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#TBT: Cruzan v. Director of Missouri Department of Health

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A woman by the name of, Nancy Cruzan was traveling in Jasper County, Missouri, where she had lost control of her car. Her car had overturned and Cruzan was found lying with her face in a ditch near her car. Her cardiac and respiratory functions weren’t working. Fortunately, the paramedics were able to restore her breathing and heartbeat at the site. Cruzan was quickly transferred to a nearby hospital, where a neurosurgeon diagnosed her with “cerebral contusions compounded by significant anoxia (loss of oxygen).”

Cruzan had been in a coma for approximately 3 weeks before she was in an unconscious state where she was able to orally ingest some nutrition. The doctor began her gastronomy feeding and hydration tube with the consent of her husband. The hospital announced that Cruzan was in a “persistent vegetative state: generally, a condition in which a person exhibits motor reflexes but evinces no indications of significant cognitive function.” The State of Missouri covered the costs for the feeding and hydration tubes.

Cruzan continued to be incompetent and showed no possibilities of ever recovering. Her parents, Lester and Joyce Cruzan decided to ask the hospital to stop the artificial feeding and hydration equipment. Ending the treatments would kill Cruzan, so, the hospital refused to stop treatment without a court approval. Cruzan’s parents then sought and gained permission from the trial court to terminate her treatment. The Court approved Cruzan’s parents’ requests because Cruzan was under extreme conditions that allowed her parents under the State and Federal Constitutions to “refuse or direct the withdrawal of ‘death prolonging procedures.’”

Nancy Cruzan had also allegedly discussed with a friend about a year before her accident, that if she was sick or injured, she does not wish “to continue her life unless she could live at least halfway normally suggests that given her present condition she would not wish to continue on with her nutrition and hydration.”

The Supreme Court of Missouri reversed Cruzan’s permission after looking at the factors that originally granted Cruzan’s parents authorization. The Court felt skeptic at first towards the implied consent under "certain circumstances," which allowed termination of treatment. The Court was also opposed to the State’s Constitution that gives the right for patients to refuse medical treatment in all cases. The judges residing the case looked over the Missouri Living Will statute that states the state’s desire to “preserve every life.” Finally, the Court addressed Cruzan’s friend’s testimony that claimed Cruzan would give permission to close members to stop treatment anytime she is in a state of no recovery. The court called the testimony “unreliable for the purpose of determining her intent.”

The court, in a divided opinion, told Cruzan’s parents that they cannot assume Nancy Cruzan’s decisions because she is incompetent. The Court referred back to the Missouri’s Living Will. Also according to the law, the common law is a sacred right that protects citizens from even touching another person without consent, if not, it is called battery.

On the other hand…

A similar case was debated in Florida.

Terri Schiavo faced a similar situation while she was in Florida. One day, Shiavo collapsed due to an “abnormally low” level of potassium in her brain, which was found in her autopsy. Shiavo was unable to send oxygen to her brain, which may have caused her to lose consciousness and enter a vegetation state. Schiavo allegedly had a history of bulimia.

The doctors revealed that while Schiavo was able to breathe on her own, but she was incapable of having thoughts or emotions. The level of brain damage was presumed irreversible.

The fate of Terri Schiavo was debated in court between her husband, Michael Schiavo, and her parents, Robert and Mary Schindler. Her husband wanted to remove the feeding tube because he claimed that the two had a conversation beforehand in which, that Terri Schiavo would “not want to live this way,” as he claims. Schiavo’s parents believed the opposite: they wanted to continue her life support because they had hope that their daughter was still with them.

Unfortunately, Michael Schiavo had won the case and his late-wife was taken off the feeding tube. Terri Schiavo died three days later.

In 2003, Governor Jeb Bush passed a state legislature in Florida that forbade removal of life support in every circumstance. That legislation, Terri’s Law, was later deemed unconstitutional by the Florida Supreme Court.


Do you think a close member to you should make the decision of stopping necessary treatments when you are in the vegetation state? Comment below or on Facebook!





Sosa, Ninette. "Terri Schiavo Has Died." CNN. Cable News Network, 31 Mar. 2005. Web. 11 July 2014.

Haberman, Clyde. "From Private Ordeal to National Fight: The Case of Terri Schiavo." The New York Times. The New York Times, 20 Apr. 2014. Web. 11 July 2014.



Joseph M. Ghabour
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Auto, Bus, Pedestrian, Motorcycle accident, medical malpractice and worker's compensation attorney.
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