However, as shown by the SUPPORT study [SUPPORT PRINCIPLE Invertigators, 1995], the presence of Natural Death Acts did not ensure that end-of-life care they desired . Guido (2006) states that the case of Nancy Cruzan, a young woman who remained in a persistent vegetative stat following an automobile accident and whose family maintained that she would never have desired such technologically driven care, motivated Congress to enact federal legislation that would require states to make patients aware of their rights to have advance directives and to decide about their own care [Cruzan v. Director ,Missouri Department of Public Health, 1990].