The year was 1990. The case was Cruzan v. Missouri Department of Health. And the issue was the right to die. This landmark case, which held unanimous sway in the Supreme Court, is still relevant today, as debates over end-of-life decisions continue to rage in many countries around the world.
At the beginning of the saga, Nancy Cruzan, a Missouri resident, was in an irreversible vegetative state due to a car accident she had suffered three years earlier. Her parents, Joseph and Joyce Cruzan, sought the right to have her artificial nutrition removed so she could die, but the Missouri Department of Health refused to accept their wishes without clear and convincing evidence from Nancy that she wanted this course of action. Ultimately, the Supreme Court sided with the Cruzans in an 8-1 ruling, determining that competent people have the right to decide the fate of their infirm relatives, and that the state could not deny the Cruzans’ wishes, as long as the decision was backed by clear and convincing evidence.
In the aftermath of the ruling, many states have enacted their own versions of the “right to die” laws, allowing patients the right to make decisions regarding end-of-life care and to withhold or withdraw life-prolonging treatments. Others have gone so far as to recognize the concept of “aid in dying” or assisted suicide, where a doctor can provide a medication to end a patient’s life upon request. Ultimately, the ruling in Cruzan v. Missouri Department of Health was a landmark moment in the fight for medical autonomy. In a time when technologies can keep a person alive against their wishes, the case brought with it an important reminder of the importance of self-determination and the right to make end-of-life decisions.