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The legality and morality of physician-assisted suicide are highly contested, not just in the United States, but across the world. Globally, most nations are of the opinion that assisted suicide should not be legal. However, there is a greater divide in the US. A mere ten states enumerate specific guidelines for performing assisted suicide. There has been much discussion in all levels of government, from local governments to the Supreme Court of the United States, as to whether states should legalize the procedure.
The fight for medically induced death began in the early twentieth century in the state of Ohio. In 1906, the first bill for euthanasia was drafted but was quickly dismissed and rejected. As the 1950s came to a close, medical and legal journals began to surface in support of the practice. Florida proposed a similar bill to that of Ohio in 1967, and while it sparked much discourse on the topic, it was similarly unsuccessful. The 1970s were characterized by the formation of various pro-euthanasia societies and organizations fighting to make their voices heard. It wasn’t until 1997 when the issue was again revisited in the landmark Supreme Court case Washington v. Glucksberg.
At this time in the state of Washington, like elsewhere in the US, the issue of physician-assisted suicide remained both highly contested and illegal. This was until Dr. Harold Glucksberg alongside three other doctors, three terminally ill patients, and the organization known as Compassion in Dying—which asserted that assisted suicide is a compassionate option for those who are terminally ill—challenged the standing law. The group filed suit in federal court alleging that the ban on assisted suicide was unconstitutional as applied to mentally competent, terminally ill adults. The district court judge ruled in favor of Glucksberg, however, the case was quickly appealed.
Ultimately, the case worked its way up to the Supreme Court, with the question of whether the Due Process Clause protects both one’s right to commit suicide as well as the right to commit suicide with assistance. Unanimously, the Court determined that the ban was not unconstitutional. Since it is a crime in almost every state to assist a suicide, the Court stated that the practice was not fundamental or foundational throughout the nation’s history. As such, the Court argued that ruling in favor of Glucksberg would demand the reversal of years of legal practice and doctrine. The Court determined that the right to commit suicide with assistance was not a fundamental liberty protected under the Due Process Clause, which protects citizens from government deprivation of life, liberty, or property. Thus, the case resulted in a unanimous 9-0 ruling that the ban on assisted suicide would remain in place.
This ruling remained for eleven more years before it was reversed with the Washington Death With Dignity Act. Passed in the 2008 election with a nearly sixty percent “yes” vote, the act legalized assisted suicide. Officially going into effect in 2009, this act permitted terminally ill and mentally competent adults to request a lethal dose of medication to be administered to them by a willing physician. Those hoping to pursue this path must be eighteen or older Washington residents, be deemed mentally competent, and have less than six months left to live as determined by two medical professionals. Since its legalization, the lethal medication has been administered to upwards of 1,600 individuals in the state of Washington between 2009 and 2018. The number of individuals who have chosen to end their lives via assisted suicide has increased in each consecutive year following the implementation of the Death with Dignity Act.
Washington is not alone in its legalization of the practice. A group of states has since followed suit in this precedent of authorizing physician-assisted suicide. The 1997 case of Vacco v. Quill, closely paralleling the circumstances of the Glucksberg case, was brought to the Supreme Court. Dr. Timothy Quill argued his case alongside two additional doctors and three terminally ill patients. The group challenged the assisted suicide ban in the state of New York, alleging that it violated both Due Process Clause protections of liberty and Equal Protection guarantees under the Fourteenth Amendment. They questioned whether the Equal Protection Clause was violated by allowing terminally ill adults to withdraw their own life-saving support while simultaneously denying this right to patients who could not withdraw their own treatment but hoped that a physician would do so in their favor. The Court ruled identically to Glucksberg in a unanimous 9-0 decision. They rejected the notion that ending medical treatment is nothing more or less than assisted suicide. The Court solidified their assertion by arguing that when a patient refuses life-sustaining medical treatment, their death will result from underlying disease or illness, but if a patient ingests prescribed lethal medication by a professional, their death will result from said medicine. Furthermore, there was no evidence that the standing statutes drew any distinctions between people or treated anybody differently than somebody else. Thus, Quill’s case was quickly rejected. However, following Washington’s lead, New York state reversed this decision eighteen years later by implementing the Death with Dignity Act in 2015.
Despite the changes made in Washington and New York, the same can not be said for most states in the nation. Without the legalization of assisted suicide in certain states, many people have found illegal alternatives to die, resulting in legal action taken against those who assist them. A 2020 case follows 80-year-old Dennis Chamberlain, serving a life sentence for the attempted murder of his wife. Convicted in 2014 in the state of Utah, Chamberlain has served 5 years in prison. While he ultimately plead guilty, his defense attorney has stated that his wife was extremely ill and Chamberlain was only assisting his wife in her wishes to die peacefully. The couple had both belonged to the Hemlock Society, which supported the right to both die and assist in suicides.
One may look at cases such as Chamberlain’s and question where the line falls in terms of morality. However, it seems as though a similar situation to Chamberlain has taken hold across the world, as there have been calls made to pardon those convicted of illegally assisting suicide in New Zealand and other nations. One case involves a man who assisted his mother in death, as she was terminally ill with cancer. While he was charged with attempted murder, he pled guilty to assisted suicide before being charged with assisted suicide once again for three deaths of friends who had suffered tragically in a motor accident. As this incident occurred in 2011 and assisted suicide has since been legalized in New Zealand, the man wrote to the Prime Minister requesting a formal pardon for his crimes. His request has since inspired others who were convicted to follow suit.Among the most contentious legal questions of our modern world, assisted suicide proves perpetually debatable. The state of Maine was the eighth and most recent jurisdiction to enact an assisted dying law. Will the rest of the US follow the lead of Washington and the eight additional states in legalizing physician-assisted suicide? Where does the rest of the world stand in their legalization of assisted suicide? Will euthanasia remain contested and disputed far into the future, or will the world shift toward acceptance of physician-assisted suicide? This remains to be seen.