Nancy Cruzan Case Summary

This problem first began to surface in the 1980s when the court had to face Cruzan v. Director, Missouri Department of Health. In this case the court had to decide by “clear and convincing evidence” that the comatose patient’s (Nancy Beth Cruzan) desire to terminate her life before the courts would allow her family’s wish of disconnecting her feeding tube be carried out. Unfortunately eight of nine judges said no to the proposition and concluded that the right

On June 25, 1990, the family appeals to the United States Supreme Court, but the court denied their request once again. On August 30, 1990, Cruzan’s parent request a second hearing from Judge Charles Teel because they believed that they had enough new evidence to prove that their daughter would rather die, than to want to live this way. Finally on December 14, 1990, Judge Teel declares that the parents have the authority to have the feeding tube removed (Chicago Tribune, 1990). After the feeding tube was removed, Nancy Cruzan passed away peacefully on December 26, 1990.

If I had to make the decision on what to do in Terri Schaivo’s case I would do what Michael Schiavo had done, I would fight to have the feeding tube removed. I believe that if a person has no quality of life and is in a PVS state, they have no feelings, they feel no pain, and they are not aware of their surroundings. According to the article Terri Schiavo and End-of-Life Decisions “Terri could not continue both to be alive and be free from invasive medical procedures” (Mathes, 2005) I feel keeping them alive is unfair to them and to their loved ones. I also believe that the surrogate decision maker should follow the “best interest” standard, which is, given the medical facts and prognosis, make decisions that would be in the best interests of the patient. (Hook & Mueller, 2005) There was a lot of evidence and proof from the doctors in regards to the fact that Terri was not going to get better, there were no medical interventions left that could help her. Prolonging treatment for Terri would not have changed her quality of life or made it better. In my opinion, Michael Schiavo acted properly as a surrogate decision maker because first of all, he followed her previously spoken wishes and views and, second of all, he acted in her

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

After 3 years of hoping Nancy would get better the Cruzan family decided that taking Nancy of the feeding and hydration tube is what Nancy would have wanted and what they thought was best. However the Cruzan's request was refused by the Missouri Department of Health. They believed they needed clear and convincing evidence that taking their daughter of the feeding and hydration tube is what Nancy would have really wanted. The Cruzans disagreed they thought that as her legal guardians they would speak for the decision she can not physically make. The Cruzans then took this to local court, but the case did not stop their. It made its way to the Supreme Court and became known as Cruzan v. Missouri Department of Health. Final outcome of the case was 5-4 in favor of the Missouri Department of Health. "The Court felt that the Cruzan case was best explored in the area of 'liberty' rather than 'privacy.' The Supreme Court upheld the authority of States to demand “clear and convincing” evidence of the injured person's wishes."(Cruzan by Cruzan v. Director, Missouri Department of Health. (n.d.). Oyez. Retrieved December 8, 2015, from

When Nancy was in a coma they were assigned as her legal guardians until she got better. They argued that if the hospital needed to get their permission, as legal guardians, to insert the tube to Nancy, their request, as legal guardians, to take the tube out should be respected. They also argued that the huge cost of Nancy's treatment "could be better spent on medical procedures for children facing death." (Cruzan v. Director, Missouri Dept. of Health (1990). (n.d.). Retrieved

An emergency call came in at 9:45 am made by Doug Greene who is a neighbor of the victim Anna Garcia claiming that he had not seen Anna Garcia since her normal morning walk at 6:30 am the previous morning and that the dog had been barking for 2 hours, he had also mentioned that Anna Garcia was wearing a sweater when he had seen her the previous morning while experiencing a 92 degree heat wave. Mr.Greene had called Anna’s telephone with no answer, and had also rang the doorbell with no answer. The EMT and local police had arrived to the scene at 9:56 am, needing to break the door down. EMS discovered Anna Garcia laying face down, dead.

Select an ethical dilemma related to health policy from the categories of moral values, professional regulation, health of individuals in society, or distributive justice. What are the controversies surrounding this issue? What are the opposing ethical principles? How has past or current health policy addressed this dilemma? Support your reasoning with reference citations.

In this assignment you will practice what you have learned in chapters 5 and 7 in the Medical Law and Ethics textbook:

In the CRUZAN v. DIRECTOR, MISSOURI DEPARTMENT OF HEALTH 497 U.S. 261 (1990) case that was presented to the Supreme Court in 1990 was about a woman named Nancy Beth Cruzan and her right to die. The According to thesciencewritinblog.com, “On January 11, 1983 Nancy Beth Cruzan’s car overturned when she was driving home from her job at a cheese factory. She was found face down in a ditch, and although paramedics restarted her heart, 15 minutes without oxygen left her with severe brain damage (Science and Law).” Cruzan stayed in a diligent vegetative state in which she showed no intellectual capacity, yet had reflexes after waking up from her 3 week coma. Cruzan parents wanted take off life support but the hospital refused to do so without a court order because there was no living will so there was no evidence to support that Nancy would have wanted that for herself.

In the year of 1990 on February 25, a presumably healthy young women by the name of Theresa Marie Schiavo better known as Terri suffered a massive heart attack in her Florida home which left her with serve brain damage. At the age of 26 she found herself unable to speak, or move, and unfortunately without a living will in place. How can she have told them what she really wanted if unable to talk in a vegetative state? Terri, although able to breathe on her own, found herself unable to eat or use the bathroom without the aid of a machine or person she was literally a prisoner in her own body. By law her husband Michael Schiavo was in charge of making treatment decisions for her , and after two years of therapy he wanted to disconnect the feeding tubes that helped keep her alive.

The ethical principles for nurses to practice with beneficence and no maleficence. This legal battle between Terri Schiavo’s husband and her family was an ethical debate between continuing artificial life or remove her feeding tube by the request of her husband. Using the theories of utilitarianism and deontology can be applied or considered in making the most ethically correct resolution. The cases are very complex and raise many moral and ethical issues. The cases have brought awareness to society of “the importance of discussing end-of-life issues with family members and underscores how an advance directive, a living will and/or durable power of attorney for health care, are a healthcare proxy clarifies and provides evidence of the wishes of an individual regarding end-of-life decisions. Terri Schiavo should impress upon laypersons and professionals alike the uncertainty of the context in which issues of continuation and termination are argued ethically. Nobody knows what Mrs. Schiavo would have wanted. She left no advance directive and in its absence her husband says one thing and her parents

After finally accepting that Nancy would not be revived, the family asked the state hospital to remove her feeding tubes so that she could move on. Unfortunately, it could not be this easy. Discovering that Nancy was not allowed by the state to be taken off of life support, they proceeded with legal action. After several suits between the Cruzan family and the state's attorney general in the Missouri court system, the U.S. Supreme Court agreed to hear its first right-to-die case, that of Nancy Cruzan. In a 5-4 decision, the Cruzan family lost, buried in hundreds of pages of the Supreme Court’s opinion. Eventually, their lawyer was able to find the key that would let them retry the case in Missouri, leading them to a victory (Gumm).

Terri Schiavo was 26 years old when she collapsed in her home and suffered acute hypoxia for several minutes. Slightly shy of a year after her injury, it was clinically determined that she was in a persistent vegetative state (Perry, Churchill, & Kirshner, 2005). There were no legal documents, such as an advance directive or living will, specifying the wishes for care under such circumstances. Her husband, Michael Schiavo, was designated as her legal guardian. The Schiavo case caught the public’s attention when her husband elected to remove her feeding tube in the mid 1900’s. He understood that there has never been a case of recovery after a year of being in a persistent vegetative state. One of the moral issues surrounding the case centered on the appropriateness of removing the life-sustaining feeding tube or maintaining it. Throughout the case, there has

They were the subjects of public disputes with family members, court systems, medical professionals, the media, and society at large. Terri Schiavo, Nancy Cruzan and Karen Ann Quinlan; their names are synonymous with permanent vegetative state (PVS). The amazing technological advancements in modern medicine has been credited with keeping persons alive who in times past would have died, therefore this is remarkable for countless families. In the cases of the Quinlan’s, the Cruzan’s and many like them, families members find it unbearable to witness loved ones who linger indefinitely in PVS with little or no chance for recovery. There are many like Terri Schiavo’s parents, who value the lives of their love ones no matter how limited their