A DRAMATIC federal appeals court ruling this week states for the first time that individuals have a constitutional right to end their lives, setting up moral, ethical, and legal questions as controversial as the Supreme Court's Roe v. Wade decision on abortion in 1973.
The 8-to-3 ruling in the Ninth Circuit Court in San Francisco is an elaborate, 112-page decision that actually draws from US Supreme Court language on abortion. It overturns a Washington State law banning doctor-assisted suicide, stating there is a "constitutionally protected liberty interest in determining the time and manner of one's death."
"This is a landmark decision that addresses an issue every bit as personal and profound as abortion ... and it canvasses all the possible objections and abuses," comments Harvard constitutional scholar Laurence Tribe.
Washington is expected to appeal the decision, which becomes law in the nine Western states covered by the Ninth Circuit. Another assisted-suicide case is pending in the Second Circuit Court of Appeals in New York. Should that court rule differently than the Ninth Circuit did, the Supreme Court would likely step in to resolve the constitutional differences.
The ruling may also help in the defense of Jack Kevorkian, the Michigan physician now standing trial for violating a now-expired law that prohibited assisting in a suicide.
Legal and medical ethics scholars agree the new ruling supports the growing proposition among those sympathetic to assisted suicide that "life at all cost" is not the ultimate value and that the pain and suffering of a patient is not accounted for by current laws.
But the issue remains deeply troubling to many in the medical community who worry that, while the choice of terminating a painful or life-threatening condition may seem the higher ethical choice, in practice it could lead to abuses and to a "slippery slope" where ending a life by suicide becomes routine. A study in the Netherlands, where euthanasia is legal, showed some 1,000 cases of nonvoluntary suicides per year.
The Ninth Circuit ruling addresses cases in which an individual or patient decides "pro-actively" to end his or her life. It does not cover cases of individuals who are alive but not conscious enough to make a decision. Currently, laws in most states allow patients to "passively" terminate their lives, either by refusing medication or requesting that medical equipment be disconnected. So far, only Oregon has passed a law allowing assisted suicide.