MBE Rules · Constitutional Law
Right to Refuse Treatment
Cruzan
The rule
Competent adults have a due-process liberty interest in refusing medical treatment including nutrition; states may require clear and convincing evidence of an incompetent patient's wishes and may bar assisted suicide.
In plain English
Competent adults have the constitutional right to refuse medical treatment, which includes the right to decline life-sustaining measures like nutrition. However, if a patient is deemed incompetent, states can require strong evidence of what that patient would have wanted and can prohibit assisted suicide.
Worked example
A 70-year-old man with advanced Alzheimer's is hospitalized and unable to communicate his wishes about treatment. His family argues he would not want to be kept alive with a feeding tube, but there is no written directive. The state requires clear evidence of his wishes before allowing the family to refuse treatment, ultimately deciding to keep him on life support until more evidence is presented.
Memory hook
Competent adults can say 'no' to treatment, but states want proof for the 'no' of the incompetent.
The trap
Exams may present scenarios where a patient's competence is ambiguous, leading students to misapply the rule about the right to refuse treatment. Students might overlook the requirement for clear evidence in cases involving incompetence.
How examiners test it
Questions often involve fact patterns with a patient’s competence being questioned, requiring students to analyze the balance between individual rights and state interests in medical treatment decisions.
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