BOUVIA AND CRUZAN

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BOUVIA AND CRUZAN
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BOUVIA BACKGROUND

• At the time of her petition, Elizabeth Bouvia was
  a 28-year-old quadriplegic from severe cerebral
  palsy, was completely bedridden, in constant pain
  from arthritis, and wanted to die from
  starvation.
• She was kept alive against her will and without
  her consent by physicians who inserted a
  nasogastric tube to force feed her to keep her
  alive.
• The court found her to be intelligent, very
  mentally competent, and without financial
  means.
• On several occasions she expressed the desire to
  die.

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COURT FINDINGS IN BOUVIA I

• The right to refuse medical treatment is a
  fundamental right of a person.
• The right to refuse medical treatment is part of
  the right to privacy.
• This right requires no one elses approval.
• The purpose and importance of withdrawing life
  support is to respect patient dignity and make
  the patient as comfortable as possible.

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COURT FINDINGS IN BOUVIA II

• The right to die is an integral part of the right
  that a person has to control his or her destiny.
  
• The relation of the right to die to the medical
  community means this
• The right to die includes the right to receive
  assistance in dying from medical personnel to
  make the desired death as quick and painless as
  possible.

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CRUZAN BACKGROUND

• Nancy Cruzan was in a persistent vegetative state
  from an automobile accident.
• A persistent vegetative state is a condition in
  which a person exhibits motor reflexes but
  evinces no indications of significant cognitive
  function.
• She had no chance of recovery and her parents
  asked that the artificial feeding and hydration
  equipment that kept her alive be withdrawn.

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COURT FINDINGS IN CRUZAN I

• The Supreme Court of Missouri denied the parents
  request saying that there was no evidence that
  that is what Nancy would have wanted, and the
  parents had no authority to act on her behalf.
• Although the Missouri court recognized a right to
  refuse treatment based on informed consent, it
  was skeptical about the application of informed
  consent in this case because Cruzan was in a
  persistent vegetative state, and so could not
  make her own wishes known.
• The Supreme Court of Missouri found Nancys
  statement to her roommate about not wanting to
  live under certain conditions to be unreliable
  and insufficient.

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COURT FINDINGS IN CRUZAN II

• In Cruzan, the U. S. Supreme Court stated that
  the common-law doctrine of informed consent is
  viewed as generally encompassing the right of a
  competent individual to refuse medical treatment.
• The Fourteenth Amendment provides that no state
  shall deprive any person of life, liberty, or
  property without due process of law.
• The Supreme Court stated that one could infer
  from the Fourteenth Amendment, and prior Supreme
  Court decisions, that a person has the right to
  refuse unwanted medical treatment.

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COURT FINDINGS IN CRUZAN III

• The Supreme Court of the United States agreed
  with the ruling of the Supreme Court of Missouri
  that, although a right to refuse treatment based
  on informed consent must be recognized, they were
  skeptical about the application of informed
  consent in this case.
• This was, again, because Cruzan was in a
  persistent vegetative state, and could not make
  her own wishes known.

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COURT FINDINGS IN CRUZAN IV

• Nancy Cruzans parents maintained that an
  incompetent person should have the same right to
  refuse life-sustaining treatment as a competent
  person.
• The U. S. Supreme Court said that that begged the
  question since an incompetent person who has not
  unequivocally made her wishes known ahead of time
  cannot make her wishes known when she is in a
  coma, and hence is not competent to make her
  wishes known.

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JUSTICE BRENNANS DISSENT

• Justice Brennan, in dissenting from the majority
  decision in Cruzan, stated the following
• 1. Nancy is entitled to die with dignity.
• 2. The Supreme Court of Missouri failed to
  consider testimony from Nancys mother and sister
  that she would prefer to die than to be in a
  persistent vegetative state.
• 3. The Missouri Court had a disdain for Nancys
  own right to choose.

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CRUZAN CONCLUSION

• Eventually Cruzans parents won by providing
  additional evidence to the U. S. Supreme Court.
• The court then decided in the parents favor.
• Life-sustaining support was withdrawn and Nancy
  died.