The Case for Euthanasia: Should Physician-Assisted Suicide be


Throughout the twentieth century, major scientific and
medical advances have greatly enhanced the life expectancy of the
average person. However, there are many instances where doctors
can preserve life artificially. In these cases where the patient
suffers from a terminal disease or remains in a "persistent
vegetative state" or PVS from which they cannot voice their
wishes for continuation or termination of life, the question
becomes whether or not the patient has the freedom to choose
whether or not to prolong their life even though it may consist
of pain and suffering. In answer to this question, proponents of
physician-assisted suicide, most notably, Dr. Jack Kevorkian, are
of the opinion that not only should patients be able to abstain
from treatment, but if they have a terminal and/or extremely
painful condition, they should be able to seek out the assistance
of a doctor in order to expedite their death with as little pain
as possible.
Contained herein are the arguments for and against the
legalization of doctor-assisted suicide, as well as where the
state courts stand in respect to this most delicate of issues.
In the hopes of clarification, we must first distinguish
between active and passive euthanasia. Passive euthanasia
involves the patient's refusal of medical assistance. It
involves the right to die which is protected by the United States
Constitution clauses of due process liberty and the right to
privacy (Fourteenth Amendment). The right to doctor-assisted
suicide, or active euthanasia, consists of, "...a patient's
right to authorize a physician to perform an act that
intentionally results in the patient's death, without the
physician's being held civilly or criminally liable for having
caused the death" .
The "passive" form of euthanasia was first deemed legal by
the New Jersey State Supreme Court in 1976 In re Quinlan . In
the Quinlan case, the court allowed a competent patient to
terminate the use of life-sustaining medical machines to prolong
life. Since New Jersey's decision, all fifty states have enacted
similar statutes which contain living will provisions. However,
although the United States Supreme Court upheld the Quinlan
decision in re Cruzan , it changed the parameters of passive
euthanasia . With the Cruzan decision, the Supreme Court held
that passive euthanasia was legal but only for competent adults
or those who are incompetent but have previously procured a
living will. However, if the patient is without a living will
and incompetent, it becomes the burden of the family to prove
that there is "clear and convincing evidence" to the affect that
the patient does not want to continue living in a vegetative
As to active euthanasia, there has been no Supreme Court
ruling determining whether the right to die, as understood in
passive euthanasia cases, can be bound over to active euthanasia.
The decision is thus left to the individual states. Currently,
thirty-one states have criminalized explicitly the act of
assisted suicide . Physician-assisted suicide is generally
recognized as illegal under the parameters of homicide, however
it is very difficult to meet all of the elements of the crime and
conviction subsequently becomes nearly impossible. The fact that
the U.S. Supreme Court has not reviewed a physician-assisted
suicide case, which would create precedent, constitutes a dilemma
for the state courts in that there is no uniform test or ruling
by which to decide.
Most states have developed their own laws to, more often
than not, make doctor-assisted suicide illegal. However, when a
case comes to trial it is usually dismissed either by the judge
in a pretrial motion or by the jury. For example, in at least
three of the assisted suicides which Dr. Kevorkian was involved
in, all criminal charges were dismissed. So, the laws have been
created, but when it comes to convicting a doctor and sending him
to prison, in lieu of the circumstances, the law often breaks
down and the charges are dismissed or the doctor is acquitted.
In the case of the nineteen states which have not delineated
the criminality of doctor-assisted suicide, the issue becomes
less clear. Many of these states have a hard time grouping
physician-assisted suicide with homicide. The case which
Michigan judges cite in refusing this linkage of criminality is
the People of the State of Michigan v. Campbell . In the
Campbell case, the "court found that 'the term suicide excludes
by definition a homicide'" . Since, suicide is not a homicide,
then an assisted suicide cannot be deemed a homicide. At the
time of the appellate courts hearing of the Campbell appeal,
there was no other codified law expressing what crime an assisted
suicide would fall under and the homicide charges were dismissed.