Assisted suicide in the United States
Encyclopedia
Physician-assisted suicide
in the United States is legal in the states of Oregon, Montana and Washington.
The process is set forth in law, including the requirements that the patient must be of sound mind when requesting assisted suicide, as confirmed by a doctor and other witnesses; and the patient must be diagnosed with a terminal illness.
movement in the early years of the twentieth century. In a 2004 article in the Bulletin of the History of Medicine
, Brown University historian Jacob M. Appel
documented extensive political debate over legislation to legalize physician-assisted suicide in both Iowa and Ohio in 1906. In Ohio, the legislation was inspired by the campaign of heiress Anna S. Hall, whose mother had died a painful death from cancer
. Despite Hall’s efforts, the bill was rejected by the Ohio legislature by a vote of 79 to 23.
, but charges were dropped on December 13, 1990 because there were no Michigan laws outlawing suicide or the medical assistance of it so he was not in violation of a law.
Years later, Kevorkian crossed the line from assisting the patient to actively killing the patient himself. Kevorkian videotaped himself giving a man a lethal injection and aired the tape on 60 Minutes
. He was found guilty of second-degree murder and served eight years of a 10-25 year sentence. He was released in 2007, and died on June 3, 2011.
facilities. This measure also did not pass with only 46 percent of the vote.
for lethal drugs and included many provisions to protect against misuse, such as two oral requests and a written request from the patient. The patient must also be referred to counseling if a mental illness is suspected. This ballot measure passed by a narrow margin with 51.3 percent of the vote. This was seen as a victory for supporters of assisted suicide
. The passage of this measure became very controversial. Many feared that people would flock to Oregon to take advantage of this law.
Ballot Measure 16 provided for enactment of the Oregon Death with Dignity Act. That law requires that patients of sound mind may request a prescription for a lethal dose of medication. Two doctors must confirm a diagnosis of terminal illness with no more than six months to live. Two witnesses, one non-doctor unrelated to the patient, must confirm the patient's request, and the patient must make a second request after 15 days. The 2008 Washington law is closely modeled on the Oregon law.
In 1997, the Oregon Legislative Assembly
sent a ballot measure to the voters, Measure 51, which sought to repeal the Death with Dignity Act. The measure was introduced because of the controversy surrounding the passage of Ballot Measure 16 and the slow implementation of it. Measure 51 was defeated by 60 percent of the vote.
) introduced Initiative 119 as an amendment to Washington’s 1979 Natural Death Act. The ballot question asked if terminally ill adults should be allowed to receive physician aid-in-dying. This initiative was very controversial. Supporters of the initiative advertised cancer patient’s statements of wanting a dignified death. Opponents invoked fear in the public by saying the initiative would allow doctors to kill patients. The initiative failed, only receiving 46 percent of the vote.
However, Washington Initiative 1000
was approved on the November 4, 2008 election
by 57.82% of Washington state voters. The provision allows an adult Washington resident who has a six month predicted survival to self-administer lethal medication prescribed by a physician.
through a trial court ruling on December 6, 2009 in the case of Baxter v. Montana
. The Attorney General of the state of Montana sought an appeal from the Montana Supreme Court, but the court, by a decision of five to two, affirmed the lower court's ruling on the state law. The Court did, however, limit the scope of the decision by not determining if the state's constitution protected the right.
was brought to the United States Supreme Court
in 2006. The Supreme Court ruled that the United States Attorney General could not enforce the Controlled Substances Act against physicians prescribing drugs to assist terminally ill patients in committing suicide because it would be in conflict with the law established by Oregon’s Ballot Measure 16. The Controlled Substances Act would have allowed the Attorney General to control or stop the distribution of fatal drugs to terminally ill patients.
Assisted suicide
Assisted suicide is the common term for actions by which an individual helps another person voluntarily bring about his or her own death. "Assistance" may mean providing one with the means to end one's own life, but may extend to other actions. It differs to euthanasia where another person ends...
in the United States is legal in the states of Oregon, Montana and Washington.
The process is set forth in law, including the requirements that the patient must be of sound mind when requesting assisted suicide, as confirmed by a doctor and other witnesses; and the patient must be diagnosed with a terminal illness.
Legal Requirements
The Oregon Death with Dignity Act, and the Washington statute modeled after it, set certain requirements and safeguards before a person may commit suicide with a doctor's assistance. The patient must be of sound mind when they request a prescription for a lethal dose of medication. Two doctors must confirm a diagnosis of terminal illness with no more than six months to live. Two witnesses, one non-doctor unrelated to the patient, must confirm the patient's request, and the patient must make a second request after 15 days.Assisted suicide movement of 1906
The first significant drive to legalize assisted suicide in the United States arose as part of the eugenicsEugenics
Eugenics is the "applied science or the bio-social movement which advocates the use of practices aimed at improving the genetic composition of a population", usually referring to human populations. The origins of the concept of eugenics began with certain interpretations of Mendelian inheritance,...
movement in the early years of the twentieth century. In a 2004 article in the Bulletin of the History of Medicine
Bulletin of the History of Medicine
The Bulletin of the History of Medicine is an academic journal founded in 1939. It is the official publication of the American Association for the History of Medicine. It is also the official publication of the Johns Hopkins Institute of the History of Medicine...
, Brown University historian Jacob M. Appel
Jacob M. Appel
Jacob M. Appel is an American author, bioethicist and social critic. He is best known for his short stories, his work as a playwright, and his writing in the fields of reproductive ethics, organ donation, neuroethics and euthanasia....
documented extensive political debate over legislation to legalize physician-assisted suicide in both Iowa and Ohio in 1906. In Ohio, the legislation was inspired by the campaign of heiress Anna S. Hall, whose mother had died a painful death from cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
. Despite Hall’s efforts, the bill was rejected by the Ohio legislature by a vote of 79 to 23.
Dr. Kevorkian
Assisted suicide in the United States was brought to public attention in the 1990s with the highly publicized case of Dr. Jack Kevorkian. Dr. Kevorkian assisted over 40 people in committing suicide in Michigan. His first public assisted suicide was in 1990, of Janet Adkins, a 54-year-old woman diagnosed with early-onset Alzheimer’s disease in 1989. He was charged with murderMurder
Murder is the unlawful killing, with malice aforethought, of another human being, and generally this state of mind distinguishes murder from other forms of unlawful homicide...
, but charges were dropped on December 13, 1990 because there were no Michigan laws outlawing suicide or the medical assistance of it so he was not in violation of a law.
Years later, Kevorkian crossed the line from assisting the patient to actively killing the patient himself. Kevorkian videotaped himself giving a man a lethal injection and aired the tape on 60 Minutes
60 Minutes
60 Minutes is an American television news magazine, which has run on CBS since 1968. The program was created by producer Don Hewitt who set it apart by using a unique style of reporter-centered investigation....
. He was found guilty of second-degree murder and served eight years of a 10-25 year sentence. He was released in 2007, and died on June 3, 2011.
California's Proposition 161
In 1992, the group Californians against Human Suffering proposed Proposition 161 to allow patients with less than 6 months to live the right to receive assistance from physicians in dying. This proposition offered more safeguards against abuse by physicians than Washington’s Initiative 119, such as special protections for patients in nursingNursing
Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from conception to death....
facilities. This measure also did not pass with only 46 percent of the vote.
New York Cases
In 1994, a suit was filed in New York claiming that the anti-assisted suicide statute was a violation of equal protection and liberty guarantees of the Fourteenth Amendment. This claim was rejected by the District Court on the basis that there is no right to assisted suicide given by the U.S. Constitution. In 1996, the U.S. Court of Appeals overturned this ruling with the reasoning that the criminalization of assisted suicide violates the Equal Protection Cause. This ruling led to the overturn of laws in Washington as well and affected states such as Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada, Oregon, Connecticut, and Vermont. This case was appealed to the U.S. Supreme Court.Oregon ballot measures
The Hemlock Society introduced Ballot Measure 16 in Oregon in 1994. It asked if terminally ill patients with less than 6 months to live should be able to receive a prescriptionMedical prescription
A prescription is a health-care program implemented by a physician or other medical practitioner in the form of instructions that govern the plan of care for an individual patient. Prescriptions may include orders to be performed by a patient, caretaker, nurse, pharmacist or other therapist....
for lethal drugs and included many provisions to protect against misuse, such as two oral requests and a written request from the patient. The patient must also be referred to counseling if a mental illness is suspected. This ballot measure passed by a narrow margin with 51.3 percent of the vote. This was seen as a victory for supporters of assisted suicide
Suicide
Suicide is the act of intentionally causing one's own death. Suicide is often committed out of despair or attributed to some underlying mental disorder, such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse...
. The passage of this measure became very controversial. Many feared that people would flock to Oregon to take advantage of this law.
Ballot Measure 16 provided for enactment of the Oregon Death with Dignity Act. That law requires that patients of sound mind may request a prescription for a lethal dose of medication. Two doctors must confirm a diagnosis of terminal illness with no more than six months to live. Two witnesses, one non-doctor unrelated to the patient, must confirm the patient's request, and the patient must make a second request after 15 days. The 2008 Washington law is closely modeled on the Oregon law.
In 1997, the Oregon Legislative Assembly
Oregon Legislative Assembly
The Oregon Legislative Assembly is the state legislature for the U.S. state of Oregon. The Legislative Assembly is bicameral, consisting of an upper and lower house: the Senate, whose 30 members are elected to serve four-year terms; and the House of Representatives, with 60 members elected to...
sent a ballot measure to the voters, Measure 51, which sought to repeal the Death with Dignity Act. The measure was introduced because of the controversy surrounding the passage of Ballot Measure 16 and the slow implementation of it. Measure 51 was defeated by 60 percent of the vote.
Washington
In 1994, the Washington state chapter of the Hemlock Society (now called Compassion & ChoicesCompassion & Choices
Compassion & Choices is a nonprofit organization in the United States working to improve patients' rights and choices at the end of life...
) introduced Initiative 119 as an amendment to Washington’s 1979 Natural Death Act. The ballot question asked if terminally ill adults should be allowed to receive physician aid-in-dying. This initiative was very controversial. Supporters of the initiative advertised cancer patient’s statements of wanting a dignified death. Opponents invoked fear in the public by saying the initiative would allow doctors to kill patients. The initiative failed, only receiving 46 percent of the vote.
However, Washington Initiative 1000
Washington Initiative 1000 (2008)
Initiative 1000 of 2008 established the U.S. state of Washington's Death with Dignity Act , which legalizes physician-assisted dying with certain restrictions. Passage of this initiative made Washington the second U.S. state to permit some terminally ill patients to determine the time of their own...
was approved on the November 4, 2008 election
Election
An election is a formal decision-making process by which a population chooses an individual to hold public office. Elections have been the usual mechanism by which modern representative democracy operates since the 17th century. Elections may fill offices in the legislature, sometimes in the...
by 57.82% of Washington state voters. The provision allows an adult Washington resident who has a six month predicted survival to self-administer lethal medication prescribed by a physician.
Florida: Krischer v. McIver
This case was brought to the Florida Supreme Court in 1997 by the Florida chapter of the Hemlock Society in an attempt to overturn the state’s anti-assisted suicide law. The question was if AIDS patient Charles Hall had this right, and the case was appealed to the Florida Supreme Court. This court upheld the constitutionality of Florida’s law against assisted suicide.Alaska: Sampson and Doe v. State of Alaska
In 1999, two terminally ill patients, Kevin Sampson and Jane Doe, sued for an order to exempt their physicians from being charged with manslaughter for assisting them in committing suicide. The superior court ruled against them, and they appealed to the Alaska Supreme Court. This court upheld the previous ruling with the reasoning that the Alaska Constitution’s right to privacy and liberty does not allow terminally ill patients to be assisted by physicians in committing suicide.Montana
Assisted suicide was made legal in MontanaMontana
Montana is a state in the Western United States. The western third of Montana contains numerous mountain ranges. Smaller, "island ranges" are found in the central third of the state, for a total of 77 named ranges of the Rocky Mountains. This geographical fact is reflected in the state's name,...
through a trial court ruling on December 6, 2009 in the case of Baxter v. Montana
Baxter v. Montana
Baxter v. Montana, was a Montana Supreme Court case, argued on September 2, 2009, and decided on December 31, 2009, that addressed the question of whether the state's constitution guaranteed terminally ill patients a right to lethal prescription medication from their physicians.-Background of the...
. The Attorney General of the state of Montana sought an appeal from the Montana Supreme Court, but the court, by a decision of five to two, affirmed the lower court's ruling on the state law. The Court did, however, limit the scope of the decision by not determining if the state's constitution protected the right.
State power to allow and regulate
States have the power to allow and regulate assisted suicide, or to prohibit it.1997 Supreme Court cases
In 1997, in the cases of Washington v. Glucksberg and Vacco v. Quill, the U.S. Supreme Court ruled unanimously that there is no Constitutional right to assisted suicide, and that states therefore have the right to prohibit it. Advocates of assisted suicide saw this as opening the door for debate on the issue at the state level.Gonzales v. Oregon
Gonzales v. OregonGonzales v. Oregon
Gonzales v. Oregon, 546 U.S. 243 , was a decision by the United States Supreme Court, which ruled that the United States Attorney General could not enforce the federal Controlled Substances Act against physicians who prescribed drugs, in compliance with Oregon state law, for the assisted suicide of...
was brought to the United States Supreme Court
Supreme Court of the United States
The Supreme Court of the United States is the highest court in the United States. It has ultimate appellate jurisdiction over all state and federal courts, and original jurisdiction over a small range of cases...
in 2006. The Supreme Court ruled that the United States Attorney General could not enforce the Controlled Substances Act against physicians prescribing drugs to assist terminally ill patients in committing suicide because it would be in conflict with the law established by Oregon’s Ballot Measure 16. The Controlled Substances Act would have allowed the Attorney General to control or stop the distribution of fatal drugs to terminally ill patients.