www.rbs2.com/rtd.pdf 6 Jul 2012 Page 1 of 157 Annotated Legal Cases Involving Right-to-Die in the USA Copyright 2005, 2012 by Ronald B. Standler no claim of copyright for works of the U.S. Government no claim of copyright for text of judicial opinions or other quotations Keywords Bouvia, Colyer, Conroy, Cruzan, Eichner, Fox, Quinlan, Schiavo, Storar, Terri, Theresa, court, courts, death, die, dying, extraordinary, law, legal, life-support, life-sustaining, persistent vegetative state, treatment, United States, U.S., U.S.A., withdraw, withhold Table of Contents Introduction . 3 Overview of the Law . 5 initial injury/disease is proximate cause of death . 7 cites to criminal cases . 7 cites to right-to-die cases . 9 advance directives . 11 physician-assisted suicide . 13 Quinlan . 13 medical facts . 13 trial court . 16 New Jersey Supreme Court . 21 Brother Fox . 32 medical facts . 32 trial court . 33 first appeal . 42 New York Court of Appeals . 50 Colyer . 53 medical facts . 53 Washington Supreme Court . 53 Conroy . 61 medical facts . 61 trial court . 62 www.rbs2.com/rtd.pdf 6 Jul 2012 Page 2 of 157 first appeal . 65 New Jersey Supreme Court . 65 Bouvia . 84 medical facts . 84 trial court . 86 appellate court . 86 concurring opinion . 92 further history . 93 similar cases . 94 Cruzan . 95 medical facts . 96 trial court . 97 Missouri Supreme Court . 99 U.S. Supreme Court . 116 Justice Brennan’s dissent . 123 Justice Stevens’ dissent . 137 remand to trial court . 140 Theresa Schiavo . 140 medical facts . 141 initial group of cases . 142 Florida Statute . 143 more litigation in Florida . 144 U.S. Statute . 145 U.S. Statute Unconstitutional . 149 autopsy . 152 excessive litigation . 153 More Information . 155 Conclusion . 156 www.rbs2.com/rtd.pdf 6 Jul 2012 Page 3 of 157 Introduction As a matter of well-established law, a mentally competent adult patient has the legal right to refuse continuing medical treatment, even if that refusal will hasten his/her death, as discussed in detail in my essay at http://www.rbs2.com/rrmt.pdf . The present essay contains annotated quotations from the major reported cases in the USA on the legal right of a patient to refuse medical care when the patient is either (1) unable to express his/her choice (e.g., patient in a persistent vegetative state) or (2) physically unable to disconnect their feeding tube or ventilator that keeps them alive (e.g., because patient is quadriplegic). The scope of this essay is limited to patients who were mentally competent adults prior to their injury/illness and excludes both children, mentally retarded adults, and inmates of prisons. These cases — involving patients either (1) currently unable to express their choice or (2) physically unable to refuse medical treatment — are conventionally known as “right-to-die” cases, although that phrase is a misnomer.1 Everyone is going to die sometime, and there is nothing that judges or physicians can do to prevent an ultimate death. The real legal issue is the right of adult patients to refuse continuing medical treatment, and thereby die sooner than they would with continued medical treatment. I list the cases in chronological order in this essay, so the reader can easily follow the historical development of a national phenomenon. I am interested in this subject for two different reasons. First, I am interested in constitutional privacy law,2 which sets limits on the power of governments to intrude in personal choices and Second, I am interested in the relationship between technology and change in the law. Prior to the 1960s, people tended to die quickly. Modern medical technology can prolong life, even when the quality of life (according to the affected individual) is not worth living. People in persistent vegetative states can live for tens of years, in a meaningless and undignified existence, and consuming large amounts of money in health care expenses. The legal and religious rules that worked well prior to the 1960s are suddenly not only inadequate, but also harsh and cruel. In 1987, the New Jersey Supreme Court wrote: Death comes to everyone. However, in our society, due to great advances in medical knowledge and technology over the last few decades, death does not come suddenly or completely unexpectedly to most people. President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Deciding to Forego Life- 1 George J. Annas, “The ‘Right to Die’ in America: Sloganeering from Quinlan and Cruzan to Quill and Kevorkian,” 34 DUQUESNE LAW REVIEW 875, 880 (Summer 1996). 2 Ronald B. Standler, Fundamental Rights Under Privacy in the USA, http://www.rbs2.com/priv2.pdf (Aug 1998). www.rbs2.com/rtd.pdf 6 Jul 2012 Page 4 of 157 Sustaining Treatment 15 (1983) (hereinafter President's Commission Report ). [footnote omitted] Instead, most people who die are under the treatment of health care professionals who are able to continue physical existence for.