Hastings Center News

What Remains of the Constitutional Right to Refuse Treatment?

The Supreme Court’s 1990 decision in Cruzan v. Director, Missouri Department of Health, recognized an individual constitutional right to decline life-sustaining medical treatment. The Court reinforced that right a few years later. But last year’s Dobbs decision creates an opening for government attempts to impose new restrictions on end-of-life choices, writes Hastings Center fellow Rebecca Dresser in the Hastings Center Report.

After Dobbs, refusals of nutrition and hydration, as well as refusals patients expressed before the onset of incapacity, could be at particular risk. As the Dobbs dissent points out, the majority ruling conflicts with Cruzan and other decisions restricting the government’s power to interfere with personal medical choices.

Dresser concludes that the U.S. Constitution is no longer a reliable basis for individual rights protection. “Dobbs is a reminder that persuading lawmakers and voters is often a better strategy than relying on courts for rights protection,” she writes. “In this vein, voters in some states have responded to Dobbs by approving state constitutional amendments aimed at protecting abortion rights. Actions like these could produce laws strengthening patients’ control over life-sustaining interventions, too.”