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The Supreme Court

Denying the Right to Die

Can a person seek assistance to die from a physician if they are terminally or seriously ill? That all depends on the state you live in. So far the Supreme Court has ruled that states can ban assisted suicide. Two cases decided June 26, 1997, upheld bans on physician-assisted suicide. One involved a law in New York state and the second involved a Washington state law.

Just the Facts

The state of Oregon is the only state that provides for legalized assisted suicide. The Oregon Death with Dignity Act was passed in 2001. The state tracks the number of prescriptions written for lethal does of medication. In 2001, 44 prescriptions were written, which was an increase from 24 prescriptions in 1998, 33 in 1999, and 39 in 2000. Ninety-four percent of patients in Oregon that request assistance from their physicians for suicide say it is because of loss of autonomy. Other major reasons are the inability to participate in activities that make life enjoyable (76 percent) or the loss of control of bodily functions (53 percent).

Dr. Harold Glucksberg challenged the Washington state law along with four other physicians and a nonprofit organization that counsels individuals contemplating physician-assisted suicide. The state of Washington criminalizes the promotion of suicide attempts by those who “knowingly cause or aid another person to attempt suicide.” The district court ruled in favor of Glucksberg and the 9th Circuit Court agreed, so Washington state took the case to the Supreme Court.

Dr. Timothy Quill challenged the constitutionality of New York state's ban on physician-assisted suicide in district court. New York does allow a patient to refuse lifesaving treatment, but makes it a crime for a doctor to help patients commit or attempt suicide, even if the patient is terminally ill or in great pain. The district court ruled in the state's favor, but the 2nd Circuit Court overturned that ruling, so the state of New York appealed to the Supreme Court.

The Supreme Court ruled unanimously that states had the right to prohibit assisted suicide. Chief Justice Rehnquist wrote the opinion for the court and was joined by Justices Kennedy, O'Connor, Scalia, and Thomas. Justice O'Connor also wrote a concurring opinion and was joined by Ginsburg and Breyer in part. Additional concurring opinions were filed individually by Stevens, Souter, Ginsburg, and Breyer.

Rehnquist wrote in his opinion for the Court in Washington v. Glucksberg:

Supreme Sayings

“… we must be wary of those who are too willing to end the lives of the elderly and the ill. If we ever decide that a poor quality of life justifies ending that life, we have taken a step down a slippery slope that places all of us in danger. There is a difference between allowing nature to take its course and actively assisting death.”

—C. Everett Koop, M.D., former Surgeon General of the United States

  • “More specifically, for over 700 years, the Anglo-American common law tradition has punished or otherwise disapproved of both suicide and assisting suicide … Though deeply rooted, the States' assisted suicide bans have in recent years been reexamined and, generally, reaffirmed. Because of advances in medicine and technology, Americans today are increasingly likely to die in institutions, from chronic illnesses. … Public concern and democratic action are therefore sharply focused on how best to protect dignity and independence at the end of life, with the result that there have been many significant changes in state laws and in the attitudes these laws reflect. Many States, for example, now permit 'living wills,' surrogate health care decision-making, and the withdrawal or refusal of life sustaining medical treatment. … Attitudes toward suicide itself have changed … but our laws have consistently condemned, and continue to prohibit, assisting suicide. Despite changes in medical technology and notwithstanding an increased emphasis on the importance of end-of-life decision-making, we have not retreated from this prohibition.”

Rehnquist's opinion for Vacco v. Quill cites the Glucksberg ruling for full legal interpretation, so I won't quote from that here. While the Court ruled that a state could ban assisted suicide it also invited continued debate on the subject:

  • “Throughout the Nation, Americans are engaged in an earnest and profound debate about the morality, legality, and practicality of physician-assisted suicide. Our holding permits this debate to continue, as it should in a democratic society.”

The debate about assisted suicide is continuing at the ballot box and in state legislatures. California and Michigan have laws on the books regarding end-of-life care. In fact California requires physicians to take classes in pain management and end-of-life care as part of getting their licenses.

book cover

Excerpted from The Complete Idiot's Guide to The Supreme Court © 2004 by Lita Epstein, J.D.. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

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