employees refused w/o court approval, to honor the request of Cruzan‘s parents, to terminate her artificial nutrition and hydration, since it would result in death.
A State Trial Court authorized the termination, finding that a person in Cruzan‘s condition has a fundamental right under the State and Federal Constituents to direct or refuse the withdrawal of death-prolonging procedures. In addition, Cruzan‘s expression to a former housemate that she would not continue her life if sick or injured, unless she could live at least halfway normally suggested that she would not wish to continue on with her nutrition and hydration.
The State Supreme Court reversed. While recognizing a right to refuse treatment embodied in the common-law doctrine of informed consent, the court questioned its applicability in this case. The Court then decided that the State Living Will stat ute embodied a state policy strongly favoring the preservation of life, and that Cruzan‘s statement to her housemate were unreliable for the purpose of determining her intent. It rejected the argument that her parents were entitled to order the termination o f her medical treatment, concluding that no person can assume that choice for an incompetent in the absence of a Living Will statute or clear and convincing evidence of the patient‘s wishes.
ISSUE: W/N THE REQUIREMENT OF CLEAR AND CONVINCING EVIDENCE IN WITHDRAWAL OF LIFE- SUSTAINING TREATMENT AN INFRINGEMENT OF A PERSON’S LIBERTY.
RULING: NO. The US Constitution does not forbid the state to require that evidence of an incompetent‘s wishes as to the
withdrawal of life-sustaining treatment be proved by clear and convincing evidence.
A competent person has a liberty interest under the Due Process Clause in refusing unwanted medical treatment. Missouri has recognized that under certain circumstances, a surrogate may act for the patient in electing to withdraw hydration and nutrition and thus cause death. It has also established a procedural safeguard to assure that the surrogate‘s action conform as best as it may to the wishes expressed by the patient while competent.
Missouri has a general interest in the protection and preservation of human life. It may legitimately seek to safeguard the personal element of an individual‘s choice between life and death. The State is also entitled to guard against potential abuses by surrogates. The State Supreme Court did not commit constitutional error in concluding that the evidence adduced at trial did not amount to clear and convincing proof of Cruzan‘s desire to have her life support withdrawn.
The Due process clause does not require a State to accept the ‖substitute judgement‖ of close family members in the absence of substantial proof that their views reflect the patient‘s. However, for the same reason that it may require clear and convincing evidence of the patient‘s wishes, it may also choose to defer only those wishes rather than confide the decisions to close family members.
THE SCHIAVO CASE:
THE GUARDIANSHIP OF THERESA MARIE SCHIAVO (TERRI). INCAPACITATED. FACTS:
Terri was married to petitioner, Michael Schiavo, on November 10, 1984. They were engaged a year prior to their marriage and have been dating for two years. Terri‘s parents Robert and Marie Schindler have generally maintained amicable relationship with Michael prior to February 14, 1993 when their relations severed due to monetary issues.
On February 25, 1990, Terri suffered cardiac arrest due to imbalance of potassium in her system. Since then, Terri never regained consciousness and remained in comatose state. She is being nourished and hydrated via a feeding tube and by this Petition her husband seeks authority to withdraw such life support.
In 1992, Michael Schiavo won a settlement against Terri‘s physician prior to her cardiac arrest, receiving $300,000 as regards his loss of consortium claim and the guardianship of Terri of $700,000 as regards her damages. Monies were actually received February 1993.
.
On February 14, 1993, amicable relationship between husband and parents was severed. Such severance was predicated on money and the fact that Mr. Schiavo was unwilling to equally divide his loss of consortium award with the parents. Money overshadows the entire case and creates potential of conflict of interest for both sides.
There is a Conflict of Interest existing between the husband and the parents:
The husband is claiming that if Terri died while still married to him, he‘ll definitely be the heir to the estate. The parents are hoping for Michael to divorce Terri and be appointed as guardians and become heirs at law.
By all accounts, Mr. Schaivo has his wife‘s best interest at heart, pursuing the best medical care for his wife. Mr. and Mrs. Schindler however think otherwise and filed an action to have him removed as guardian based on numerous unsupported allegations which the Guardian Ad Litem denied.
ISSUE:
Should the Petition for Authorization to Discontinue Articficial Life Support of Michael Schiavo, guardian of Terri Schiavo, an incapacitated person, be granted?
ruling: Court ruled in favour of petitioner.
2 Considerations:
1. Terri‘s oral declarations. 2. Terri‘s incapacity.
Court finds beyond reasonable doubt that Terri is in a persistent vegetative state per specific testimony of Dr. James Barnhill and corroborated by Dr. Vincent Gambone. Medical evidence conclusively established that she has no hope of ever regaining consciousness and without the feeding tube she will die in 7-14 days. Medical opinions are supported by CAT scans. Chances of recovery are slim since she has suffered severe brain damage.
Court applied the law set forth in In re: Guardianship of Estelle M. Browning* (wherein a will was made prior to her incapacity) to the facts of Schiavo case. Court must decide whether or not there is clear and convincing evidence that Terri made oral declaration which would support what her surrogate (Petitioner) now wishes to do. Court previously found that the second part of that test i.e. the patient does not have a reasonable probability of recovering competency is without a doubt satisfied by the evidence.
Statements which Terri made which do support the relief sought by petitioner includes statements to him prompted by her grandmother being in intensive care that if she was ever a burden she would not want to live like that.
The court specifically finds that these statements are Terri‘s oral declarations concerning her intentions as to what she would want done under the present circumstances and the testimony regarding such oral declarations is reliable, creditable, and rises to the level of clear and convincing evidence to this court.
Guardian Ad Litem – appointed to prosecute/defend a suit on behalf of a party incapacitated by infancy or otherwise.
In the case of Estelle Browning, she had a living will and the issue was essentially whether or not an incapacitated person possessed the same right of privacy to withhold or withdraw life supporting medical treatment as did a competent person.
CLINTON v. JONES 27 MAY 1997
FACTS: Respondent sued to recover damages from petitioner, the current President of the United States, alleging, inter alia15, that while he was Governor of Arkansas, petitioner made ―abhorrent‖ sexual advances to her, and that her rejection of those advances led to punishment by her supervisors in the state job she held at the time. It is perfectly clear that the alleged misconduct of petitioner was unrelated to any of his official duties as President of the US and, indeed, occurred before he was elected to that office. In response to the complaint, petitioner promptly advised the District Court that he intended to file a motion to dismiss on the grounds of Presidential immunity. The Court of Appeals explained that the President, like all other government officials, is subject to the same laws that apply to all other members of our society that he could find no ―case in which any public official ever has been granted any immunity from suit for his unofficial acts.‖
15
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ISSUES:
W/N THE PRESIDENT ENJOYS TEMPORARY IMMUNITY FROM CIVIL DAMAGES LITIGATION ARISING