Hastings Law Journal


The United States Supreme Court's landmark decision in Cruzan v. Director, Missouri Department of Health refused to recognize a constitutional right for Nancy Cruzan, a permanently comatose woman, to have her family decide whether life-sustaining medical treatment should be terminated. Eight members of the Court, however, acknowledged that a competent patient could have ordered the termination of life support.

After reviewing the Supreme Court's decision, Professors Martyn and Bourguignon present what they find to be a critical error in the Court's Cruzan analysis. Earlier state court decisions required procedural protections in surrogate decisionmaking cases but did not impose the state's own substantive values upon the family's decision regarding termination of life support. The Supreme Court majority expressed concern for the risk of erroneous decisionmaking in refusing to defer to the decision of Cruzan's family without clear proof of her wishes. The authors argue, however, that the majority exacerbated rather than prevented Missouri's usurpation of Cruzan's rights. They then offer an alternative model for conservative constitutional analysis that would avoid the problems created by the Court's Cruzan decision.

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