Deciding Life and Death in the Courtroom
Gostin, Lawrence O.
JAMA. 1997 Nov 12; 278(18): 1523-1528.
This article analyzes judicial determinations on the "right to die" from Quinlan to Cruzan, Glucksberg, and Vacco. The body of law known as right-to-die cases extends ordinary treatment refusal doctrine to end-of-life decisions. The courts, having affirmed a right to refuse life-sustaining treatment, held that certain categorical distinctions that had been drawn lacked a rational basis. No rational distinction could be made between competent vs incompetent patients, withholding vs withdrawing treatment, and ordinary vs extraordinary treatment. The courts, however, had persistently affirmed one categorical distinction: between withdrawing life-sustaining treatment on the one hand and active euthanasia or physician-assisted dying on the other. In Washington v Glucksberg and Vacco v Quill, the Supreme Court unanimously held that physician-assisted suicide is not a fundamental liberty interest protected by the Constitution. Notably, five members of the Court wrote or joined in concurring opinions that took a more liberal view. The Court powerfully approved aggressive palliation of pain. The Supreme Court, hinting that it would find state legalization of physician-assisted suicide constitutional, invited the nation to pursue an earnest debate on physician assistance in the dying process.
Active Euthanasia; Advance Directives; Allowing to Die; Artificial Feeding; Assisted Suicide; Autonomy; Coercion; Competence; Constitutional Law; Criminal Law; Consent; Death; Decision Making; Double Effect; Drugs; Due Process; Economics; Euthanasia; Extraordinary Treatment; Freedom; Government; Health; Historical Aspects; Intention; Judicial Action; Killing; Law; Legal Aspects; Legal Liability; Legal Rights; Legislation; Life; Liability; Pain; Palliative Care; Patients; Physician Patient Relationship; Physician's Role; Physicians; Public Opinion; Review; Right to Die; Rights; Risks and Benefits; Social worth; State Interest; Suicide; Supreme Court Decisions; Terminally Ill; Treatment Refusal; Value of Life; Values; Wedge Argument; Withholding Treatment;
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Miller, Franklin G.; Quill, Timothy E.; Brody, Howard; Fletcher, John C.; Gostin, Lawrence O.; Meier, Diane E. (1994-07-14)CONCLUSIONS: The ethical norms of relieving suffering and respecting patients' rights to self-determination support the permissibility of voluntary physician-assisted death as a last resort for terminally or incurably ...