Cruzan v. Director, Missouri Department of Health

Definition

Cruzan v. Director, Missouri Department of Health is a landmark U.S. Supreme Court case from 1990 that addressed the right to refuse medical treatment and the standards for determining whether a patient wishes to withdraw life-sustaining treatment. This case reinforced the importance of advanced directives and informed consent in medical settings, impacting the legal landscape around life-sustaining treatment decisions, including those made through Physician Orders for Life-Sustaining Treatment (POLST) and considerations in palliative care and hospice settings.

5 Must Know Facts For Your Next Test

1. The case involved Nancy Cruzan, a woman who was in a persistent vegetative state after a car accident, and her family's efforts to remove her feeding tube.
2. The Supreme Court ruled that states have the authority to establish standards for determining whether an individual wishes to refuse life-sustaining treatment.
3. The decision emphasized the need for clear evidence of a patient's wishes, leading to increased awareness and utilization of advance directives and POLST forms.
4. This case set a significant precedent for patient autonomy in medical decisions and established that competent individuals have the right to refuse medical treatment.
5. Cruzan's ruling has influenced subsequent cases and legislation regarding end-of-life care and the rights of patients in palliative care contexts.

Review Questions

• How did Cruzan v. Director impact patient autonomy in medical decisions regarding life-sustaining treatment?
  • Cruzan v. Director established a crucial legal precedent affirming that patients have the right to refuse life-sustaining treatment based on their own wishes. The Supreme Court's ruling underscored the need for clear evidence, such as advanced directives, to determine a patient's intentions. This decision empowered individuals to make autonomous choices about their healthcare and reinforced the importance of documenting those wishes through legal means.
• Discuss the implications of Cruzan v. Director on the development and use of Physician Orders for Life-Sustaining Treatment (POLST).
  • The Cruzan case highlighted the necessity for clear documentation of patient preferences regarding end-of-life care, which led to the creation and wider adoption of POLST forms. These orders provide healthcare providers with explicit instructions from patients about their desires for life-sustaining treatment, ensuring that their choices are respected even when they cannot communicate them. As a result, POLST became an important tool for translating patient wishes into actionable medical orders.
• Evaluate how Cruzan v. Director informs current legal considerations in palliative care and hospice settings when addressing patient treatment preferences.
  • Cruzan v. Director plays a critical role in shaping current legal frameworks surrounding palliative care and hospice services by reinforcing the principle of patient autonomy. The decision supports the notion that patients have the right to make informed choices about their treatment preferences, including opting for comfort care over aggressive interventions. This legal backdrop encourages healthcare providers in palliative and hospice care settings to prioritize conversations about advance directives and actively engage with patients and families about their end-of-life wishes.

Related terms

Advanced Directive: A legal document that allows individuals to outline their preferences for medical treatment in case they become unable to communicate those wishes.

Informed Consent:

The process of obtaining permission from a patient before conducting a healthcare intervention, ensuring that patients are fully aware of the risks and benefits involved.

Life-Sustaining Treatment: Medical procedures that extend the life of a patient who is unable to sustain life independently, such as mechanical ventilation or feeding tubes.