After Cruzan: the "values base" to advance directives

Technologic advances produce ethical quandaries for health care professionals and the public. Often difficult decisions must be made about treatment. In light of the 1990 U.S. Supreme Court's ruling in the case of Nancy Cruzan, health care decisions surrounding life-sustaining treatment may be affected. National attention is refocused on advance directives (the living will and durable power of attorney for health care decisions). This article considers the possible need for additional "clear and convincing" evidence of the patient's wishes regarding these directives. Included is a Value History Form that provides an avenue of expression for patient values and beliefs.