Nancy Cruzan’s Case in End-of-Life Decision Ethics

When considering a challenging situation of terminating life support, the ethical analysis is applied by both medical personnel and family members to determine the best outcome. Most people feel that such cases require all possible interventions. Morally, it is considered that life-sustaining treatment should be terminated if the chances of a beneficial outcome are smaller than the possibility of harming the patient.

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From a philosophical perspective, by performing a certain action (such as maintaining life-support), the natural course is disrupted, and someone becomes morally responsible. Medical treatment is warranted by medical diagnosis and consent of the patient (or their guardian). If these are considered, then making an end-of-life decision is neither neglect nor euthanasia. From the standpoint of medical professionals, if any certified treatment that can benefit the patient has been attempted, their ethical duty has been fulfilled (Welie & Ten Have, 2014).

Most courts and common laws recognize the concept of a patient to receive treatment. When a patient is incompetent to make the decision, a legal representative must be established by the court to resolve any future medical interventions. The US Supreme Court recognizes the patient’s rights to the refusal of treatment. However, many local jurisdictions require certain conditions to be met before any decisions are made.

The case of Nancy Cruzan was difficult because the woman had no directive of what should be done, and the evidence of her wishes consisted of undocumented conversation. The law on the subject is broad and provides a basic framework that is then used on a case-by-case basis. However, the legal aspect demands that before any decisions are made, the patient should have a terminal or irreversible condition that cannot be successfully treated by any medical intervention (Koppel & Sullivan, 2011).

Advanced directives (ADs) are legal documents that a person completes while having competent decisionmaking ability, which determines which actions should be taken if they lose the capacity of directing treatment. These include selecting an individual who will have the durable power of attorney and directives, which indicate possible wishes or values that the patient might hold regarding such situations. Approximately 70% of Americans now have some form of ADs. When faced with situations of irreversible conditions, medical professionals seek out any advanced directives or living will that a patient might have completed. The presence of this documentation tremendously eliminates the legal and ethical challenges that may occur during end-of-life decision making (Detering & Silveira, 2017).


Detering, K., & Silveira, M. (2017). Advance care planning and advance directive. Web.

Koppel, A., & Sullivan, S. M. (2011). Legal considerations in end-of-life decisionmaking in Louisiana. The Ochsner Journal, 11(4), 330–333. Web.

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Welie, J. V., & Ten Have, H. A. (2014). The ethics of forgoing life-sustaining treatment: Theoretical considerations and clinical decision making. Multidisciplinary Respiratory Medicine, 9(1), 14. Web.

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