to play when one attempts to critically analyze the differences between the types of terminally ill patients and the subtle ethical/legal nuances between withholding and withdrawing treatment. According to a review by Larry Gostin and Robert Weir about Nancy Cruzan, “…courts examine the physician’s respect for the desires of the patient and the level of care administered. A rule forbidding physicians from discontinuing a treatment that could have been withheld initially will discourage doctors from attempting certain types of care and force them prematurely to allow a patient to die. Physicians must be free to exercise their best professional judgment, especially when facing the sensitive question of whether to administer treatment.”

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