"RIGHT TO DIE" CASES

"RIGHT TO DIE" CASES. "Right to die" does not refer to any general right of able-bodied and healthy people to commit suicide. Rather, the expression is conventionally used to refer to situations in which issues concerning physician-assisted suicide typically arise. The central question is whether, and under what circumstances, an individual whose illness is incapacitating will be allowed to die or be assisted in dying rather than be sustained on life support indefinitely.

Earlier generations presumably handled many of these difficult problems by having the doctor consult with the family or even possibly resolve the question without consultation. Currently, right to die cases often involve public discussion and the relatively transparent decision-making process characteristic of the present age. New technologies ranging from drugs to respirators increase the complexity of the problem. In 1997, the U.S. Supreme Court held in Washington v. Glucksberg that there was no constitutionally protected right to die assisted by a physician. Thus the issue is treated largely as a matter of state law. States often have statutes on substituted judgment, or living wills. One state, Oregon, has a Death with Dignity statute authorizing medical personnel to participate in the death of a patient, not by assisting, but by providing access to drugs.

One recurrent theme in the ongoing discussion is whether a judgment reached by a spouse or family is a judgment in which the surrogate (family or spouse typically) speaks for the patient, seeking to express the wishes of the patient, or speaks for the surrogate. The case of a comatose patient unable to speak for herself was at issue in both the case of Karen Quinlan, which in 1976 reached the New Jersey Supreme Court, and that of Missouri resident Nancy Cruzan, which reached the U.S. Supreme Court in 1990. A different question is whether the state will assist, or permit others to assist, those who directly communicate their wish to die. This issue was raised in the criminal prosecutions against Dr. Jack Kevorkian, who was convicted and sentenced to prison for assisting suicide. While some argue in terms of the state's interest in life, others are concerned that a right to die will translate into a duty to die, typically in the interest of the welfare of the next generation. The Assisted Suicide Funding Restriction Act of 1997 forbids the use of federal funds to support physician-assisted suicide.

Legislation in the Netherlands concerning the right to die has been widely discussed in the United States. The Dutch approach imposes a number of stringent requirements before any physician-assisted suicide is permitted and involves specific cases of people in intense pain or whose quality of life seems to them not to justify continued existence.

BIBLIOGRAPHY

Schneider, Carl E. The Practice of Autonomy: Patients, Doctors, and Medical Decisions. New York: Oxford University Press, 1998.

CarolWeisbrod

See alsoAssisted Suicide ; Euthanasia ; Washington v. Glucksberg (1997) .