Essay Sample on Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990)

Published: 2023-03-03
Essay Sample on Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990)
Type of paper:  Essay
Categories:  Medicine Ethical dilemma Human rights Social issue
Pages: 5
Wordcount: 1145 words
10 min read

There are several factors to put into consideration when deciding to end someone's life. Moral, legal, and ethical matters have to be factored in determining to eliminate an individual from life support. This essay uses the case of Nancy Cruzan.

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In 1983, Nancy Cruzan, a 25 years old woman, was injured severally in a road accident. She ended up with distressing injuries and breathing problems, a situation that needed the emergency response team to conduct CPR to save her.

Upon her admission to the hospital, she was on care life support that entailed hydration and feeding tubes. Within a month, her doctor concluded that she was in an insistent condition. This implied her brain was no conducting any function. Thus, she could not react to her surroundings. This fact raised several issues regarding the moral, legal, and ethical matter

Ethical and Moral Issues

Unluckily, often-family members are faced with decision making regarding ongoing life support or not. Such a decision can arrive quickly primarily when an individual wish is known since it usually has an outline of what remedial measure the individual would recommend and who can express their preference in the occurrence that they are unable to speak for themselves.

In Cruzan's situation, the advance directive was absent, but her loved one claim to know what Nancy would want them to do in such an event. Her family members settled for her removal from life support since they knew Nancy could never wish to stay in a coma having considering four years passed, and her condition was not improving.

However, her physicians refused, considering that she was only being offered basic needs: water and food. Doctors asserted that her removal would cause her death, which is illegal and immoral since her death would be then caused by dehydration and starvation (Lapointe, 1989).

The ethical concern was whether someone has a right to decide to end another individual's life when the person in a life support machine has no advance directive. Health care providers have the responsibility and are obligated to act according to their code of ethics that aims at improving life. The accountability fell on the loved ones to verify what Cruzan would wish for since their beloved one was incapable of doing so while she was in a coma state.

Legal Matters

The moral and legitimate concerns of the case turned to a legal matter. The U.S. offers the right to decline medicinal treatment but does not highlight whether the right still applies in the occasion that an individual is incapable of making decisions for themselves (Barton, 990). This suggested that courts are left with the task to declare a ruling constructed on their interpretations of the constitution.

Court Decision

Cruzan's family took the matter into Missouri Court to request the court to offer the physicians a defensive order allowing them to remove Cruzan from life support. The State's final court ruling granted the plea based on Cruzan's cohabitant attesting that Cruzan articulated to her that she would not want to stay in a coma. The court justified itself, claiming Nancy was knowledgeable when she was making that wish.

However, the state court terminated the grant due to the inability of the family to provide precise and persuading evidence of Nancy's request. Further, in 1990, the United States Supreme court maintained the decision when the family presents the housemate's proof.


The Self-Determination Case of Nancy Cruzan went to trial, and the Court considered the petition of the patient's parents. The parents stated that Ms. Cruzan had outlined in quite a few instances she wanted to stop living. The Court lightly interpreted the Evidence Standard for Removal of life-sustaining treatments on the grounds of the ineffectual evidence of the patient's kin and ordered the gastronomy tube detached.

In the appeal at the Missouri Supreme Court, the ruling was overturned, the State Supreme Court scratched the testimony concerning Ms. Cruzan based on the evidence provided because Ms. Cruzan was not able to articulate her wishes clearly by speech. The Court maintained its argument that the gastronomy tube was not for medical treatment (Lapointe, 1989).Still, for supporting food nourishment; Missouri had strict principles regarding the Living Will Statue that privileged life despite its quality. The Missouri Court went against the judgment of the preceding trial.

The case was appealed in the U.S Supreme Court, and it was the first Hearing of a "right to die" case. The Court argued that the U.S constitution does not prohibit Missouri from holding Clear and Convincing Evidence Standard of an inept patient's desire. Further, the ruling made was supported by the case of Elizabeth Bouvia the court had outlined the differences between dying from declining treatment, and death caused by suicide (Steinbrook, 1986). The Court further held that the 14th guarantees that a person should have a liberty interest in any situation In the Court's defense, the U.S constitution does not necessitate that family members be official surrogates in such cases. The state can inflict its necessities for surrogacy.

The Supreme Court acknowledges some rights that patients have in such medical matters; Patients have a right to make healthcare decisions, whether capable or not. The Court urged that people should let their wishes known clearly in advance in case of such an occurrence. This case laid a foundation stone for the Self- determination Act as it has given direction on how to handle issues. Nancy Cruzan would have died years back if she had an advance directive.


The Self-determination Act allows for Patients with advance directives to have "right to die" when the patient is incompetent. The choice and the constitution give the patients the power and framework to have their wishes honored legally. Patients who are deficient in decision-making capabilities are occasionally put on invasive treatments that are not constant with their inclination, their families could not want them, and the decision that the kin make could necessarily not be in the patient's best interest. The Supreme Court's ruling in the case of Cruzan may push some health- workers to be less willing than they already are in abating treatment with non-independent patients, even when the remedy is opposing the patient's best interests. However, the government needs to endorse resourceful laws to encourage physicians and families to discuss final care and help individuals in making simple and clear wishes regarding their preferences.


Barton, R. S. (1990). Cruzan v. Director, Missouri Dept. of Health. Issues L. & Med., 6, 409. Retrieved from:

Lapointe, R. L. (1989). The Removal of Feeding Tubes: Has the Right to Die Reached Its Limit. New Eng. L. Rev., 24, 185. Retrieved from:

Steinbrook, R., & Lo, B. (1986). The case of Elizabeth Bouvia: Starvation, suicide, or problem patient?. Archives of internal medicine, 146(1), 161-164. Retrieved from: 10.1001/archinte.1986.00360130199026

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Essay Sample on Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990). (2023, Mar 03). Retrieved from

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