In 1990 ruling, justices saw right to decline treatment

WASHINGTON -- The Supreme Court ruled in 1990 that a terminally ill person in a ''persistent vegetative state" has a constitutional right to decline life- sustaining treatment.

But the 5-to-4 opinion written by Chief Justice William H. Rehnquist also held that the right was not absolute, saying a state may impose a higher legal burden on a family to demonstrate that a patient actually had consented by ''clear and convincing evidence."

The ruling returned the case of Nancy Cruzan to Missouri state court, which eventually determined the comatose woman indeed had indicated that she wanted to die.

She died 12 days after her feeding tube was removed at her family's request.

Five of the nine justices in that case remain on the court.

Here are excerpts from their opinions:

Rehnquist: ''Close family members may have a strong feeling, a feeling not at all ignoble or unworthy, but not entirely disinterested, either, that they do not wish to witness the continuation of the life of a loved one which they regard as hopeless, meaningless, and even degrading.

''But there is no automatic assurance that the view of close family members will necessarily be the same as the patient's would have been had she been confronted with the prospect of her situation while competent."

Sandra Day O'Connor, concurring: ''Today we decide only that one state's practice does not violate the Constitution; the more challenging task of crafting appropriate procedures for safeguarding incompetents' liberty interests is entrusted to the 'laboratory' of the states in the first instance."

Antonin Scalia, arguing in a concurrence that there is no constitutional right to refuse treatment: ''While I agree with the court's analysis today, and therefore join in its opinion, I would have preferred that we announce, clearly and promptly, that the federal courts have no business in this field, that American law has always accorded the state the power to prevent, by force if necessary, suicide."

Anthony Kennedy joined the majority opinion without comment.

John Paul Stevens, dissenting: ''In my view, the Constitution requires the state to care for Nancy Cruzan's life in a way that gives appropriate respect to her own best interests."