Practicing medicine, fiduciary trust privacy, and public moral interloping after Cruzan

The Supreme Court decision in Cruzan reaffirmed the power of the states to set procedural standards for due process regarding the individual's exercise of his liberty interest. As a result, to effect an autonomous decision to refuse treatment when one becomes incompetent requires an affirmative articulation by means of an advance directive. This article argues against simplified advance directives in that they fail to enhance individual liberty and responsibility and fail to provide physicians with needed information. A model protective advance directive is advocated with direction to terminate personal and health insurance payments for health care that is not desired by the patient.