The Right to Die with Dignity

By Jonathan Stahl

Jonathan Stahl is a junior at the University of Pennsylvania majoring in Philosophy, Politics, and Economics (PPE) with a minor in American Public Policy.  

On October 6th, Brittnay Maynard was featured in a YouTube video uploaded by the advocacy group Compassion & Choices, in which she explained on that November 1st she would exercise her right to physician-assisted suicide. She would do so in the comfort of her own home, surrounded by friends and family. Maynard was diagnosed with an aggressive form of brain cancer in early 2014; in April, she was told that she had six months to live. Given her bleak prognosis and deteriorating quality of life, which included violent, frequent seizures and painfully debilitating headaches, Maynard and her husband decided that it would be best for her to seek physician-assisted suicide rather than let the disease run its course. [1] 

The video, which got over 7 million hits in less than a week, was picked up by multiple national news sources and renewed the salience of the death with dignity debate, which has been a source of both legal and moral contention for decades. Maynard and her husband hope that sharing their story will provide an impetus for the expansion of the right to die because of the obstacles they had to overcome in order to legally obtain the lethal prescription. [2] They had to move from California—where physician-assisted suicide is illegal—to Oregon, where, since 1997, terminally ill patients have been allowed to end their lives with lethal medication. This ordeal forced Maynard and her family to find new doctors and a new house. In addition, they had to change their voter registration and her husband took a leave of absence from work, all of which was extremely burdensome given her condition. [3] There are five states in which the right to die is protected, and death with dignity bills have been introduced in seven other states’ legislatures.

Advocacy groups focus on passing legislation on a state-by-state basis rather than using the state or federal courts to secure the right since the Supreme Court has already ruled that there is no Constitutional right to die with dignity. In 1983, the Supreme Court ruled in Cruzan v. Director, MO Department of Health that there is an implicit constitutional right to refuse medical treatment, even if this choice results in the death of the patient. In 1997, however, the Court decided in Glucksburg v. Washington that terminally ill patients are not guaranteed the right to die with dignity through the Due Process Clause of the 14th amendment. In Vacco v. Quill, which was concurrently decided with Glucksberg, the Court ruled that states have a legitimate interest in banning physician-assisted suicides and that state laws banning the practice are constitutional.

The Court explained that there is both a moral and common-law distinction between letting a patient die and physician-assisted suicide in Vacco and Cruzan. They describe that in the case of withholding medical treatment at the request of a patient, it is the disease that ultimately kills the patient, so the right cannot be curtailed. However, in cases of physician-assisted suicide, like that of Ms. Maynard, the physician is the active cause of the patient’s death [4]. They make clear that there is no common-law or constitutional basis for the protection of this right.

The Court too rejected the notion that the right to die with dignity is implicit in the liberties guaranteed by the 14th amendment in Glucksburg. The Court ruled in Planned Parenthood v. Casey just five years earlier that the State could not prohibit abortions or subject women seeking them to undue burdens because abortions are deeply private matters, and involving the government in such an issue would violate the Constitution’s implicit right to privacy. The Court rejected the notion that this logic could be applied to a Constitutional right to physician assisted suicide by explaining that the right to privacy and the 14th amendment only protect liberties that are “deeply rooted our nation’s history” which, in their assessment, did not include the right to die.

Since these decisions and the passage of Oregon’s Death with Dignity Act in 1997, 752 terminally ill patients in Oregon have exercised their right to physician-assisted suicide.  Although advocates for patients like Ms. Maynard have failed to secure a constitutionally protected right to die through federal litigation, they hope that her story and those of patients in similar situations will result in the expansion of the right through state law. The right to die is not without its opponents, however, who make compelling moral, religious and legal arguments in favor of banning the practice.

The Court’s decision means that the right will have to be secured on a state-by-state basis either through state legislatures or ballot initiative, and ensures that the issue will be resolved not through legal doctrine, but through democratic deliberation.

 
[1] Colgrass, Neal. "29-year-old Woman: Why I'm Taking My Own Life." USA Today. October 13, 2014.
[2] Briggs, Bill. "Why Newlywed Brittany Maynard Is Ending Her Life in Three Weeks." NBC News. October 9, 2014.
[3] Bever, Lindsey. "Cancer Patient Brittany Maynard, 29, Has Scheduled Her Death for Nov. 1." Washington Post. October 8, 2014.
[4] ""Right to Die"" Justia US Law.

Photo Credit: Flickr User Ralf