Assisted Suicide and the Right to Die

The 1975 case of Karen Ann Quinlan was publicized nationwide, illustrating the ethical dilemma that exists because of the use of modern medical equipment such as mechanical respirators and feeding tubes. Quinlan had suffered a respiratory arrest, leaving her in a permanent vegetative state. Her family, in a long legal battle, argued that their daughter would not want to be kept alive in this way, with no hope for recovery. The court eventually granted the Quinlans the right to remove Karen from life support. This case helped define this gray but growing area of ethical and legal controversy. Court cases, such as the U.S. Supreme Court case of Cruzan v. Director, Missouri Department of Health (1990), have helped define policy on these issues. Society has become more accepting of policies that honor a terminally ill patient's request to withhold or withdraw medical interventions. However, the issue of assisted suicide, the act of hastening death, has not achieved the same level of comfort for many people.

In June of 1997, the U.S. Supreme Court reaffirmed the right to die in its decisions in the Washington v. Glucksberg and Vacco v. Quill cases, but emphasized the difference between these types of end-of-life decisions, "pulling the plug," and physician-assisted suicide. In these cases the Court found that assisted suicide was not a constitutional right and left it to the states to decide whether or not to legalize assisted suicide. An individual's right to refuse treatment is still valid when he or she becomes incompetent. All 50 states and the District of Columbia authorize the use of a written advance medical directive to help honor the decisions of those who are not able to speak for themselves but who have recorded their wishes in a living will or medical power of attorney. Oregon was the first state authorizing physician-assisted suicide in specific circumstances. While Oregon voters had approved the Oregon Death With Dignity Act in November of 1994, the act was challenged in court and enactment was delayed. In February of 1997, the U.S. Supreme Court refused to hear the appeal after the Ninth Circuit Court of Appeals held that the plaintiffs did not have cause to challenge the act. In a repeat voter referendum in November of 1997, Oregon voters refused to repeal the act. Assisted suicide proponents view the issue as an extension of an individual's right to decide on his or her final care. Opponents argue that if assisted suicide is legalized on a national basis, many elderly and dependent individuals will feel guilty for being alive and for not making a substantial contribution to society and will feel obligated to commit suicide.

One supporter of the cause, Dr. Jack Kevorkian of Michigan, otherwise known as "Dr. Death," deserves mention since he has assisted over 120 individuals with their own suicides. Dr. Kevorkian has been jailed, gone on hunger strikes, lost his medical license, dropped the bodies of his patients at the hospital after their deaths, and appeared in court countless times in such attire as a sackcloth and in seventeenth century costumes. His outlandish behavior has attracted attention to the right to die/assisted suicide cause, but some supporters say his behavior has done more harm than good. In 1999, he was convicted of second-degree murder, in a conviction that is expected to be appealed.