Assisted suicide in the United States

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State laws regarding assisted suicide in the United States
  Legal
  Legal under court ruling1
  Illegal

1 In some states assisted suicide is protected through court ruling even though specific legislation allowing it does not exist.

Assisted suicide is defined as suicide committed with the aid of another person, sometimes a doctor. It applies outside of the medical context as well, such as when someone assists a suicidal individual achieve their own death by providing a weapon or other means. "Assisted suicide" has been used to describe medical aid in dying in the United States for terminally ill, mentally capable adults who self-administer medication to shorten their own dying process. The term is often used interchangeably with physician-assisted suicide (PAS), "physician-assisted dying", "physician-assisted death", "assisted death" and "aid in dying".

Assisted suicide is often confused with euthanasia (sometimes called "mercy killing"). In cases of euthanasia another party acts to bring about the person's death in order to end ongoing suffering. In cases of assisted suicide a second person provides the means through which the individual is able to voluntarily end their own life, but they do not directly cause the individual's death.

Physician-assisted death or "aid in dying" is legal in eight jurisdictions: California, Colorado, District of Columbia, Hawaii, Montana, Oregon, Vermont, and Washington.[1] These laws (excluding Montana since there is no law) expressly state that, "actions taken in accordance with [the Act] shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide, under the law". This distinguishes the legal act of “medical aid in dying” from the act of suicide.

History[edit]

Early movements[edit]

The first significant drive to legalize assisted suicide in the United States arose in the early years of the twentieth century. In a 2004 article in the Bulletin of the History of Medicine, Brown University historian Jacob M. Appel documented extensive political debate over legislation to legalize physician-assisted death in both Iowa and Ohio in 1906. In Ohio, the legislation was inspired by the campaign of heiress Anna S. Hall, whose mother had died a painful death from cancer.[2] Despite Hall's efforts, the bill was rejected by the Ohio legislature by a vote of 79 to 23.[2][3]

Glucksberg v. Washington[edit]

Dr. Harold Glucksberg, along with four other physicians, three terminally ill patients, and Compassion and Dying, brought a case against the state of Washington for banning assisted suicide. The case was filed in District Court in 1994.

Following a series of appeals, the U.S. Supreme Court decided in 1997 in a unanimous decision to uphold Washington's ban. They cited the Due Process Clause and argued that assisted suicide isn't guaranteed as a fundamental liberty protected by due process. The case allowed individual states to decide independently on the medical aid-in-dying issue. It set the stage for legislative efforts on the state level.

Dr. Kevorkian[edit]

Assisted suicide in the United States was brought to public attention in the 1990s with the highly publicized case of Dr. Jack Kevorkian. Dr. Kevorkian assisted over 40 people in committing suicide in Michigan.[4] His first public assisted suicide was in 1990, of Janet Adkins, a 54-year-old woman diagnosed with early-onset Alzheimer's disease in 1989. He was charged with murder, but charges were dropped on December 13, 1990 because there were no Michigan laws outlawing suicide or the medical assistance of it so he was not in violation of a law.[5]

Years later, Kevorkian crossed the line from assisting the patient to actively killing the patient himself. Kevorkian videotaped himself giving a man a lethal injection and aired the tape on 60 Minutes. He was found guilty of second-degree murder and served eight years of a 10–25 year sentence. He was released in 2007, and died on June 3, 2011.[6]

Brittany Maynard[edit]

In 2014, the death of Brittany Maynard, an advocate for the legalization of aid in dying, from brain cancer led to renewed debate in the United States over assisted suicide, and was cited as being responsible for bills in several states on the topic. Her home state of California, which she left to reside in Oregon to access its Death With Dignity Act, became the fifth state to authorize aid in dying, in 2015.

Jurisdictions where assisted suicide is authorized[edit]

California[edit]

In 1992, the group Californians against Human Suffering proposed Proposition 161 to allow patients with less than six months to live the right to receive assistance from physicians in dying. This proposition offered more safeguards against abuse by physicians than Washington's Initiative 119, such as special protections for patients in nursing facilities. This measure failed to pass with 46 percent of the vote.[7]

Subsequent efforts were tried to pass assisted death legalization through the California State Legislature in 1999, 2005, and 2006, all of which failed. The California legislature passed the California End of Life Option Act, a bill legalizing the practice in September 2015, and the bill was signed into law by Governor Jerry Brown on October 5, 2015, making California the fifth state to authorize medical aid in dying and the second to do so through the legislature. The Act began implementation on June 9, 2016.[8][9] The law went into effect in June 2016.[10]

In May 2018, Judge Daniel A. Ottolia of the Superior Court of Riverside County ruled that the method of enacting the law was unconstitutional[11][12], but the law was reinstated by a state appeals court the following month[13].

Colorado[edit]

Representatives Lois Court and Joann Ginal introduced assisted suicide legislation in 2015 in the Colorado House. The bill was voted down in committee 8-5.

In April 2016, Julie Selsberg and Jaren Ducker filed an initiative with the secretary of state seeking to authorize medical aid in dying in November 2016 through the ballot process.

On November 8, 2016 Colorado voters passed Proposition 106 making assisted death legal among patients with terminal illness.[14]

District of Columbia[edit]

In January 2015, D.C. Council member Mary M. Cheh introduced the Death with Dignity Act of 2015.[15] On October 5, 2016, the D.C. Committee on Health and Human Services voted 3-2 for the Death with Dignity Act. On November 1, 2016 the D.C. Council voted 11–2 to advance the Death with Dignity Act. It then went through another vote in the council and the Mayor's office.[16] Mayor Bowser's signed the bill on 23rd December, 2016. After the-30 day U.S. Congress review mandated by the federal Home Rule Act, and following the inability of Congressional Republicans to block the bill, the law went into effect on February 18, 2017, with D.C. becoming the seventh jurisdiction in the U.S. to legalize this.[1]

Hawaii[edit]

Starting January 1, 2019 Hawaii will legally allow assisted dying, based on the Oregon and Washington state models. Governor David Ige signed a medical aid-in-dying law on April 5, 2018.[17] The law has safeguards to protect against abuse, including two health care providers being required to confirm a patient’s diagnosis, prognosis, his or her ability to make decisions, and that the patient's request is voluntary; as well as a counselor being required to determine that the patient isn’t suffering from conditions that may interfere with decision-making, such as a lack of treatment of depression. The law requires that the patient must make two oral requests for the life-ending medication, with a 20-day waiting period in between, and sign a written request witnessed by two people, one of whom cannot be a relative. Criminal penalties applies to anyone attempting to coerce people into obtaining life-ending medication or tampering with said patient's request.[18]

Montana[edit]

Aid in dying is legal in Montana through a state supreme court decision. In Baxter v. Montana (2009) the Montana Supreme Court ruled in a 5-2 decision that state law allows for terminally ill Montanans to request lethal medication from a physician under existing statutes, in 2008. The Attorney General of the state of Montana sought an appeal from the Montana Supreme Court, but the court, by a decision of five to two, affirmed the lower court's ruling on the state law. The Court did, however, limit the scope of the decision by not determining if the state's constitution protected the right.[19]

Oregon[edit]

Oregon voters first approved the Death with Dignity Act (DWDA) by general election in November 1994 by a margin of 51% to 49%. Ballot Measure 16, a citizen initiative sponsored by Oregon Right to Die Political Action Committee,[20] asked if terminally ill patients with less than 6 months to live should be able to receive a prescription for lethal drugs and included many provisions to protect against misuse, such as two oral requests and a written request from the patient. The patient must also be referred to counseling if a mental illness is suspected.

The law went into effect in October 1997 after an injunction delayed implementation. In November 1997, Measure 51 was placed on the general election ballot to repeal the Act. Voters chose to retain the Act by a margin of 60% to 40%.[21] Since the law has been in effect, it has given Oregon residents and patients a full range of options when dealing with their illness. This law has allowed for patients to consult their doctors about this option (about 1 in 50), while then at least 1 in 6 patients go on to talk to their families about the matter (Quill & Sussman, n.d.) URL:https://www.thehastingscenter.org/briefingbook/physician-assisted-death/. The law gives patients a full range of options when ultimately deciding the best route to help make their lives comfortable when coping with this illness.

Challenges[edit]

Lee v. State of Oregon[edit]

In December 1994, doctors and patients argued that the DWDA violated the U.S. Constitution's first and fourteenth amendments in Lee v. Oregon. U.S. District Court Judge Michael Hogan placed a temporary injunction, that he later made permanent, on the Act.

In February 1997, the Ninth Circuit Court of Appeals ruled to dismiss the challenge to the Death with Dignity Act.

Measure 51, Oregon Repeal of Death with Dignity[edit]

In 1997, Measure 51 was placed on the November ballot. It failed and 60% of Oregon voters, more than the original 1994 vote, expressed their support for the Death with Dignity Act.

Oregon v. Ashcroft[edit]

U.S. Attorney General John Ashcroft issued a directive in 2001 to prevent the Oregon Death With Dignity Act from being implemented. The state of Oregon successfully sued and proceeded with implementation.[22]

Vermont[edit]

In May 2013, the Vermont Legislature passed the Patient Choice and Control at End of Life Act. Governor Peter Shumlin signed it into law. The law is based on, but is less restrictive than, the Oregon model.[23]

Vermont was the first state to pass an aid in dying law through the legislative process. In January 2013 the act was introduced to the Senate, and in May 2013 it was passed by both the house and senate.

Vermont residents 18 years old or older who are mentally capable adults with a terminal illness and a prognosis of 6 months or less to live can make an oral request and obtain medication from a physician. The bill requires a second opinion, written and oral requests, and other provisions. [24]

Washington[edit]

In 1991, a ballot question asked if terminally ill adults should be allowed to receive physician aid-in-dying. The initiative failed, receiving 46 percent of the vote.[7]

Washington voters approved the Death with Dignity Act by general election in November 2008 by a margin of 58% to 42% "This measure would permit terminally ill, competent, adult Washington residents medically predicted to die within six months to request and self-administer lethal medication prescribed by a physician. The measure requires two oral and one written request, two physicians to diagnose the patient and determine the patient is competent, a waiting period, and physician verification of an informed patient decision. Physicians, patients and others acting in good faith compliance would have criminal and civil immunity."[25]

Other jurisdictions[edit]

Alaska[edit]

In 1999, two terminally ill patients, Kevin Sampson and Jane Doe, sued for an order to exempt their physicians from being charged with manslaughter for assisting them in dying. The superior court ruled against them, and they appealed to the Alaska Supreme Court. This court upheld the previous ruling with the reasoning that the Alaska Constitution's right to privacy and liberty does not allow terminally ill patients to be assisted by physicians in dying.[26]

Arizona[edit]

In Arizona, the city of Bisbee became the first municipality in the country to approve an aid in dying resolution, although the vote is not legally binding.

The resolution states that the city of Bisbee:

  • Respects the diversity of perspectives of its citizens,
  • Supports equal protection within the diversity of perspectives on end-of-life decisions,
  • Recognizes the practice of Aid in Dying as a legitimate individual liberty,
  • And, while not a legally enforceable document, urges prosecutorial discretion by the Cochise County Attorney in de-prioritizing cases involving prosecution of a person who has supported, been present, or facilitated a loved one to advance the time of his or her imminent death when facing intolerable suffering.[27]

Connecticut[edit]

Legislation to legalize assisted suicide received a public hearing by Connecticut's state legislature for three consecutive sessions in 2013, 2014, and 2015, but has failed to receive a committee vote. State representative Jonathan Steinberg introduced HB 6024, An Act Concerning Aid in Dying for Terminally Ill Patients, on January 19, 2017, with Representative Josh Elliott (D-88th District) co-sponsoring. The bill was referred to the Joint Committee on Public Health.[28][29]

Florida[edit]

Krischer v. McIver was a case brought to the Florida Supreme Court in 1997 by the Florida chapter of the Hemlock Society in an attempt to overturn the state's anti-assisted suicide law. The question was if AIDS patient Charles Hall had this right, and the case was appealed to the Florida Supreme Court. This court upheld the constitutionality of Florida's law against assisted suicide.[26]

Maryland[edit]

In early 2015 Maryland lawmakers began debating a "Death With Dignity" bill, though governor Larry Hogan had suggested he would oppose it.[30]

Massachusetts[edit]

The Massachusetts Death with Dignity Initiative, a ballot measure to legalize aid in dying, was narrowly defeated in the 2012 general election, with 51% of voters against the proposal.[citation needed]

A poll taken by the Boston Globe and the University of New Hampshire between September 21 and September 27, 2012, found Massachusetts residents supporting Question 2 68%, with 20% opposed. Another public poll by the University of Massachusetts and YouGov American found similar results as late as October 8 with 65% in support and 19% opposed.[citation needed]

New Jersey[edit]

A New Jersey Assembly committee voted in favor of assisted suicide legislation, and the full state Assembly plans to vote on Assemblyman John Burzichelli's bill, known as A 2270, the New Jersey Death with Dignity Act,[31] on November 13, 2014, although the bill failed to receive a vote in the Senate. The bill would have required patients suffering from a terminal disease to first verbally request a prescription from their attending physician, followed by a second verbal request at least 15 days later and one request in writing signed by two witnesses.[32] In addition, the attending physician would have to offer the patient a chance to rescind their request. Governor Chris Christie, at the time the bill was going through a legislative review and voting, vowed to veto any bills related to allowing assisted suicide.[33][34][35] Recently, the State Senator, Nicolas Scutar, has recently introduced the Aid in Dying for the Terminally Ill Act in January 2018.[36] It is unknown if Governor Phil Murphy plans to support or veto any bills that may allow assisted suicides in New Jersey.

New Mexico[edit]

A New Mexico court legalized the practice in Bernalillo County in January 2014; this decision was overturned on August 11, 2015, which upheld the state's ban on assisted suicide.[37]

New York[edit]

In 1994, a suit was filed in New York claiming that the anti-assisted suicide statute was a violation of equal protection and liberty guarantees of the Fourteenth Amendment. This claim was rejected by the District Court on the basis that there is no right to assisted suicide given by the U.S. Constitution. In 1996, the U.S. Court of Appeals overturned this ruling with the reasoning that the criminalization of assisted suicide violates the Equal Protection Clause. However, the U.S. Supreme Court unanimously reversed the U.S. Court of Appeals decision in Vacco v. Quill, 521 U.S. 793 (1997).

In February 2015, New York state senators Brad Hoylman and Diane Savino introduced a "Death With Dignity Act" to allow physician-assisted suicide in the state.[38]

On September 7, 2017, in Myers v. Schneiderman, the New York Court of Appeals held that terminally-ill persons did not possess a right to physician-assisted suicide under the New York State Constitution.[39]

Nevada[edit]

In May 2017, a bill was passed by the state senate, which sought to legalize physician-assisted suicide. The Nevada Assembly Committee on Health and Human Services chose not to advance the bill in the 2017 season. Supporters say that they intend to reintroduce the legislation at Nevada's next legislative session, which will not take place until 2019. [40][41]

Tennessee[edit]

Tennessee's legislature debated legalizing assisted suicide in 2015.[42]

State power to allow and regulate[edit]

States have the power to regulate, allow or prohibit assisted suicide.

In 1997, in the cases of Washington v. Glucksberg and Vacco v. Quill, the U.S. Supreme Court ruled unanimously that there is no Constitutional right to assisted suicide, and that states therefore have the right to prohibit it. Advocates of assisted suicide saw this as opening the door for debate on the issue at the state level.[26]

Gonzales v. Oregon was brought to the United States Supreme Court in 2006. The court ruled that the United States Attorney General could not enforce the federal Controlled Substances Act against physicians who prescribed drugs, in compliance with Oregon state law, for the assisted suicide of the terminally ill.

See also[edit]

References[edit]

  1. ^ a b http://www.washingtontimes.com, The Washington Times. "D.C. physician-assisted suicide law goes into effect". 
  2. ^ a b Appel, JM (2004). "A Duty to Kill? A Duty to Die? Rethinking the Euthanasia Controversy of 1906". Bulletin of the History of Medicine. 78 (3): 610–34. doi:10.1353/bhm.2004.0106. PMID 15356372. 
  3. ^ Emanuel, E. (November 1994). "History of Euthanasia Debates in the United States and Britain". Annals of Internal Medicine. 121 (10): 793–802. doi:10.7326/0003-4819-121-10-199411150-00010. PMID 7944057. 
  4. ^ Angell, M. (1997). "The Supreme Court and Physician-Assisted Suicide — the Ultimate Right". The New England Journal of Medicine. 336 (1): 50–53. doi:10.1056/NEJM199701023360108. PMID 8970940. 
  5. ^ "People v. Kevorkian; Hobbins v. Attorney General" Archived 2003-09-08 at the Wayback Machine.. Ascension Health. 2007. Ascension Health. 7 April 2009.
  6. ^ "Kevorkian Case: Kevorkian sentenced to 10 to 25 years". CNN 31 Dec 2007 1. 7 April 2009.
  7. ^ a b Annas, G. (1994). "Death by Prescription. The Oregon Initiative". The New England Journal of Medicine. 331 (18): 1240–1243. doi:10.1056/NEJM199411033311822. PMID 7935680. 
  8. ^ McGreevy, Patrick (5 October 2015). "After struggling, Jerry Brown makes assisted suicide legal in California" – via LA Times. 
  9. ^ "Gov. Brown signs bill legalizing medically-assisted suicide for terminal patients". 5 October 2015. 
  10. ^ Soumya Karlamangla (May 12, 2016). "How California's aid-in-dying law will work". latimes.com. 
  11. ^ Smith, Wesley J. (16 May 2018). "California Assisted-Suicide Law Unconstitutionally Enacted". National Review. Retrieved 16 May 2018. 
  12. ^ Koseff, Alexei (2018-05-15). "California assisted death law overturned in court". The Sacramento Bee. ISSN 0890-5738. Retrieved 2018-05-17. 
  13. ^ "State Appeals Court Reinstates California's Right-To-Die Law". The New York Times. 15 June 2018. Retrieved 17 June 2018. 
  14. ^ "Colorado passes medical aid in dying, joining five other states". 8 November 2016. 
  15. ^ DeBonis, Mike (16 January 2015). "'Death With Dignity' laws are proposed, bringing national debate to D.C. and Md." Washington Post. Retrieved 16 Jan 2015. 
  16. ^ Richardson, Bradford (5 October 2016). "'Death With Dignity Act' clears first hurdle as D.C. weighs physician-assisted suicide". The Washington Times. Retrieved 8 October 2016. 
  17. ^ "Medically assisted suicide becomes legal in Hawaii". apnews.com. 5 April 2018. Archived from the original on 7 April 2018. Retrieved 5 April 2018. 
  18. ^ "Medically assisted suicide becomes legal in Hawaii". apnews.com. 5 April 2018. Archived from the original on 7 April 2018. Retrieved 5 April 2018. 
  19. ^ "Mont. court: State law doesn't prevent assisted suicide". The Spokesman-Review. 2009-12-31. Archived from the original on 3 January 2010. Retrieved 2009-12-31. 
  20. ^ "Oregon's Fight over the Right to Die". Courtney S. Campbell; The Hastings Center Report, Vol. 24, 1994.
  21. ^ "Death with Dignity Act". 
  22. ^ https://scholar.google.com/scholar_case?case=1750729 3978677110948&hl=en&as_sdt=6&as_vis=1&oi=scholarr 11Oregon v.s Ashcoft, 368 F.3d 1118 (2004) https://scholar.google.com/scholar_case?case=6864220915455 147792&hl=en&as_sdt=6,38
  23. ^ Hallenbeck, Terri (May 14, 2013). "Vermont end-of-life bill heads to governor". USA Today. Burlington, Vermont. Retrieved May 14, 2013. 
  24. ^ Hallenbeck, Terri (July 14, 2013). "Vermont adjusts to new way of dying". The Burlington Free Press. Burlington, Vermont. pp. 6B–9B. Retrieved July 20, 2013. 
  25. ^ The Washington Death with Dignity Act
  26. ^ a b c Marker, Rita L. (2009). "Assisted Suicide: The Continuing Debate". International Task Force 1-18. 1 March 2009.
  27. ^ Taracena, María Inés. "Bisbee Becomes First City in Arizona to Approve an 'Aid in Dying' Resolution". 
  28. ^ "Aid-in-dying bill hasn't gained sufficient support". Connecticut Post. 9 April 2015. Retrieved 2 May 2015. 
  29. ^ "Connecticut General Assembly". Connecticut General Assembly. 
  30. ^ Wiggins, Ovetta (6 March 2015). "Maryland weighs 'Death With Dignity' legislation". Washington Post. Retrieved 1 April 2015. 
  31. ^ "A2270". www.njleg.state.nj.us. 
  32. ^ "Assisted suicide bill advances in New Jersey Assembly". 
  33. ^ Malo, Sebastien (13 November 2014). "New Jersey state Assembly approves assisted suicide bill". Reuters. Retrieved 13 November 2014. 
  34. ^ Ford, Andrew (4 March 2015). "N.J. conflicted on aid in dying". Courier-Post. Retrieved 1 April 2015. 
  35. ^ [1]
  36. ^ [2]
  37. ^ "New Mexico Court of Appeals strikes down ruling that essentially allowed assisted suicides\url=http://www.lcsun-news.com/las_cruces-news/ci_28623731/new-mexico-court-appeals-strikes-down-right-die". Las Cruces Sun-News. 11 August 2015. 
  38. ^ Lovett, Kenneth (9 February 2015). "Timothy Cardinal Dolan will fight efforts in New York to legalize physician-assisted suicide". Daily News (New York). Retrieved 1 Apr 2015. 
  39. ^ Niedzwiadek, Nick (September 7, 2017). www.politico.com https://www.politico.com/states/new-york/albany/story/2017/09/07/court-of-appeals-rejects-right-to-aid-in-dying-114347. Retrieved October 29, 2017.  Missing or empty |title= (help)
  40. ^ Richardson, Seth (23 May 2017). "Senate passes bill permitting doctor-assisted suicide". Reno Gazette Journal. Retrieved 26 May 2017. 
  41. ^ "NV Assisted Suicide Bill Dead in Committee: Becomes 16th state to reject legislation in 2017". Washington Free Beacon. 2017-06-07. Retrieved 2017-10-18. 
  42. ^ Boucher, Dave (8 June 2015). "Tennessee joins national debate on assisted suicide". The Tennessean. Retrieved 15 June 2015. 

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