Annas faults the New Jersey Supreme Court for continuing, in its 1985 In re Conroy decision, the "catch-22" approach to treatment refusal by incompetent patients that it instituted in its 1976 In re Quinlan decision. He accuses the court of affirming broad-ranging substantive rights to refuse treatment and then attempting procedurally to restrict their application to very narrow categories of patients, thus hampering the exercise of those rights and failing to promote patient autonomy. In the course of his argument, he analyzes problematic areas in the court's reasoning in the Conroy decision, focusing on its attempt to limit the case to nursing home residents and its equation of artificial feeding with any other life-sustaining medical treatment.
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George J. Annas (1985) studied this question.