Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana |
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington (state)
Washington, D.C.
West Virginia
Wisconsin
Wyoming
United States |
Foregoing artificial nutrition and hydration has come to be widely accepted as a legitimate option under state law. A survey of how the 50 states (and D.C.) view this issue is provided here (with citations to statutes and court cases in each state).
Key principles to keep in mind regarding the law . . .
- ALL states recognize the competent patient's right to forgo medical treatment of any kind (including artificial nutrition and hydration), at any time, regardless of the patient's condition or prognosis.
- ALL states recognize the right of an incompetent patient to have his or her previously expressed wishes regarding medical treatment followed, regardless of the patient's condition or prognosis. The only important difference among the states is the level of evidence that is required to establish what a patient's wishes would be for his or her present situation.
Most states allow the closest family member to authorize the withholding or withdrawing of life-sustaining treatment (including artificial nutrition and hydration) based on the concept of substituted judgment, where the decision is based on the patient's value system and general outlook on life.
Some states (New York and Missouri, for example) require more explicit expressions of preference (often referred to as clear and convincing evidence) before life-sustaining treatment (especially tube feeding) can be withheld or withdrawn.
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