Physician Assisted Suicide (PAS)

Court activity; legislative
attempts; physician survey

Sponsored link.

U.S. Supreme Court decision - 1997:

The Supreme Court rendered its decision on the New York and Washington cases, on 1997-JUN-26. They found that the average American has no constitutional right to a physician assisted suicide. The vote was 9 to 0, an unusual, unanimous decision. Thus, the New York and Washington laws which ban such suicides are constitutional. On the other hand, the court implied that there is no constitutional bar that would prevent a state from passing a law permitting physician assisted suicide. Oregon has done exactly this. So, the battle must be fought on a state by state basis. Chief Justice Rehnquist wrote:

"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 an democratic society"

This is a disadvantage to the "pro-life" camp who are working to make certain that freedom to choose assisted suicide remains unavailable to all Americans. The ruling means that they will have to prevent all 50 states from passing permissive laws. If even one state passes such a law, then at least wealthy patients will be able to relocate to that state, satisfy the resident requirements, and obtain help in dying.

The Supreme Court decision was very narrow in scope. It only ruled on whether the public had a general right to assisted suicide. The case was originally brought by six terminally ill individuals in intractable pain who wanted access to assisted suicide. But by the time that the court heard legal arguments, all six had died. Thus, the court was unable to rule on whether terminally ill individuals should have a right to assisted suicide. Instead, they made a decision on whether citizens generally had that right.

Many of the justices indicated that certain groups within society might have a constitutional right to access to suicide (e.g., individuals who are terminally ill and in intractable pain). If a case were brought by such a person, then the court might find in their favor. The trick will be to find a person who can survive a terminal illness long enough for their case to wander through the judicial system and reach the Supreme Court. If even one of the original six patients had been able to survive, the court's decision might have been very different. They might have ruled that people generally had no legal right to obtain assistance in dying, but that terminally ill patients in pain did have.

Some justices discussed the dual effect theory. This is a situation in which a physician prescribes an adequate level of morphine or other drugs to control pain, even while knowing that it will shorten the patient's life. They found that this was acceptable behavior. Some of the justices expressed concern about any laws which permitted assisted suicide; they were worried that such laws might be abused, and that they might be the first of a series of laws which might generate a "slippery slope" towards a society that has wide-open assisted suicide, without effective controls.

Pain Relief Promotion Act:

The main purpose of this bill is to block access to physician assisted suicide in the state of Oregon. Although the title of the bill implies that it is intended to promote pain relief," it would probably have the opposite effect. Many doctors would likely be concerned about a DEA agent reviewing prescriptions. They would feel pressured to under-prescribe pain medication, leaving their patients in agony, to avoid prosecutions. 

The bill is clearly unconstitutional. The U.S. Supreme Court decision of 1997 implied that states can pass laws which permit physician assisted suicide, and that individuals have a right to take advantage of these laws if they wish. The Federal Government can hardly pass a law to prevent such access.

Survey of Physicians:

Dr. Diane Meier of Mount Sinai School of Medicine in New York, NY led a survey of 1,902 doctors during the year 2000 on the topic of physician assisted suicide. _2,3 They polled doctors who specialized in aging, infectious diseases, cancer and diseases which affected kidneys, nerves and lungs. These were the areas of medicine where they felt that requests for assisted suicide might commonly surface. They found that:

It would appear that laws which restrict physician assisted suicide to cases involving terminal illness with intractable pain will only handle the wishes of a minority of those persons who seek assisted death.

References:

1. Jeff Johnson, "Pain relief promotion act passes house," Family news in focus, at: http://www.family.org/cforum/fnif/news/a0008306.html
2. John Giglio, "Misnamed 'Pain Relief Promotion Act' Fails as Congress Adjourns," 2000-DEC-16, American Pain Foundation, at: http://www.painfoundation.org/page_policy.asp
3. "Doctor-assisted Suicide Not Rare in U.S., Study Finds," Reuters News Agency, 1998-APR-23.
4. Article, New England Journal of Medicine, 1998-APR-23.
5. "S.1024; Title: A bill to amend the Public Health Service Act to provide for a public response to the public health crisis of pain, and for other purposes," Thomas, Library of Congress, at: http://thomas.loc.gov/

Copyright © 1997 to 2009 by Ontario Consultants on Religious Tolerance
Last updated 2009-MAR-06
Author: Bruce A Robinson