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In July 1980, respondent Jan Hannah purchased a building at 201 Featherston Street in Cleburne, Texas. Hannah intended to lease the property to Cleburne Living Center, Inc. (CLC) for use as a group home. The home would house thirteen mentally retarded men and women under constant staff supervision. The building contained four bedrooms and two baths, and CLC planned to add a half bath while complying with all applicable state and federal regulations for an Intermediate Care Facility for the Mentally Retarded. The site lay in an R-3 Apartment House District. The city's zoning ordinance permitted apartment houses, boarding houses, hospitals, and nursing homes in that district without special permission. However, the ordinance required a special use permit, renewable annually after a public hearing, for hospitals for the insane or feeble-minded. The city classified the proposed group home as a hospital for the feeble-minded and informed CLC that a permit was required. After a public hearing, the City Council voted three to one to deny the application. CLC and its prospective residents filed suit in federal district court against the city and its officials. They alleged that the ordinance and its application discriminated against the mentally retarded in violation of the Equal Protection Clause. The district court upheld the ordinance and the denial. It found that the council's decision was motivated by the residents' mental retardation yet rationally related to legitimate interests such as neighborhood safety and property values. The Court of Appeals for the Fifth Circuit reversed, holding that mental retardation is a quasi-suspect class and that the ordinance was invalid both facially and as applied. The Supreme Court granted certiorari to review the equal protection issues raised by the zoning ordinance and its application to the proposed group home.

Estelle Griswold served as Executive Director of the Planned Parenthood League of Connecticut. Dr. C. Lee Buxton served as the League's Medical Director and was a professor at Yale Medical School. Together they opened and operated a center in New Haven that was open from November 1 to November 10, 1961. At the center they gave information, instruction, and medical advice to married persons as to the means of preventing conception. They examined the wife and prescribed the best contraceptive device or material for her use. Fees were usually charged, although some couples were serviced free. The statutes involved were sections 53-32 and 54-196 of the General Statutes of Connecticut (1958 rev.). Section 53-32 made it a crime to use any drug, medicinal article or instrument for the purpose of preventing conception. Section 54-196 punished accessories as principals. The appellants were found guilty as accessories and fined $100 each. The Appellate Division of the Circuit Court affirmed the convictions. The Supreme Court of Errors of Connecticut affirmed that judgment in State v. Griswold, 151 Conn. 544, 200 A. 2d 479. The United States Supreme Court noted probable jurisdiction. The appellants asserted standing to raise the constitutional rights of the married persons with whom they had a professional relationship. A criminal conviction for serving married couples removes doubts about case or controversy. The rights of husband and wife would be diluted unless considered in a suit involving those who have this kind of confidential relation to them.

On the night of January 11, 1983, Nancy Beth Cruzan lost control of her car as she traveled down Elm Road in Jasper County, Missouri. The vehicle overturned, and Cruzan was discovered lying face down in a ditch without detectable respiratory or cardiac function. Paramedics were able to restore her breathing and heartbeat at the accident site, and she was transported to a hospital in an unconscious state. An attending neurosurgeon diagnosed her as having sustained probable cerebral contusions compounded by significant anoxia. The Missouri trial court found that permanent brain damage generally results after six minutes in an anoxic state, and it was estimated that Cruzan was deprived of oxygen from twelve to fourteen minutes. She remained in a coma for approximately three weeks and then progressed to an unconscious state in which she was able to orally ingest some nutrition. Surgeons implanted a gastrostomy feeding and hydration tube in Cruzan with the consent of her then husband. Subsequent rehabilitative efforts proved unavailing. She now lies in a Missouri state hospital in what is commonly referred to as a persistent vegetative state in which a person exhibits motor reflexes but evinces no indications of significant cognitive function. The State of Missouri is bearing the cost of her care. After it had become apparent that Nancy Cruzan had virtually no chance of regaining her mental faculties, her parents Lester and Joyce Cruzan, who serve as coguardians, asked hospital employees to terminate the artificial nutrition and hydration procedures. All agree that such a removal would cause her death. The employees refused to honor the request without court approval. The parents then sought and received authorization from the state trial court for termination. The trial court found that a person in Nancy's condition had a fundamental right under the State and Federal Constitutions to refuse or direct the withdrawal of death prolonging procedures. The court also found that Nancy's expressed thoughts at age twenty-five in conversation with a housemate friend suggested that given her present condition she would not wish to continue on with her nutrition and hydration. The Supreme Court of Missouri reversed by a divided vote. The court recognized a right to refuse treatment embodied in the common-law doctrine of informed consent but expressed skepticism about the application of that doctrine in the circumstances of this case. The court found that Cruzan's statements to her roommate regarding her desire to live or die under those conditions were unreliable for determining her intent and thus insufficient to support the coguardians' claim to exercise substituted judgment on Nancy's behalf. It rejected the argument that Cruzan's parents were entitled to order the termination of her medical treatment, concluding that no person can assume that choice for an incompetent in the absence of the formalities required under Missouri's Living Will statutes or the clear and convincing inherently reliable evidence absent here. The Supreme Court granted certiorari to consider the question whether Cruzan has a right under the United States Constitution which would require the hospital to withdraw life-sustaining treatment from her under these circumstances.