Living wills and the right to die

Two recent court decisions clarified whether and under what circumstances a patient may refuse life-sustaining medical treatment, including food and water. The Nancy Cruzan case, decided by the U.S. Supreme Court on June 25, 1990, and the case of Shirley Crabtree, decided by Family Court Senior Judge Daniel G. Heely in Hawaii on April 26, 1990, had differing outcomes. Moreover, Hawaii has a living will statute which purports to place limits on when and whether a person may choose to die rather than live in a severely disabled condition. This article will summarize the current law, and will offer practical advice to physicians on how to deal with these sensitive issues that affect their patients.