Mid-Atlantic Health Law TOPICS
Supreme Court Finds No Constitutional Right to Physician-Assisted Dying
In a pair of decisions, the U.S. Supreme Court held, on June 26, 1997, that terminally ill individuals do not have a constitutionally protected right to a physician's assistance to die. The result of the decisions is that individual states have the right either to permit or to ban physician assisted suicide on a state-by-state basis.
The Supreme Court rulings specifically found that laws prohibiting physician-assisted suicide in New York and Washington State did not violate the Due Process or Equal Protection Clauses of the United States Constitution.
A. Washington v. Glucksberg
In Washington v. Glucksberg, the Supreme Court held that Washington State's prohibition against causing or aiding a suicide does not violate the Due Process Clause of the Fourteenth Amendment to the U.S. Constitution. The Due Process Clause prohibits the states from taking away rights, except for good reason and with due process of law. Moreover, the Clause requires stricter scrutiny of state actions when "fundamental" rights are involved.
In this context, the Supreme Court observed that the Due Process Clause protects fundamental rights and liberties which are "deeply rooted in the Nation's history and tradition." Since the treatment of assisted suicide in this country has been, and continues to be, one of rejecting nearly all efforts to permit it, the Supreme Court concluded that the asserted "right" to assistance in committing suicide is not a fundamental liberty.
Moreover, the Supreme Court found that Washington State's assisted suicide ban is rationally related to several legitimate government interests, such as: prohibiting intentional killing and preserving human life; preventing suicide, especially among the young, elderly, and individuals suffering from untreated pain, depression or other mental disorders; protecting the medical profession's integrity and ethics, and maintaining the physician's role as healer; protecting vulnerable groups from psychological and financial pressure to end their lives; and avoiding euthanasia.
Consequently, the Supreme Court found that the Washington State statute prohibiting assisted suicide did not violate the U.S. Constitution.
B. Vacco v. Quill
The Supreme Court also found, in Vacco v. Quill, that New York's prohibition on assisting suicide does not violate the Equal Protection Clause of the Fourteenth Amendment to the U.S. Constitution. The Equal Protection Clause embodies the general rule that states must treat like situations alike, but may treat unlike situations differently.
In this context, the Supreme Court rejected a lower appellate court's conclusion that ending or refusing life-sustaining medical treatment "is nothing more nor less than assisted suicide." Instead, the Supreme Court found that the distinction between letting a patient die through inaction and making that patient die is important, logical and rational. In one instance, the patient dies from the underlying disease, and in the other, an affirmative action ends the patient's life--not the underlying disease.
The Supreme Court noted that the overwhelming majority of state legislatures, including New York's, permit the refusal of life-sustaining treatment, while prohibiting assisted suicide. Therefore, the Supreme Court found that the two acts, that is, refusing treatment and assisting suicide, could be treated differently without violating the U.S. Constitution.
C. Impact of the Court's Decisions
While the Supreme Court's opinions in Washington v. Glucksberg and Vacco v. Quill failed to strike down Washington State's and New York's ban on assisted suicide, the fate of physician-assisted dying is far from resolved. In fact, the majority opinion in Glucksberg ended with the comment that "Americans are engaged in an earnest and profound debate about the morality, legality, and practicality of physician- assisted suicide" and the Supreme Court's holdings permit such debate to continue.
Quite simply, since the Supreme Court concluded that the U.S. Constitution does not require a particular outcome, states are free to permit or to ban physician assisted suicide. In fact, Oregon has since opted to permit it.
On November 4, 1997, Oregon voters chose not to repeal the Oregon Death With Dignity Act. That Act allows a mentally competent adult that has been diagnosed with less than six months to live to request a lethal prescription from a physician, and to obtain that dosage after a fifteen day waiting period.
January 30, 1997