Dr. Jack Kevorkian died June 3, 2011. Kevorkian was at one time the US's leading advocate and practitioner of physician-assisted suicide.
Although branded Dr. Death by some in the media, Kevorkian always said physician-assisted suicide was about ending a terminal patient's suffering with dignity and compassion. Like many advocates, he chose to push the limits of societal norms and go past the boundaries of existing law prohibiting suicide or assisted suicide. Although he was convicted and served time in prison for these defiant acts, he helped moved the law toward change. Even so, only three states currently allow physician-assisted suicide.
In a closely-watched case, the Montana Supreme Court recently decided that doctors can help terminally ill patients end their lives without fear of prosecution.
The 4-to-3 decision was seen as a win for physicians, the disabled and the terminally ill who have been advocating the death-with-dignity movement. However, the decision was not as broad as they hoped. In fact, the court avoided any constitutional issues altogether.
The Montana case was brought on behalf Robert Baxter, a retired truck driver from Billings, who died in 2008 of complications related to lymphocytic leukemia at age 76.
What is Doctor-Assisted Suicide?
Doctor-assisted suicide is when a medical professional gives someone drugs or other necessary equipment to end his or her life. Other common names for this are "aid in dying" or "death with dignity."
There is also the process of euthanasia, which involves someone other than the patient ending a life in a less painful manner than would occur naturally. This could involve withholding medical treatment, removing the patient from life support or using a lethal substance to end the patient's life.
The Ethical Issues
Allowing doctors the freedom to end their patient's lives has been an ethical concern in the US for many years. You may remember the media attention Dr. Jack Kevorkian received. He is currently serving a 15 year sentence after honoring his patient's wish to die. Nonetheless, if an individual is set on dying, chances are they'll make it happen one way or another.
This case brings up important religious, social and policy issues. Those against assisted suicide claim the decision endangers patient lives, rather than protect their dignity. They also forecast practical issues that may emerge. For example, imagine doctors who make medical mistakes and want to hide their malpractice. They could now safely arrange for the patients' death. If the patient doesn't have a family or advocate, no one will ever know.
The Legal Issue
The Montana court heard arguments in this case in September 2009. The decision that came out in December 2009 was deeply divided. There were four separate written opinions written between the seven justices. They included a four-justice majority, a two-justice dissent, and two concurring opinions.
Legally speaking, there is a difference between a court finding there's a constitutional right to die, or for doctors to help patients die, and what the court decided in this case.
Here, the court ruled that Montana had no law prohibiting assisted suicide, which means that doctors are protected from lawsuits if they prescribe lethal doses to patients wanting to die.
The majority said that terminally ill patients deciding to die using lethal doses are responsible for their deaths, not the doctors who provide them the prescriptions. The court explained that doctor-assisted suicide is a policy question that should be decided by the people of Montana and their lawmakers.
What Does This Mean?
Because of Montana's narrow ruling, the Montana legislature could go back and limit assisted suicide by passing a law. Currently, only Washington and Oregon allow doctors to help terminally ill people end their lies.
In both of these states the laws were approved by voters in statewide referendums. In neither case did the courts examine the issue of a constitutional right to die. Montana would've been the first, yet the court shied away from that challenge.
One way to ensure your wishes are followed is to complete a Living Will. Often, if you have one before surgery you'll be asked even if it's fairly minor. Doctors and insurance companies want themselves, and you, to be protected.
Questions for Your Attorney
I live in New Jersey, can I help my brother who lives in Montana kill himself if he's terminally ill?
Do I need to make written instructions to my doctor about my wishes before asking her to help me die?
How will patients be protected against doctors who accidentally kill a patient but claim they requested to die?