DOCTOR-ASSISTED SUICIDE: HIGH COURT GIVES POWER TO STATES
"Stepping for the first time into the wrenching politicalThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
and moral debate over doctor-assisted suicide," the Supreme Court
unanimously ruled yesterday "that states may continue to ban the
practice but at the same time suggested that the door remained
open to constitutional claims for assistance by dying patients in
the future," New York Times reports (Greenhouse, 6/27). The high
court ruling reverses two federal appeals court rulings that
overturned bans on physician-assisted suicide in Washington and
New York states (Chiang, cite>San Francisco Chronicle, 6/27).
However, New York Times reports that the high court's "tone was
that of a tentative first step rather than a definitive final
ruling on the issue." In the majority opinion, Chief Justice
William Rehnquist said, "Our opinion does not absolutely
foreclose such a claim" (6/27). President Clinton said, "[W]e
must never ignore the agony of terminally ill patients, but the
Supreme Court made the right decision today. The risks and
consequences of physician-assisted suicide are simply too great"
(Farrell, Boston Globe, 6/27).
Rehnquist wrote, "The history of the law's treatment of
assisted suicide in this country has been and continues to be one
of the rejection of nearly all efforts to permit it. That being
the case, our decisions lead us to conclude that the asserted
'right' to assistance in committing suicide is not a fundamental
liberty interest protected by the Due Process Clause. ...
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" (Chronicle, 6/27). ALL CONCUR
Justice Sandra Day O'Connor, said in a concurring opinion,
"I agree that there is no generalized right to 'commit suicide,'
and because 'the difficulty in defining terminal illness and the
risk that a dying patients's request for assistance in ending his
or her life might not be truly voluntary justifies the
prohibitions on assisted suicide we uphold here." But, Boston
Globe reports that "O'Connor underscored that yesterday's
decision left open the question of whether 'a mentally competent
person who is experiencing great suffering has a constitutionally
cognizable interest in controlling the circumstances of his or
her imminent death.'" She wrote that "a patient who is suffering
from a terminal illness and who is experiencing great pain has no
legal barriers to obtaining medication, from qualified
physicians, to alleviate that suffering, even to the point of
causing unconsciousness and hastening death" (6/27). Justice
Paul Stevens wrote in a concurring opinion that "he did not
'foreclose the possibility that an individual plaintiff seeking
to hasten her death, or a doctor whose assistance was sought,
could prevail in a more particularized challenge. Future cases
will determine whether such a challenge may succeed" (Ryan,
Detroit News, 6/27).
Dr. Timothy Quill, lead plaintiff in the New York case,
said, "We are back with the status quo which is an arbitrary,
unpredictable, secretive process for those physicians who are
willing to work with their terminally ill patients who face this
hard decision" ("World News Tonight," ABC, 6/26). He added, "The
best protection we can have for patients is to have an open
process." However, New York Attorney General Dennis Vacco (R)
said "the decisions will protect some of the most vulnerable in
our society -- the elderly, disabled and the poor with inadequate
health care -- who would be at most risk if these bans are
overturned." He added, "This ruling will protect Americans from
a regime that says its cheaper to kill patients than to treat
them" (Chronicle, 6/27). He added, "In our wildest estimations,
our wildest dreams, we could never have predicted a 9-0 victory"
("World News Tonight," ABC, 6/26).
FROM THE DOCTORS
Dr. Nancy Dickey, president-elect of the American Medical
Association, said, "To suggest a constitutional right to
physician-assisted suicide would have so fundamentally altered
the relationship between the patient and his or her physician
that it would have undermined the principles of medical ethics
that we as a profession work to protect" (Washington Times,
6/27). She said, "To actively take a patient's life in assisted
suicide is against all of the principles of medical ethics"
("Evening News," CBS, 6/26). She added, "There's a difference
between allowing a patient to die and taking a patient's life"
("Nightly News," NBC, 6/26).
THE END OF THE BEGINNING
According to the New York Times, "the issue ultimately
remains to be negotiated in the private realm occupied by dying
patients, their families and doctors and nurses." Both sides of
the debate say that the practice will "continue underground in
the way doctors say it has been done quietly for years."
Opponents "hope the court ruling will discourage it; some
proponents hope it will inspire more doctors and patients who
resort to the practice to speak out in the hope of convincing the
public that it should be made legal." Arthur Caplan, director of
the Center for Bioethics at the University of Pennsylvania, said,
"The Supreme Court, when it refused to recognize a right to
assistance in dying, flung open the door to what wil become a
long, prolonged, heated societal debate about the morality of
assisted suicide. I see this not as the end of anything, but as
the beginning of what is going to take years to work through."
Yale Kamisar, a professor of constitutional and criminal law at
the University of Michigan, said "that within the next 10 years
he would expect the practice to be legalized in a handful of
states, like Oregon, Florida and California." "If that happens,"
New York Times reports, "he and others said they would anticipate
that some patients would travel out of state to die." He said,
"It will happen, but I don't think it will be a major thing, like
getting divorced in Las Vegas" (Scott, 6/27).