Where Does Assisted Suicide Currently Stand Legally?

Last week brought news of the death of Dr. Jack Kevorkian. As you probably know, Kevorkian was a pathologist who helped terminally ill patients end their own lives. Throughout the 1990s, his actions were at the forefront of the emerging right-to-die debate in the United States, which continues to rage on.

Dr. Kevorkian reportedly assisted 130 terminally-ill people in committing suicide. He was tried several times for assisted suicide, and was acquitted all but once. In 1999, he was convicted of second-degree murder, after assisting a terminally-ill man in suicide, by administering a lethal injection. His medical license had been revoked several years earlier.

This incident was unique, because Dr. Kevorkian actually administered the injection himself. Usually, he would hook the patient up to an apparatus that would deliver the lethal drugs, but the patient had to physically activate the mechanism, to ensure that the patient had absolute control over the decision. In this case, however, the patient was mostly paralyzed and not physically capable of activating the device himself.

The whole incident was videotaped and broadcast on 60 Minutes, and is what led to his trial and conviction for second degree murder. He was paroled for good behavior and deteriorating medical health after serving 8 ½ years.

Though Dr. Kevorkian brought the debate over voluntary euthanasia to the forefront 20 years ago, the debate is far from settled. The legal and public policy discussion on the issue of physician-assisted suicide has made only moderate progress.

So, where does the law on assisted suicide currently stand? It should be noted that, in the vast majority of states in the U.S., it remains illegal. Anyone who aids or abets a person in committing suicide will be tried for some form of homicide, in those states.

However, three states in the U.S. – Oregon, Washington and Montana – have legalized doctor-assisted suicide, under very limited circumstances. Both laws legalizing assisted suicide were passed by voter initiative, and won by fairly significant margins. And nationwide polls suggest that around 70% of Americans support at least a limited right for terminally ill patients to seek the assistance of a doctor in ending their own lives.

However, the U.S. Supreme Court ruled some time ago that there is no constitutional right to physician-assisted suicide. This means that both the state and federal governments have the power to criminalize it, if they so choose. The Supreme Court did, however, hold that the federal government cannot interfere with a state’s right to legalize assisted suicide, should it so choose.

So, this means that the question of whether or not assisted suicide should be legal is going to be determined on a state-by-state basis, with a patchwork of different laws across the country being the norm for the foreseeable future. However, it appears that the trend is in the direction of legalizing assisted suicide, rather than restricting it. In the two states where it is currently legal, the controversy appears to have died down.

And it should be noted that, even when assisted suicide is legal, it comes with some pretty heavy restrictions. And this is reasonable, considering the fact that, if there’s one right that we don’t want to see abused, the right to die would be it. So, the laws that allow assisted suicide require strong medical evidence that the patient is terminally ill, with less than six months to live. They also require a psychiatric evaluation, to determine that the patient is mentally competent to make the decision. There is also a waiting period. The patient must also make the request voluntarily, without any evidence of coercion whatsoever. The patient’s medical prognosis must be verified by two physicians. Their mental competency must be verified by at least two psychiatrists.

Finally, when all of these facts are verified, the doctor is allowed to prescribe to the patient a drug cocktail meant to cause death as quickly and painlessly as possible – typically a combination of sedatives, painkillers, and antihistamines. The patient must administer the drugs to themselves, to provide an additional level of assurance that the act is completely voluntary. Studies in Washington and Oregon have shown that most patients who are prescribed these drugs don’t end up actually taking them. However, both the patients and their loved ones take a good deal of comfort in the knowledge that the option exists.

Personally, I think that this approach is the best one. I firmly believe in the right of a terminally-ill individual (assuming they are of sound mind) to end their own life, and to seek the assistance of a willing physician, to ensure that their death is as dignified and painless as possible.

Of course, I’m a realist. I recognize the potential for abuse of such a right, if it is unlimited. For that reason, strong safeguards against abuse need to be put into place, such as a waiting period, a psychiatric evaluation to ensure that the patient is of sound mind, as well as verification of the patient’s medical condition by at least two independent physicians, should be in place.

Clearly, the debate regarding assisted suicide is far from over, and few other topics elicit such an emotional response, from both sides of the issue. However, it’s a debate that we need to have.