Cruzan vs. Missouri Dept. of Health

Cruzan v. Director, Missouri Department of Health

Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990), was a United States Supreme Court case argued on December 6, 1989 and decided on June 25, 1990. In a 5-4 decision, the Court affirmed the ruling of the Supreme Court of Missouri below and ruled in favor of the State of Missouri, finding it was acceptable to require "clear and convincing evidence" for removal of life support.


On January 11 1983, Nancy Cruzan lost control of her old car that had no seat belts, was thrown from it and landed face down in a water-filled ditch. Paramedics found her with no vital signs, but they resuscitated her. After a couple weeks of remaining dormant within a coma, she was diagnosed as being in a persistent vegetative state (PVS). Surgeons inserted a feeding tube for her long-term care. Her husband and parents waited for a more substantial recovery, but eventually, after four years, accepted that there was no hope.

Issues presented

The issue of this case was whether the State of Missouri had the right to require "clear and convincing evidence" in order for the Cruzans to remove their daughter from life support.


In a 5-4 decision, the Court found in favor of the Missouri Dept. of Health. However, it upheld the legal standard that competent persons are able to exercise the right to refuse medical treatment under the Due Process Clause. Because there was no "clear and convincing evidence" of what Nancy Cruzan wanted, the Court upheld the state's policy.

Following the Decision

After the case was decided the family went back and found more proof that Nancy Cruzan would have wanted her life support terminated and eventually won a court order to have her removed from life support. Cruzan died 11 days later on December 26, 1990.

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