Cruzan, by Her Parents and Co-Guardians, Cruzan et ux. v. Director, Missouri Department of Health, et al.
In a 5–4 decision, the Court affirmed the earlier ruling of the Supreme Court of Missouri and ruled in favor of the State of Missouri, finding it was acceptable to require "clear and convincing evidence" of a patient's wishes for removal of life support.
497 U.S. 261 · No. 88-1503 · 1989 term · Rehnquist Court
Decided Jun 25, 1990 · argued Dec 6, 1989
Privacy · Right to die
Landmark · End of life
Majority opinion: William Rehnquist
The voteMajorityDissent
5–45 in the majority, 4 in dissent
4 dissents (5–4)
Affirmed. Cruzan, by Her Parents and Co-Guardians, Cruzan et ux. lost.
What this ruling means
Affirmed: the Supreme Court upheld the decision of the Missouri Supreme Court, so it stands (sometimes with changes the Court made to it).
Cruzan, by Her Parents and Co-Guardians, Cruzan et ux. was the petitioner, the side that asked the Supreme Court to review the case. “Lost” means the Court did not give that side the result it asked for.
From the Supreme Court Database. A justice who agreed with the result but not the reasoning counts in the majority.
Summary
The opening of the case’s Wikipedia article: what the case was about and what the Court held.
Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990), is a landmark decision of the Supreme Court of the United States involving a young adult incompetent. The first "right to die" case ever heard by the Court, Cruzan was argued on December 6, 1989, and decided on June 25, 1990. In a 5–4 decision, the Court affirmed the earlier ruling of the Supreme Court of Missouri and ruled in favor of the State of Missouri, finding it was acceptable to require "clear and convincing evidence" of a patient's wishes for removal of life support. A significant outcome of the case was the creation of advance health directives.
Data notes
The text is Wikipedia’s (CC BY-SA 4.0), matched to the case by its citation, docket number or name and year, and is not checked against the opinion. The site keeps the article’s opening section, ending on its last full sentence. The one-sentence summary under the title is the Decisions list’s: Wikipedia’s own ruling sentence, or, tagged “AI-written”, one Claude wrote from this opening.
How the justices voted
Each justice who took part, placed by their Martin–Quinn ideology score for the 1989 term. Filled: the 5 in the majority. Hollow: the 4 in dissent. Colour is the party of the president who appointed them.
Majority(5)
William RehnquistWrote the majority opinion
Sandra O'ConnorWrote a concurrence
Antonin ScaliaWrote a concurrence
Byron WhiteJoined the majority
Anthony KennedyJoined the majority
Dissent(4)
William BrennanWrote a dissent
John StevensWrote a dissent
Thurgood MarshallJoined a dissent
Harry BlackmunJoined a dissent
Data notes
Each justice’s vote and what they wrote are from the justice-centered file of the Supreme Court Database. “Wrote a concurrence” means the justice sided with the majority and wrote separately; a justice who dissented in part is counted on the side they took overall. A justice who wrote nothing is listed as joining their side.
Positions are each justice’s Martin–Quinn score for the case’s term, the same scores as the Ideology page: negative is more liberal, positive more conservative. A score sums up a justice’s votes across the whole term, so it says where they usually sit, not why they voted as they did here. The median line is the Court’s median justice that term.
The parties
Who brought the case to the Court, who answered it, and how it got there.
- Petitioner
- Cruzan, by Her Parents and Co-Guardians, Cruzan et ux.Retarded person, or mental incompetent
- Respondent
- Director, Missouri Department of Health, et al.State (Missouri)
- Reached the Court by
- Certiorari (the Court chose to hear it)
Data notes
The names are the two sides of the case’s title. The description under each is the Supreme Court Database’s category for that party, in its own wording. The petitioner is the side that asked the Supreme Court to review the decision below. “Why it was taken” appears only when the majority opinion says lower courts disagreed or were unsure about the question; reasons that would fit any case (“to resolve the question presented”, “an important question”) are left out.
The law at issue
The law the Court was asked to apply, and the kind of power it used to decide.
- Provision
- Fourteenth Amendment (due process)
- Kind of law
- Constitutional Amendment
- Decided by
- Judicial review (state level)
Data notes
The Supreme Court Database codes the main constitutional provision, statute or court rule each case turned on, and the basis of the decision: judicial review of a federal or state law, interpreting a statute, supervising the lower courts, and so on. A case can rest on more than one. “Overruled” counts only where the majority opinion says so.
Timeline
What happened at the Court and how the case got there, newest first.
- Jun 25, 1990DecidedDecided · Decided 5–4: affirmed. Cruzan, by Her Parents and Co-Guardians, Cruzan et ux. lost.
- Dec 6, 1989ArguedArgued · Oral argument before the Court.
- Not datedTaken upTaken up · The Supreme Court agreed to hear the case (certiorari).
- Not datedCourt belowCourt below · Decided by the Missouri Supreme Court: reversed, with a dissent.
- Not datedBeganBegan · The case began in the Missouri trial court.
Data notes
From the Supreme Court Database: the court the case began in, the court whose decision the Supreme Court reviewed and what that court did, how the case came to the Court, and the dates of argument and decision. The database does not date the steps in the lower courts. Court names are the database’s.
Other decisions on the same issue
3 other argued cases since 1946 on right to die, newest first.
- Alberto R. Gonzales, Attorney General, et al. v. Oregon, et al.Landmark · End of life546 U.S. 243Jan 17, 2006 · 546 U.S. 243PrivacyLandmark · End of life6–36–3 band
- Dennis C. Vacco, Attorney General of New York, et al. v. Timothy E. Quill et al.Landmark · End of life521 U.S. 793Jun 26, 1997 · 521 U.S. 793PrivacyLandmark · End of life9–0Unanimous band
- Washington, et al. v. Harold Glucksberg et al.Landmark · End of life521 U.S. 702Jun 26, 1997 · 521 U.S. 702PrivacyLandmark · End of life9–0Unanimous band
Data notes
Every other orally argued case with a clear vote, from the 1946 term on, that the Supreme Court Database files under the same issue as this one. The database gives each case one issue from a list of about 270 (abortion, search and seizure of vehicles, the death penalty, and so on), whatever law it turned on.
Official record
Read the full opinion on Justia, the argument audio on Oyez and Wikipedia. Case data from the Supreme Court Database, Version 2026 Release 01, through the 2025 term.