Physician Assisted Suicide

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Physician Assisted Suicide

• Jody Blanke, Professor
• Computer Information Systems and Law
• Mercer University, Atlanta

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Ancient Rome

• Its good to be King (or Emperor)
• Convicted criminals forfeited real and personal
  property to the Emperor
• Suicide became a crime

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English Common Law

• Still good to be King
• Suicide also a crime, but punished by forfeiture
  of personal property only
• Early American colonies adopted this rule, but
  over time, abolished forfeiture penalties
• By Civil War, suicide is not a crime

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United States Today

• 39 states have statutes specifically banning
  assisted suicide
• Another 3 criminalize it by common law
• Another 4 have no specific law or are unclear
  about it
• But competent adults have a right to refuse
  medical treatment

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Karen Anne Quinlan

• 1975 Karen Anne Quinlan mixed drugs and alcohol
  and became comatose
• Family sought court order to pull the plug
• Order granted, but family convinced to wean her
  from respirator
• She remained comatose for over 10 years, until
  her death in 1986

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Living Wills

• In aftermath of Quinlan case, every state enacted
  some sort of living will
• Most states also have some type of durable power
  of attorney

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Nancy Cruzan

• 1983 Nancy Cruzan was in a car accident and
  became comatose
• Court refused to let parents pull the plug
  absent clear and convincing proof that that was
  what Nancy would have wanted
• Supreme Court state has sufficient interest to
  adopt this higher standard

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Nancy Cruzan (cont.)

• Justice OConnor safeguarding incompetents
  liberty interests is entrusted to the
  laboratory of the states
• Epilogue a good friend came forward with
  clear and convincing evidence that Nancy would
  not have wanted to live this way she died in
  1990

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Dr. Kevorkian

• Assisted in many suicides in the 1990s
• Some states enacted legislation in response e.g.,
  Georgia
• Finally, successfully prosecuted for murder on
  the fourth try
• Paroled in 2007 after serving 8 years of a 10-25
  year sentence

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Oregons Death with Dignity Act

• Ballot initiative passed in 1994
• Challenged in court
• Becomes effective in 1997
• Legal (societal) experiment
• Oregon, the Suicide State?

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Oregons Death with Dignity Act
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Oregons Death with Dignity Act
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Oregons Death with Dignity Act
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Supreme Court Cases

• Washington v. Glucksberg, and Quill v. Vacco
  (1997)
• Challenged bans on assisted suicide in Washington
  and New York states
• Fundamental liberty interest and equal
  protection challenges denied
• Court referred to Oregon and the laboratory of
  the states

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Terry Schiavo

• 1990 Terry Schiavo became comatose as a result
  of eating disorders
• 1998 husband sought order to remove feeding
  tube
• 2005 Schiavo died after feeding tube was
  removed - after 14 appeals, numerous motions and
  hearings, 5 federal suits, state legislation,
  federal legislation, and 4 denials of certiorari
  by the U.S. Supreme Court

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Other States

• Death with Dignity Act
• Washington passed it in 2008
• Vermont passed it in 2013
• Montana
• First Judicial Court ruled that a terminally ill
  patient has a right to die under the Montana
  Constitution (2008)
• Montana Supreme Court held that physician
  assisted suicide is not banned by state law, but
  did not address the issue of whether there is a
  constitutionally protected right to die (2009)
• New Mexico
• Court of Appeals reverses lower courts holding
  that aid in dying is a fundamental liberty
  interest (August 11, 2015)

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The Netherlands

• Decriminalized physician assisted suicide in 1993
• Legalized it in 2002
• Intolerable suffering

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The Netherlands

• The law allows medical review board to suspend
  prosecution of doctors who performed euthanasia
  when each of the following conditions is
  fulfilled
• the patient's suffering is unbearable with no
  prospect of improvement
• the patient's request for euthanasia must be
  voluntary and persist over time (the request can
  not be granted when under the influence of
  others, psychological illness or drugs)
• the patient must be fully aware of his/her
  condition, prospects and options
• there must be consultation with at least one
  other independent doctor who needs to confirm the
  conditions mentioned above
• the death must be carried out in a medically
  appropriate fashion by the doctor or patient, in
  which case the doctor must be present
• the patient is at least 12 years old (patients
  between 12 and 16 years of age require the
  consent of their parents)