Select legal decisions related to end-of-life care
| Case | Decision |
|---|---|
| Terry Schiavo, 1990–2005 | A series of federal and state court decisions, ending in 2005 when a court decision allowed the removal of a feeding tube from an incompetent patient who had suffered an anoxic brain injury. The patient’s husband requested withdraw of the patient’s feeding tube and the trial court found that there was clear and convincing evidence that Ms. Schiavo would not have wanted a feeding tube, based on prior oral statements Ms. Shiavo had made to family members. |
| Texas Advance Directives Act, 1999 | Provides in relevant part that, “A physician, or a health professional acting under the direction of a physician, who participates in withholding or withdrawing life-sustaining treatment from a qualified patient in accordance with this subchapter is not criminally liable or guilty of unprofessional conduct as a result of that action unless the physician or health professional fails to exercise reasonable care when applying the patient’s advance directive.” (§ 166.044) and that, “If an attending physician refuses to honor a patient’s advance directive or a health care or treatment decision made by or on behalf of a patient, the physician’s refusal shall be reviewed by an ethics or medical committee. The attending physician may not be a member of that committee. The patient shall be given life-sustaining treatment during the review” (§ 166.046). |
| Death With Dignity Act, 1994 | Permits mentally competent, terminally ill patients to obtain a prescription from their physician for a lethal dose of drug provided certain conditions are met. |
| Patient Self Determination Act, 1990 | Applies to institutions that receive Medicare or Medicaid funding and requires that patients must be informed of their rights regarding medical decision making, including the right to refuse life-sustaining treatment. Such institutions are also required to inquire as to whether patients have an advance directive and to documents any advance directive in the patient’s medical record. |
| Cruzan v. Director, Missouri Department of Health, 1990 | US Supreme Court Case holding that, “(1) the United States Constitution did not forbid Missouri from requiring that clear and convincing evidence of an incompetent’s wishes to the withdrawal of life-sustaining treatment; (2) state Supreme Court did not commit constitutional error in concluding that evidence adduced at trial did not amount to clear and convincing evidence of patient’s desire to cease hydration and nutrition; and (3) due process did not require state to accept substituted judgment of close family members absent substantial proof that their views reflected those of patient.” |
| Bouvia v. Superior Court, 1986 | California decision that a competent 28-year-old quadriplegic patient had right to removal of nasogastric feeding tube inserted against her will. |
| Bartling v. Superior Court, 1984 | California decision that a competent 70-year-old, seriously ill man had right to the removal of respirator. |
| California Natural Death Act, 1976 | First state law establishing a formal procedure to allow certain terminally ill competent adult patients to refuse or have withdrawn life-sustaining interventions. |
| Quinlan, 1976 | Supreme Court of New Jersey decision (70 N.J. 10, 355 A.2d 647 (NJ 1976)) holding that, “upon the concurrence of the guardian [here, the patient’s father] and family of Karen [Quinlan], should the responsible attending physicians conclude that there is no reasonable possibility of Karen’s ever emerging from her present comatose condition to a cognitive, sapient state and that the life-support apparatus now being administered to Karen should be discontinued, they shall consult with the hospital ‘Ethics Committee’ or like body of the institution in which Karen is then hospitalized. If that consultative body agrees that there is no reasonable possibility of Karen’s ever emerging from her present comatose condition to a cognitive, sapient state, the present life-support system may be withdrawn and said action shall be without any civil or criminal liability therefor on the part of any participant, whether guardian, physician, hospital or others.” |