Does a terminally ill patient have the right to die by choice? It’s a question that, for decades, has been answered: no. In America, physician-assisted suicide is illegal according to federal law, despite protests from advocacy groups who say that terminally ill patients who stand no chance of improving, and in fact are undergoing a great deal of pain, should have the right to die. Still, U.S. law states that any doctor who gives her patient a lethal prescription – regardless of whether or not the patient has asked her to do so – is subject to prosecution.
However, as indicated in an article this week from the New York Times, there is much evidence that opinions toward assisted suicide may be changing across America, and that in the future this practice may be decriminalized or even legalized in a number of states.
Assisted suicide is already legal in four states: Oregon, Montana, Washington and Vermont. Oregon has maintained its Death With Dignity Act since 1994, but the other three states passed their assisted suicide laws relatively recently: Washington in 2008, Montana in 2009 and Vermont last year. In 2013, two other Northeastern states – Connecticut and New Jersey – also considered laws that would have allowed doctors to administer lethal prescriptions; however, both bills were eventually voted down by each state legislature.
This year, other states are showing an interest in assisted suicide legislation. In New Mexico’s Second Judicial District in January, Judge Nan Nash ruled that if a mentally competent, terminally ill patient wishes to die, he should be allowed to do so, and with the help of a physician. Judge Nash’s decision came in response to a case brought by The ACLU and the advocacy organization Compassion & Choice, on behalf of a New Mexico cancer patient. In the written court decision, Nash referred to the right to physician assisted suicide as being fundamental to “liberty, safety and happiness.”
But despite this interest from states in legalizing assisted suicide, administering lethal drugs for any purpose is still illegal according to the federal government of the United States. Federal law on euthanasia states that it is prohibited in all 50 states, this according to homicide law. Therefore, a doctor who practices assisted suicide, even in a state such as Oregon that has legalized the practiced, may be at risk of federal investigation and imprisonment. In fact, between 2005 and 2006, then Attorney General Alberto Gonzales brought a case in front of the Supreme Court arguing that the Controlled Substances Act gave him the power to prohibit physician assisted suicide. The state of Oregon won that case and retained its Death With Dignity law, but doctors may still fear federal repercussions for acting on a patient’s wish to die.
Besides federal law, another roadblock to widespread legalization of assisted suicide might be state residents who don’t agree with the practice. Although a recent Gallup Poll showed that 70 percent of Americans believe a terminally ill patient should be able to choose when to die, only 51 percent of respondents thought that physician assisted suicide was okay. Last November, Massachusetts voters rejected a pro assisted suicide bill, and religious groups such as the Family Institute have blamed outside organizations for coming into the Northeast states and pushing assisted suicide legislation.
New Mexico’s Archbishop Michael J. Sheehan, like many who oppose doctor assisted death for religious reasons, has said that his opposition to the state’s recent ruling stems from church teachings that life is sacred. Others agree that the morality surrounding a doctor’s role in helping to kill a patient is cloudy, and counter to the Hippocratic Oath in which a physician swears to respect and preserve human life.
Those in favor of assisted suicide argue that a patient undergoing great suffering as a result of illness should have the right to choose a planned and painless death. Compassion & Choices is a leading organization that promotes ‘aid in dying,’ and one of the groups that has been advocating for pro assisted suicide legislation in the Northeast of the United States. The organization argues that having the choice to die with the help of a doctor gives patients control over their own bodies, and that unwanted medical treatment is a violation of patients’ rights.
In Oregon, where the assisted suicide law has been twice approved by voters, the Death With Dignity National Center lays out many reasons why the practice should remain legal. The Center says that a medical decision to choose death should remain between doctor and patient, and that the Supreme Court’s support of Oregon in the 2006 case Gonzales v. Oregon proves that states should be free to determine assisted suicide medical policies regardless of federal euthanasia law. After all, euthanasia refers to involuntary death, whereas physician assisted suicide should come as a result of the patient’s explicit wishes, or from family members who have been designated as health care decision advocates to a patient unable to voice his wishes.
Weighing in on the assisted suicide debate, the American Medical Association issued its opinion in 1994 opposing the practice. In Opinion 2.211, the Association argues that although it is regrettable that some patients must suffer during the final weeks or months of a terminal illness, it is too risky to allow physicians to assist patients in dying, and moreover assisted suicide would violate a doctor’s responsibility to act as a healer. The American Medical Association recommends that instead of turning to assisted suicide, terminally ill patients can seek support from counselors or religious leaders, and that end-of-life hospice care can be used to reduce discomfort or pain.
Although there is no agreement amongst patient advocates, health care professionals and lawmakers, it seems certain that assisted suicide will receive increasing attention as more and more states, such as New Mexico and Connecticut, consider laws that will allow doctors to end a patient’s life – and health care experts will be watching closely to see where the assisted suicide debate goes next.