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http://caselaw.lp.findlaw.com/data/cons ... /11.html#4
''Right to Die'' .--In Cruzan v. Director, Missouri Dep't of Health, 314 the Court upheld Missouri's requirement that, before nutrition and hydration may be withdrawn from a person in a persistent vegetative state, it must be demonstrated by ''clear and convincing evidence'' that such action is consistent with the patient's previously manifested wishes. The Due Process Clause does not require that the state rely on the judgment of the family, the guardian, or ''anyone but the patient herself'' in making this decision, the Court concluded. 315 Thus, in the absence of clear and convincing evidence that the patient herself had expressed an interest not to be sustained in a persistent vegetative state, or that she had expressed a desire to have a surrogate make such a decision for her, the state may refuse to allow withdrawal of nutrition and hydration.
''A State is entitled to guard against potential abuses'' that can occur if family members do not protect a patient's best interests, and ''may properly decline to make judgments about the 'quality' of life that a particular individual may enjoy, and [instead] simply assert an unqualified interest in the preservation of human life to be weighed against the . . . interests of the individual.'' 316
The Court's opinion in Cruzan ''assume[d]'' that a competent person has a constitutionally protected right to refuse lifesaving hydration and nutrition. 317 More important, however, a majority of Justices separately declared that such a liberty interest exists. 318 Thus, the Court appears committed to the position that the right to refuse nutrition and hydration is subsumed in the broader right to refuse medical treatment. Also blurred in the Court's analysis was any distinction between terminally ill patients and those whose condition has stabilized; there was testimony that the patient in Cruzan could be kept ''alive'' for about 30 years if nutrition and hydration were continued.




