The United States Supreme Court has agreed to take up physician-assisted suicide, potentially one of the most profound political and social issues today. The case involves Oregon's law allowing certain individuals to take their own lives with the help of a doctor. The outcome could determine whether such laws are enacted in other parts of the country.
The issue is a complicated one, as a series of legislative debates, ballot measures, and court cases around the country in recent years have shown. It involves medical ethics, federal drug law, questions of privacy, and the balance of legal and political power between states and the federal government.
Oregon's "Death with Dignity Act" became law in 1997 after voters twice had approved it at the polls by wide margins. It applies only to mentally competent adults who declare their intentions in writing, are diagnosed as terminally ill, and take the prescribed drug themselves orally after a waiting period. Oregon's law specifically prohibits "lethal injection, mercy killing, or active euthanasia."
Critics had predicted that vulnerable patients could be pressured by doctors or family members to end their lives, and also that out-of-staters might rush to Oregon to take advantage of its unique law. Apparently, neither has happened. On average, fewer than 25 people a year chose to end their lives under the law.
The Bush administration and key members of Congress argue that prescribing a lethal drug for purposes of suicide violates the federal Controlled Substances Act, and that this trumps state law and the long-held position that medical practices are to be regulated by the states.
A federal judge and then the Ninth US Circuit Court of Appeals rejected that position. To do so, the appeals court ruled, "interferes with the democratic debate about physician-assisted suicide."
In earlier cases, the US Supreme Court ruled that there is no constitutional right to assisted suicide. But the high court also did not declare the practice to be illegal. As Associate Justice Sandra Day O'Connor wrote: "There is no reason to think the democratic process will not strike the proper balance...."
The broader political and social context here includes ending medical efforts to prolong the life of certain patients believed to be severely brain-damaged. In Florida, a state appeals court is set to rule on a case involving Terri Schiavo. Ms. Schiavo's husband has been in a lengthy legal battle with her parents over removal of the feeding tubes doctors believe have kept her alive for 15 years.
But terminating such medical means of prolonging life is different from involving doctors - sworn to save life - in ending life.
Most Americans apparently want the option of ending their own life with the help of their doctor.
For more than 20 years, public opinion polls have shown consistent support for physician-assisted suicide. In one Harris Poll, for example, a substantial majority (65 to 29 percent) agreed that "the law should allow doctors to comply with the wishes of a dying patient in severe distress who asks to have his or her life ended." A 58 to 35 majority disagreed with federal attempts to overturn Oregon's law.
Nevertheless, efforts to enact a law like Oregon's have failed in other states, and anything like euthanasia is outlawed in 43 states.
Today, the issue is being debated in the California legislature. Gov. Arnold Schwarzenegger hasn't taken a public position on the issue. But despite the fact that he's Catholic, and the Roman Catholic Church is opposed to physician-assisted suicide, he's also broken with the church on gay rights and stem-cell research.
Other opponents of physician-assisted suicide include antiabortion groups and socially conservative organizations such as the Family Research Council. With Bill Frist of Tennessee, a physician, as Senate majority leader, pro-life activists who view officially sanctioned suicide as odious as abortion appear to have a champion who could stymie any possible trend in the direction of more doctor-assisted suicides.
Arguments in the Oregon case will be heard when the Supreme Court's next term begins in October.