The "Supremes" decide on assisted suicide: what should a doctor do?

On June 26, 1997, the US Supreme Court ruled in 2 unanimous decisions that there is no constitutionally protected right to assisted suicide. Overturning 2 1996 Federal Appeals Court rulings that had struck down Washington and New York state laws prohibiting assisted suicide, the Supreme Court rejected 2 key arguments. First, the Supreme Court rejected the argument that the right to liberty guaranteed by the US Constitution includes the right to seek the assistance of a physician to commit suicide. The court has previously assumed that the right to liberty includes decisions to forgo life-sustaining treatment. However, it drew a clear distinction between forgoing life-sustaining treatment, which was consistent with “the common-law rule that forced medication was a battery and the long legal tradition protecting the decision to refuse unwanted medical treatment,” and assisted suicide, which “may be just as personal and profound as the decision to refuse unwanted medical treatment . . . [but] has never enjoyed similar legal protection.” The court found that “[t]he distinction between letting a patient die and making that patient die is important, logical, rational, and well established” and is “widely recognized and endorsed in the medical profession, the state courts, and the overwhelming majority of state legislatures.” Second, the Supreme Court rejected the argument that laws prohibiting assisted suicide violate the right to equal protection of the laws guaranteed by the US Constitution — that states must treat like cases alike. In the rejected argument, decisions to forgo treatment (which are legally permissible) were said to be the same thing as assisted suicide and so should be legally permissible, too. However, the court opined that permitting decisions to forgo treatment (but prohibiting assisted suicide) does not “[treat] anyone differently from anyone else, or [draw] distinctions between persons. Everyone, regardless of physical condition, is entitled, if competent, to refuse unwanted life-saving medical treatment; no one is permitted to assist a suicide.” The Supreme Court’s decisions do not resolve the ethical or legal debate about euthanasia and assisted suicide. Instead, the court has returned these issues to the state legislatures, reflecting the reluctance of the Supreme Court Justices to substitute their views for the democratic will of the people. The court said simply that 2 state laws prohibiting assisted suicide withstood constitutional challenge, not that assisted suicide itself is or should be illegal. Therefore, these Supreme Court decisions would not necessarily prevent a state legislature from legalizing euthanasia or assisted suicide. In November 1997, residents of Oregon will vote for a second time on that state’s controversial Death With Dignity Act, which was passed by a 51%-to-49% margin in a 1994 referendum but never implemented because of legal challenges. (In Canada the criminal law is a federal responsibility.) In 1993 the Supreme Court of Canada also upheld the Criminal Code prohibition against assisted suicide, although by a narrow 5-to-4 margin, in the Sue Rodriguez case. Like the US Supreme Court, the Supreme Court of Canada held that the Canadian Charter of Rights and Freedoms’ guarantee of security of Editorial