The Supreme Court announced Tuesday it will decide whether Americans who are terminally ill have a right to get help from their doctors and family members to end their lives.
The appeal of New York and Washington state “right-to-die” cases is probably the most far-reaching constitutional issue to come before the court since abortion.
In its 1973 abortion ruling, the court declared that the Constitution’s right to “liberty” and privacy includes a right of pregnant woman to choose abortion. Now, the justices will decide whether the right to “liberty” also protects a dying person’s freedom to get medication that will hasten his death.
The issue comes to the Supreme Court amid a growing national debate about how Americans die.
Until the middle of this century, most persons died at home, usually surrounded by their families.
But today, recent studies have found, about 85 percent of Americans die in hospitals, nursing homes or other institutions. Thanks to medical advances, many of these patients have been kept alive for months or even years despite illnesses that otherwise would be fatal.
But this medical progress has set off something of a backlash. Many who have watched friends or loved ones linger in agony have voiced doubts about the price of this progress.
In reaction, many have tried to take control of their dying days by filing “advance directives” or “living wills.” Others have insisted on dying at home rather than in an institution.
The most controversial step is for a patient to seek to cut short his dying days with a fatal dose of medication.
“Now that the court has gotten involved, all these issues are going to move to center stage,” said Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania. “We’re going to have a yearlong national seminar on dying and assisted suicide.”
But while public sentiment about the dying process has been changing, the law has not.
Suicide no longer is deemed a crime, but at least 44 states make it a felony to aid or encourage another person to commit suicide. That means doctors and family members can be charged with a crime if they help a patient or relative end his life.
Prosecutions are rare, although New York state lawyers threatened to bring charges against Rochester physician Dr. Timothy Quill after he wrote about helping a patient die. His case is one of two that will be heard by the Supreme Court.
Both cases began with a small Seattle group known as Compassion in Dying. It was made up of retirees, AIDS activists and physicians who had volunteered to counsel persons who were terminally ill. In some instances, the volunteers sat with patients who had taken a large dose of barbiturates to end their lives.
In 1991, the group failed to win a Washington state ballot initiative that would make it legal to help dying persons end their lives.
Three years ago, they filed a lawsuit in federal court challenging the laws as unconstitutional. The first suit was filed on behalf of three dying patients and several physicians who complained they were barred from aiding such patients. Later, a second suit was filed in New York on behalf of Quill and other physicians there.
Earlier this year, both lawsuits resulted in victories.
The 9th U.S. Circuit Court of Appeals based in San Francisco ruled the Constitution’s guarantee of individual liberty protects “competent, terminally ill adults who wish to hasten their deaths.”
“By permitting the individual to exercise the right to choose, we are following the constitutional mandate to take such decisions out of the hands of government, both state and federal, and to put them where they rightly belong, in the hands of the people,” wrote Judge Stephen Reinhardt for an 8-3 majority.
The 2nd U.S. Circuit Court of Appeals in New York reached the same result, but by a different route. It ruled the state’s law unfairly discriminates among terminally ill persons. Doctors can end the lives of those on life-support systems by agreeing to their requests to withdraw treatment, but physicians cannot take steps to hasten the death of those who are not on life support. Those circumstances violate the guarantee of “equal protection of the laws,” the appeals court said on a 2-1 vote. Both states appealed, and the Supreme Court agreed to hear their cases in late January.
xxxx Court actions The Washington state law was challenged by three anonymous terminally ill patients, four doctors and a non-profit group, Compassion in Dying. They prevailed in U.S. District Court, but a three-judge panel of the 9th U.S. Circuit Court of Appeals overturned that decision. A panel of 11 judges then set aside the first ruling. Supreme Court arguments will be scheduled in January, and decisions are expected by early next summer.