No constitutional right to assisted suicide

In Washington v. Glucksberg, 521 U.S. 702 (1997), the U.S. Supreme Court held that Washington’s prohibition against causing or aiding a suicide does not violate the Fourteenth Amendment to the United States Constitution.

In Glucksberg, the Court found assisting with a suicide had always been a crime in Washington State and that it remainde a felony punishable by up to five years impriosonment. Simultaneously, Washington’s Natural Death Act, enacted in 1979, states that the “withholding or withdrawal of life-sustaining treatment” at a patient’s direction “shall not, for any purpose, constitute a suicide.”

The Petitioners were physicians who treated individuals with terminal conditions. They claimed there was a liberty interest protected by the Fourteenth Amendment which extends to a personal choice by a mentally competent, terminally ill adult to commit physician-assisted suicide. The District Court agreed, concluding Washington’s assisted-suicide ban is unconstitutional because it “places an undue burden on the exercise of [that] constitutionally protected liberty interest.

A Ninth Circuit panel reversed, emphasising that in the two hundred and five years of our existence no constitutional right to aid in killing oneself has ever been asserted and upheld by a court of final jurisdiction. The case was reheard en banc by the Ninth Circuit, reversing the panel decision and affirming the trial court relying on the Casey and Cruzan decisions.

The Supreme Court found that bans on assisted suicide were not innovations. They are longstanding expressions of the States’ commitment to the protection and preservation of all human life. A majority of States have laws imposing criminal penalties on one who assists another to commit suicide. For over 700 years, the Anglo-American common-law tradition has punished or otherwise disapproved of both suicide and assisting suicide. Initially those who committed suicide were said to have committed self-murder and their property was forfieted to the government. By the 1700s, Ameican law eliminated civil forfeiture of property as unfair to the surviving family, but continued to regard suicide as serious and criminalize assisted suicide.

The court recognized that due to advances in medicine and technology, Americans today are increasingly likely to die in institutions, from chronic illnesses. Public concern and democratic action are therefore sharply focused on how best to protect dignity and independence at the end of life,with the result that there have been many significant changes in state laws and in the attitudes these laws reflect. However, voters and legislators continue for the most part to reaffirm prohibitions on assisted suicide. At the time Glucksberg was heard, the Court noted Oregon allowed assisted suicide, while voters in California rejected it.

The Court notied it had always been reluctant to expand the concept of substantive due process because guide posts for responsible decision making in this unchartered area are scarce and open-ended. With this in mind, the Court framed the issue as  whether there is a liberty interest in determining the time and manner of one’s death,” 79 F. 3d, at 801, or, in other words, “[i]s there a right to die?” The respondents also asserted the existence of a “liberty to choose how to die” and a right to “control of one’s final days.

The Court rejected the argument that Cruzan authorized assisted suicide. Cruzan stood for the proposition that a patient can refuse treatment, noting the common-law rule that forced medication was a battery, and the long legal tradition protecting the decision to refuse unwanted medical treatment. Assisted suicide has never enjoyed similar legal protection.

The Court noted, in addition to protecting life, States have an interest in protecting vulnerable groups—including the poor, the elderly, and disabled persons—from abuse, neglect, and mistakes. The risk of harm is greatest for the many individuals in our society whose autonomy and well-being are already compromised by poverty, lack of access to good medical care, advanced age, or membership in a stigmatized social group. The State also has an interest in guarding against euthanasia. In reversing the decision below, the Court left the decision to the individual States, concluding Americans are engaged in an earnest and profound debate about the morality, legality, and practicality of physician-assisted suicide and that its decision allowed that debate to continue.