The Case for Euthanasia: Should Physician-Assisted

Suicide beLegalized?
Throughout the twentieth century, major scientific and
medical advances have greatly enhanced the life expectancy of the
average person. However, there are many instances where doctors
can preserve life artificially. In these cases where the patient
suffers from a terminal disease or remains in a “persistent
vegetative state” or PVS from which they cannot voice their
wishes for continuation or termination of life, the question
becomes whether or not the patient has the freedom to choose
whether or not to prolong their life even though it may consist
of pain and suffering. In answer to this question, proponents of
physician-assisted suicide, most notably, Dr. Jack Kevorkian, are
of the opinion that not only should patients be able to abstain
from treatment, but if they have a terminal and/or extremely
painful condition, they should be able to seek out the assistance
of a doctor in order to expedite their death with as little pain
as possible.

Contained herein are the arguments for and against the
legalization of doctor-assisted suicide, as well as where the
state courts stand in respect to this most delicate of issues.

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In the hopes of clarification, we must first distinguish
between active and passive euthanasia. Passive euthanasia
involves the patient’s refusal of medical assistance. It
involves the right to die which is protected by the United States
Constitution clauses of due process liberty and the right to
privacy (Fourteenth Amendment). The right to doctor-assisted
suicide, or active euthanasia, consists of, “…a patient’s
right to authorize a physician to perform an act that
intentionally results in the patient’s death, without the
physician’s being held civilly or criminally liable for having
caused the death” .

The “passive” form of euthanasia was first deemed legal by
the New Jersey State Supreme Court in 1976 In re Quinlan . In
the Quinlan case, the court allowed a competent patient to
terminate the use of life-sustaining medical machines to prolong
life. Since New Jersey’s decision, all fifty states have enacted
similar statutes which contain living will provisions. However,
although the United States Supreme Court upheld the Quinlan
decision in re Cruzan , it changed the parameters of passive
euthanasia . With the Cruzan decision, the Supreme Court held
that passive euthanasia was legal but only for competent adults
or those who are incompetent but have previously procured a
living will. However, if the patient is without a living will
and incompetent, it becomes the burden of the family to prove
that there is “clear and convincing evidence” to the affect that
the patient does not want to continue living in a vegetative
state.

As to active euthanasia, there has been no Supreme Court
ruling determining whether the right to die, as understood in
passive euthanasia cases, can be bound over to active euthanasia.

The decision is thus left to the individual states. Currently,
thirty-one states have criminalized explicitly the act of
assisted suicide . Physician-assisted suicide is generally
recognized as illegal under the parameters of homicide, however
it is very difficult to meet all of the elements of the crime and
conviction subsequently becomes nearly impossible. The fact that
the U.S. Supreme Court has not reviewed a physician-assisted
suicide case, which would create precedent, constitutes a dilemma
for the state courts in that there is no uniform test or ruling
by which to decide.

Most states have developed their own laws to, more often
than not, make doctor-assisted suicide illegal. However, when a
case comes to trial it is usually dismissed either by the judge
in a pretrial motion or by the jury. For example, in at least
three of the assisted suicides which Dr. Kevorkian was involved
in, all criminal charges were dismissed. So, the laws have been
created, but when it comes to convicting a doctor and sending him
to prison, in lieu of the circumstances, the law often breaks
down and the charges are dismissed or the doctor is acquitted.

In the case of the nineteen states which have not delineated
the criminality of doctor-assisted suicide, the issue becomes
less clear. Many of these states have a hard time grouping
physician-assisted suicide with homicide. The case which
Michigan judges cite in refusing this linkage of criminality is
the People of the State of Michigan v. Campbell . In the
Campbell case, the “court found that ‘the term suicide excludes
by definition a homicide'” . Since, suicide is not a homicide,
then an assisted suicide cannot be deemed a homicide. At the
time of the appellate courts hearing of the Campbell appeal,
there was no other codified law expressing what crime an assisted
suicide would fall under and the homicide charges were dismissed.

Anti-active euthanasia proponents feel that it is the duty
of physicians to help and heal patients as opposed to hastening
their exit from this world. They also fear that the legalization
of doctor-assisted suicide may be abused by doctors who do not
feel that there is any hope for the patient and counsel them to
terminate their life. The state also has an interest in the life
of the individual. The individual state was originally set up to
protect the rights of individuals and to see that “the value of
an individual’s life…and the value of life to society as a
whole” is protected. The value of an individual’s life includes
their personal well-being and safety from harm, even if it is
self- inflicted. So, it has now become the duty of the
individual states to balance the interests of the state against
the interests of the individual patient in order to come up with
a law which is accommodating to both.

Persons who are for active euthanasia believe that
legislation against it is “violative of the fundamental concepts
of liberty, freedom of choice, and self-determination” They base
these beliefs on the text of the fourteenth amendment to the
United States Constitution. The voluntary choice between life
and death is, to them, a basic human right which the government
has no right to legislate. They often compare this choice of
euthanasia to the right to abortion.Judge Lynn Compton
embodies these views in her opinion in the case of Bouvia v.

Superior Court , “If there is a time when we ought to be able to
get the government ‘off our backs’, it is when we face death-
either by choice or otherwise” .

The trend in the law seems rather obviously to be against
the legalization of physician-assisted suicide. This is clear
due to the thirty-one states which have already incorporated the
act into their penal codes as being illegal. As to the other
states, there is much controversy as to it’s legalization.

Although in popular polls, the general public seems to be in
favor of active euthanasia’s legalization, the courts in all of
the states find that the possibility for infraction of the
statute supersedes the wishes of the patient. The courts aim to
protect doctors from civil suits, patients from doctor’s advisory
abuse, and the country’s general policy of the sanctity of life.

In the courts view, passive and active euthanasia are two
entirely different things. One involves the withholding or
cessation of care which may or may not end up in death and the
other involves a doctor’s administration of a lethal substance
with the specific intent of impending death. In other words, one
entails allowing death to occur without doctor intervention and
the other is killing, albeit “mercy” killing.

Based on my research, it seems clear that the effort to
legalize active euthanasia is one that is not going to go away in
the near future. This is especially due to the spread of the
AIDS virus and other incurable diseases. However, although I
feel that it should be legalized with certain provisions, I
cannot foresee it’s uniform, federal regulation in the near
future, especially with a conservative Supreme Court as is
sitting today.

Presently, there are twenty-one states which allow citizen
legislation through the use of the general election ballot. In
these states, special interest groups which support active
euthanasia have placed initiatives on the ballot. An example of
one of these groups is the California based Americans for Death
with Dignity or ADD . The DDA designed a statute, proposition
161, that would legalize doctor-assisted suicide. The statute
was also created “with extraordinary care to provide all
reasonable precaution to protect against the risks” of
legalizing the practice of active euthanasia. One of the clauses
of the statute which aims at the prevention of abuse is that the
statute would only allow licensed physicians to partake in
helping someone end their life. Although proposition 161 was not
passed, it is a reflection of the general population’s sentiment
that active euthanasia should not be illegal. At the time of the
publication of this article, California, Washington, Oregon, and
Michigan were preparing or has already proposed general election
initiatives which would permit aid-in-dying by physicians.

The act of taking a life is a serious one. The American
people are notoriously weary of it’s implementation, as can be
seen in the case of capital punishment. Although, active
euthanasia is consensual, the paradox which lingers in the term
“physician-assisted suicide” is difficult for lawmakers and
citizens alike to consent to.