8-end-of-life

8/8/2019 8-end-of-life

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Defending Life 2010

411

enD Of Life


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Americans United for Life


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Defending Life 2010

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ed o L

i may 2008, og sid Babaa Wag civd a chillig -

jci l f h halhca isuac cpay. Wags sahalh pla did cvag f dicai ha wuld a h cac ad

xd h lif, bu isad ffd pay f h cs-ffciv pi f

dig h lif by lhal pscipi.

Wags lug cac, which had b i issi f w yas, had -

ud. H dc had pscibd dicai a h cac. th di-

cai cs $4,000 p h. A 64-ya-ld id bus div, Wag

culd psally affd h pscipis. rlyig h og Halh

Pla, sh qusd cvag f h cac dicais, ly civ a

cold, at denial. Her health insurance would not cover the $4,000-a-monthcac dugs, bu wuld pay $50 f a assisd suicid.

Wag ad h faily w dvasad. I was hibl, sh said, as

ooding her eyes. I got a letter in the mail that basically said if you want

ak h pills, w will hlp yu g ha f h dc ad w will sad

h ad wach yu di. Bu w w giv yu h dicai liv.

Physicia-assisd suicid was lgalizd by og i 1994 wh i acd

is Dah wih Digiy Ac. o nvb 4, 2008, ighbig Wash-

ig bca h scd sa lgaliz h gisly pacic f physicia-assisd suicid wh vs appvd Iiiaiv 1000. th Iiiaiv k

ffc i mach 2009 ad a 66-ya-ld wa cly diagsd wih

terminal pancreatic cancer was the rst to legally commit suicide in May

2009.

ev ublig, i Dcb 2008, h Fis Disic Cu f m-

tana became the rst court in America to declare a constitutional right to

di f cp, ially ill pais. th judg claid his igh

di is cpassd i maas csiuial ighs idividual pi-

vacy ad hua digiyad his igh icluds assisac f phy-sicias ad xpis f liabiliy f h physicias ud maa

hicid saus. this maa judg ffcivly ipsd physicia-

assisd suicid h ciizs f maa wih safguads apppi-

a lgislaiv liiais i plac. Sh siply chagd h lgislau wih

h ask f iplig his wfud igh di.


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414


Wha is happig i Washig ad, paiculaly, i maa is a wak up

call h ai ad hs wh wa pc h dyig, h ldly, h

sick, ad h disabld. Cpassi ad Chics, h Dah wih Digiy na-

ial C, ad h uhaasia advcacy gups dcpiv aa clai

unbearable suffering for the terminally ill and patient choice as justications

fuh hi issi xp h pacic f physicia-assisd suicid all 50 sas.

Pi nvb 2008, h Dah wih Digiy naial C calld is

agd pla og plus o. Accdig his pla, if jus h

sa bsids og w lgaliz physicia-assisd suicid, i wuld

ssially igg a di ffc ad h s f h ai wuld s fl-

lw. Washig ad w maa hav pssibly s h di ffc i

i. I is ciical sp ad pssibly vs a pplig wad assisd

suicid, uhaasia, ad h fuh dvaluig f hua lifa ciuu

which h igh di has pv bc h duy di.


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Defending Life 2010

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Psvg Huma Dgty at th ed o L:A survey of federal and state laws

By Jssca J. Sag

Staff Counsel, Americans United for Life

L gal uhaasia i Aica ss ay b a ipssibiliy, bu uhaa-sia advcas a diligly a wk, ic-

ally advacig hi agdaaccplishig

bh big ad sall vicis i public pii,

i lgislaus, ad i judicially-aciv cus.

euhaasia advcas clvly clak hasig

h dahs f Aicas s vulabl cii-

zs as Cpassi ad Chic. th a-kig s f cpassi ad chic

dcpivly pay slf-dsuci as ally

cc ad pwig. Ufualy, hy

have gained right to die proponents signi-

ca u as og, Washig, ad

maa culy saci physicia-assisd

suicid (PAS).

this pi is dsigd duca ad cu-

ag lawaks ad ciizs ciu hght against the culture of death promulgated

by supps f uhaasia. As xpicd i

h nhlads, c a ai pis vlu-

ay uhaasia ad assisd suicid, h pi-

cipl f uivsaliy qual a

fcs accp dig h livs f hs

wihu xplici qus. tuig Dah wih

Digiy ad chic f h ially-ill

i isuffabl pai is ly a ical

sp i h ciuu wad hasig dahf h ldly, disabld, dpssd, ad hs

dd hav a lw qualiy f lif a ay ag

sag f lif.

Brief History of Euthanasia Advocacy

in America

th uhaasia v i Aica b-

ga by pig livig wills as a as

bgi a uhaasia discussi ad advac

public accpac f i. tw gups, h eu-

haasia Sciy f Aica ad euhaasia

educai Cucil, iducd livig wills i1967 ad claid hy w cssay giv

pais h igh fus uwad di-

cal pcdus i h v hy la bca

icapaciad. La, hs gups iducd

cy-killig bills allw dcs giv

disabld dyig pais lhal vdssi

vaius sa lgislaus wihu succss. I

ligh f hs failus, h livig will sad h

discussi f wihhldig dical as

ad gav uhaasia advcas a ic-al ad palaabl sp i h igh di

capaig.

th Hlck Sciy, fudd i 1980 by

Dk Huphy, spsd physicia-aid-i-

dyig iiiaivs i Washig i 1991 ad

Califia i 1992. Bh asus pid

lhal ijcis ad assisd suicid f i-

ally-ill pais, bu bh faild. Pps

ccly aibud h dfas h publicslucac allw dcs kill pais.

Af a i f -sagizig, h gup -

branded itself rst as Compassion in Dying and

cly as Cpassi & Chicsh

gaizai ha iiiad ad succssfully


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416


dicd h assisd suicid capaigs i o-

g ad Washig f PAS.

Current Federal and State Laws

Fdal ad sa laws gally addss wd-f-lif issus: 1) h fusal f dical

a ( iclud h wihdawal f ui-

i ad hydai f ially-ill pais

pais i psis vgaiv sas), ad

2) assisd suicid ad uhaasia. Whil h

Uid Sas Sup Cu did ul a

lad cas uil 1990, sas hav lgislad i

hs aas sic h bgiig f h nai.

I fac, Agl-Aica c law has ad-

dssd hasig dah a h d f lif fa las 700 yas by puishig phibiig

suicid, assisd suicid, ad ud.1

Sa laws gadig h wihdawal f fd

ad hydai w iiially gudd i h

c law f , bay, ad ifd

cs.2 F his c law spug h

igh fus dical a, ad h -

fusal ad wihdawal f fd ad hydai

was viwd as a xcis f his igh. o hh had, s sas xpssly phibid

assisd suicid ad uhaasia. I fac, sv-

al f h Aica clis wuld, as pu-

ishment, conscate the property of individuals

ha cid suicid.3 Whil h clis

vually ablishd such palis, h cus

ciud cd suicid as a gav pub-

lic wg.4

Since 1990, the Supreme Court has afrmedh sas iss i psvig lif uil is

aual d. I Cruzan v. Missouri Department

of Health, the Court for the rst time was pre-

sd wih a igh di issu.5 th qus-

i bf h Cu was whh h Csi-

ui fbids sas f quiig cla ad

cvicig vidc f a pais wishs

bf h wihdawal f fd ad hydai.

th Cu hld ha i ds . rah, h

Cu uld ha sas ay lgiialy sk

safguad pais hugh h ipsii fhighd vidiay quis.6 thus,

whil pais ay hav a igh fus fd

ad hydai hav fd ad hydai wih-

daw,7 sas ay, i h is f pcig

h livs f pais, apply a cla ad cvic-

ig sadad wh a guadia sks disc-

iu such lif-susaiig as.8

I 1997, h Sup Cu k is x lk

a d-f-lif issus i Washington v. Glucks-berg9 ad Vacco v. Quill.10 thugh hs cas-

s, h Cu dclad h is fdal c-

siuial igh assisd suicid ud h

Du Pcss equal Pci Clauss f h

Fuh Ad, bu iplid ha sas

hav h pw dcid whh pi

phibi PAS.

Af xaiig h nais lg hisy f

fbiddig suicid ad assisd suicid, h Su-p Cu i Glucksbergreafrmed a states

unqualied interest in the preservation of

hua lif.11 Alg wih psvig lif, h

sas iss i pvig suicid iclud:

pcig h hics ad igiy f h di-

cal pfssi; pcig vulabl gups f

ppl f cci, pjudic, syps,

ad scial idiffc; ad pvig

h slid wad uhaasia. th Cu islf

ackwldgd ha PAS wuld b xlydifcult to police and contain and that [bans]

assisig suicid pv such si. th

Cu ccludd ha hs vaius iss a

uqusiably ipa ad lgiia. 12


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Defending Life 2010

417

I Vacco, the Supreme Court afrmed the dis-

ici bw assisig suicid ad h wih-

dawal f lif-susaiig a, saig i is

a disici widly cgizd ad dsd

i h dical pfssi ad i u lgal a-

diis ad ha i is ipa, lgical, adaial.13 th Sup Cu fcusd h

diffc bw causig dah ad allwig

s di f his h udlyig disas.

Fially, h Cu d

h fllwig as valid ad

ipa public iss:

phibiig iial kill-

ig ad psvig lif; p-

vig suicid; aiai-

ig physicias l as hi pais hals; pcig

vulabl ppl f i-

diffc, pjudic, ad

psychological and nancial

pssu d hi livs;

ad avidig a pssibl slid wad uhaa-

sia.14

tha sa ya, Cgss passd h Assisd

Suicid Fudig rsici Ac, which p-hibis h us f fdal fuds f is ad

svics h pups f which is caus (

assis i causig) h suicid, uhaasia,

cy killig f a idividual.15 Whil h

Ac was add i 2000, i ais a bai

h fdal fudig f PAS ad uhaasia.

mos saes prohibi assised suicide. thiry-

fve states expressly prohibit assisted suicide by

saue, and anoher six saes iply is prohibi-ion hrough use of he coon law or by iner-

preing heir hoicide saues o apply o assis-

tance in suicide. However, fve states and the

Disric of Colubia have neiher express nor

iplied prohibiions agains assised suicide.

tw sasog ad Washigx-

pssly auhiz h pacic. mv, i

Dcb 2008, a maa ial cu v-

ud h sas ba PAS.16 Hwv, h

cas is pdig bf h maa Sup

Cu. Ah saCalifiaw -quis physicias cusl hi pais

hw d hi livs, ad als quis ha

physicias pvid pscipis f sdaivs

f pais wishig sav

dhyda hslvs

dah.

Ufualy, uhaasia

advcas hav had s

succss i bddig hidisd viw f d-f-

lif issus i h ids f

h Aica ppl. th

igh di is w a

phas f c hus-

hld kwldg. Whil h issu f PAS ap-

pad da i h yas idialy fl-

lwig Glucksbergad Vacco, suicid pp-

s a agai skig valida ad lgaliz

PAS i ay sas. Dspi h xplici adiplici assisd suicid phibiis i s

sas, i sas csidd lgislai l-

galiz PAS i 2009. effs us b ad

pv h spad f accpig ad lgalizig

suicid as apppia dical a ad

a lgiia chic bf i ifcs

sas acss h ai.

ISSUES

The Oregon Experience

On November 8, 1994, Oregon became the rst

sa i h nai auhiz PAS f cp-

, ially-ill pais.17 Babaa Cbs


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L, Psid f Cpassi & Chics, au-

hd ad lbbid f ogs PAS iiiaiv,

kw as h Dah wih Digiy Ac (Ac).

Whil a fdal disic cu iiially jid

fc f h v iiiaiv, h nih

Cicui vsd. Fiv hs fllwig hSup Cu dcisis i Glucksburg ad

Vacco, h Ac k ffc i 1997.

I 2001, h-Ay Gal Jh Ashcf

issud a diciv saig ha PAS is a l-

giia dical pups ad ha subsacs

gulad ud h fdal Clld Sub-

sacs Ac culd lgally b usd f PAS.

Supporters of PAS and euthanasia led suit,

ad, i 2004, h nih Cicui uld ha hdiciv was illgal ad ufcabl. o

January 17, 2006, the Supreme Court afrmed

h nih Cicuis ulig, hldig ha C-

gss did id f h Ay Gal

hav such auhiy. Hwv, h Cus

pvius dcisis dyig a fdal csiu-

tional right to assisted suicide remained rm,

bu s did h iplicai ha sas hav h

igh di whh pi p-

hibi PAS.18

Cpassi & Chics is pig ogs

Ac i uus sas as h dl lgaliz

PAS ad clais og as a succss sy f

hw assisd suicid is wk, bu h al-

ity in Oregon exemplies the inadequacy and

cicuvi f safguads wihi h law

ad h ih lack f aspacy i PAS

pig.

Undiagnosed Depression

and Inadequate Waiting Periods

t qus PAS i og, a ps us b:

a capabl adul ad sid f og, ad

diagsd wih a ial illss pdicd

pduc dah wihi six hs. 19 th is

qui f h physicia di h

as why a pai is qusig PAS ad

addss h al issu a had isuffabl

pai, bu dpssi ad fa f h ukw.

Supporters of PAS offer horric stories of ex-

aiy, claiig ially-ill pais

d PAS liv hi ubaabl pai ad

suffig. of, h ially-ill d xpss

a fa f ubaabl pai ad suffig, bu

i is a fa f pssibiliy, cssaily h

alizai f pai ad suffig. Whas i

acualiy, h s fquly cid ccs

f ially-ill pais i ogs aual

ps a pai ad suffig, bu h lssf psal auy ad bdily fuci ad

h dcasd abiliy paicipa i aciviis

ha ak lif jyabl.20 th ially-ill

als fa bcig a bud faily -

bs ad fids ad, iically, physicias ad

faily bs ifc his fa wh hy

iduc h pi f PAS as pssibl di-

cal a. th b sps is af-

rm the value of the patients life and compas-

sialy supp h hugh a aual df hi lif.

Ud ogs Ac, physicias a ly -

quid f a pai f cuslig a psy-

chlgical valuai if hy suspc a psychi-

aic psychlgical disd dpssi

[is] causig ipaid judg. I h PAS

pig, h ub f pais fd f

cuslig has csisly dclid f

pais i h scd ya z pais ih h ya f pig. I og, physi-

cias d uiliz h psychiaic valuai

as a pciv asu f hslvs

ha f h pai. Sigly, as physicias

cplad lss pial liabiliy i assisig


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Defending Life 2010

419

suicids, hy ad lss psychiaic fals.

I is als ukw if h cuslig fal is

pfd wih ay lvl f pfssial sa-

dads if i is siply a aiglss xcis.

Wh ly six pc f og psychiaiss

surveyed said they were condent they couldsaisfacily di whh a pai was

cp ci suicid abs a lg-

laiship wih a pai, h csul

siply bcs a ubb sap.

th og Ac ds pc pais a

hi s vulabl. Ay civig a

pgsis f a ial illss is i shck ad

udsadably aks a pid f i c

s wih h ws. thy ay ac fa assupi ha h diagsis is cc, bu

wha if i is ? ogs Ac ly quis

h physicia ak a asabl dical

judg f six hs liv. A physicias

subjciv diai f lif xpcacy is

certainly not sufcient to make a life and death

dcisi, ad lc ci suicidpaic-

ulaly wh physicias a f is wg

i hi pdicis.21 Fuh, h Ac

ly quis a 48-hu waiig pid f awi qus f a lhal dicai ad h

pscipi ad a 15-day waiig pid f a

al qus. th fac ha h is qui-

ha i b h sa physicia ha civs

the request and then lls the prescription fur-

h diiishs ay pcis hs waiig

pids suppsdly ff. I h wds, a

qus f PAS ca b ad physicia

wh h fuss, bu 2 15 days la a c-

plly diff dcs f is lcad hugh h assisd suicid advcacy

gaizaica pvid h pscipi.

Claly, hs waiig pids pvid p-

ci wh s dcs a willig sp-

cializ i suicid ad ak advaag f hs

i a dpssd ad faful sa.

Encourages Physician Shopping

and Germinates Suicide Specialists

Assisd-suicid advcas pay PAS as a

psal chic b ad bw h paiad a lg-i, usd physiciaa vy

isladig picu. Hl, a og wa

diagsd wih asaic bas cac livig

i hspic, dcidd qus assisd suicid.

H w physicia fusd h qus f u-

dcud ass. A scd physicia fud

Hl b dpssd ad fusd h qus.

Hls husbad h calld h pdcss

Cpassi & Chics, Cpassi i Dy-

ig, ad civd a fal a physicia will-ig assis Hls suicid. th pscibig

physicia kw Hl f abu w wks ad

csuld ih f h h dcs bf h

pvidd h pscibd pcl sulig i

h dah. 22

Hls sy dsas hw c i

is f a pai skig PAS visi ulipl

doctors to nd one that is willing to prescribe

h lhal dug wih lil kwldg f h pa-is physical, ial, ad psychlgical

saad wih lil is i cuslig

life-enhancing alternatives. In the rst three

yas f ogs PAS xpic, ps i-

dicad ha i 59 pc f h cass pais

had ask w physicias bf -

civig a pscipi f lhal dugs.23 m

ublig, as dsad by Hls cas, a

pai f lcas a dc spcializig i

suicid hugh a assisd suicid gaiza-i such as Cpassi & Chicsfa f

a usd, lg-i faily physicia.24


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420


Permits Involuntary KillingNo Witness at

Death and Undened Self-Administration

th og Dpa f Hua Svic-

s (oDHS) adviss h Ac as allwig

ially-ill ogias d hi livs

hugh h vluay slf-adiisai flhal dicais, xpssly pscibd by a

physicia f ha pups.25 Whil h Ac

quis pai cpc ad wisss a

h i f h qus f PAS, h a

such quis a h i f adiisai

f h dug. oc h lhal dug is pscibd

h a pciv asus kw if h

suicid is caid u vluaily ad acually

slf-adiisd. th Ac islf cais

formal denition of self-administration. Rath-, i fs h pais

adiisai as a f f

igs igsig i h

cx f pcig isu-

ance policies from nullica-

i;26 ad h oDHS p-

ig quis dic h

attending physician to ll out

is iviw f wihi

days f a pais igsif lhal dicai.27

mv, slf-adiisai ds qui

ha lyh pai adiis h lhal p-

scription. Once the prescription is lled, the

Ac pvids pci f a hid pay

adiisig h lhal dicaiwih

wihu h pais xpss kwldg

cs. I addii, cai issus ais wh

h lhal dug ds acually caus dah,lavig h physicia faily bs i a

cpisd siuai f cayig u h sui-

cide wishes through other nal measures such

as suffcai.

A isd cciv hid pay ay

allw h pai h pupd igh -

scid sic will kw hw h dah

acually ccud c h pscipi is wi-

. th dah will pvk ivsigai

bcaus h acig physicia ay sig h

death certicate and will classify the death asnatural. Oregons Act signicantly fails to

recognize the real and dangerous conict of

iss ih i bh h suicid-ablig

physicia ad ihiig faily bs a h

acual i f dahffig lil p-

ci f h ially-ill.

Lack of Transparency in Reporting Requirements

ogs Ac pis lil aspacy

ad ds pai chic ad pcis il-lusy. I allws f upc-

dd liabiliy pci

f dcs assisig suicids

ad ps sccy f

h public. th og Pub-

lic Hua Divisi (oPHD)

is askd wih cllcig

ad pig ifai

su cpliac wih

h law, i d pch wlfa f hs skig

assisd suicid. Bu i pacic, i piiizs

iuiis f physicias. th Ac shilds

dcs f civil ciial liabiliy p-

fssial discipliay aci if h physicia

acs i gd faih cpliac wih h law.28

this vy subjciv sadad icluds c-

sidai f asablss pfssial

cuiy sadads as s i h aas f

h law, which is spcially ublig wh huc f lack f cpliac is h dah f

a vulabl idividual.

oPHD has faild ac pig qui-

s ffciv is chag a fc-


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Defending Life 2010

421

chais su physicias cply

wih is vsigh. As a sul, h pig

quis hav bc jus a faliy ad

provide less and less insight as to the ramica-

is f PAS, paiculaly wh sccy ss

b h bjciv. oPHD has piizdpatient-physician condentiality in relation to

PAS; and the Act specically states that the in-

fai cllcd by oPHD shall b a

public cd ad ay b ad availabl

f ispci by h public.29 n ly is h

cllcd ifai pcd, h accuacy

f wha is cllcd is i qusi du li-

ac up h dcs slf-pig (ad ly

hs pscibig lhal dugs), h ukw

ub f PAS dahs pd, h lack fwiss quis a i f dah, ad h

undened nature of self-administration within

h law.

th shcigs f ogs Ac a i-

csquial, bu a h subsqu ad al

csqucs f accpig dah as a chic i

dical a ad pwig physicias

ak h lif f hi paisvluaily a

rst, but inevitably involuntary.

Acceptance of Physician-Assisted Suicide:

The Inevitable Slide Toward Euthanasia

PAS Contradicts Suicide Prevention and In-

vites Abuse of Elderly and Disabled

Allwig assisd suicid us cplly c-

ay h pvi f suicid, ld abus,

ad disciiai agais h disabld. Fis,

i vy h cx Aica sks p-v suicid bcaus i is udsd b slf-

dsuciv ad haful h idividual ad

sciy. I is h fuh ladig caus f dah

ag hs agd 18 65 ad lvh v-

all i h Uid Sas. ov 60 pc f

hs wh ci suicid suff f sv

dpssi v hugh i is ag h s

treatable of psychiatric illnesses. The rst step

i a is cgizig h dpssi. B-

w 80 ad 90 pc f ppl wih dps-

si spd psiivly a.30 thsspss a f dpssi a p-

fudly siila f hs skig PAS; c

ad, hy wa ciu livig.

Scd, PAS is a cip f dsic ad ld

abus. th naial C eld Abus

sias w illi Aicas ag

65 ld a ijud, xplid, hwis

abusd physically, ially, psychlgi-

cally, or nancially each year by a caregiver usd idividual hy dpd f ca

pci.31 th physicias ad faily -

bs wh a ially-ill pai lks

f supp ad pci a h sa s

cuslig ha suicid ay b h bs p-

i.

thid, PAS disciias agais ad dgads

h livs f ppl wih disabiliis. I dis

people with disabilities the benet of suicidepvi ad h fc f hicid

laws.32 PAS cuags physicias ad hid

pais ak a qualiy f lif dia-

i f hs hy d b suffig liv-

ig a lif ha hy hslvs wuld wa

liv. th ass cid by hs qus-

ig PAS a suggls ppl wih disabiliis

cp wih vy day. oc assisd suicid

is accpd as a asw suffig, lss f

auy, dpdc hs, h d-casd abiliy paicipa i jy

aciviis f lif, h is hig pv

hs lif-valu judgs f pvadig

Aica culu ad ipsig hs sa

qualiy-f-lif judgs h disabld i-


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422


vluaily, ad a ay sag f lif.

Switzerland and the NetherlandsIndisput-

able Evidence

Swizlad lgalizd assisd suicid i 1918

ad has h s libal law i h wld. I ish ly juisdici ha pis sids

avl Swizlad kill hslvs.

Digias, a Swiss suicid cliic, ad is fud-

, Ludwig milli, dsa h psis

agda f advcas f dah challg ad

cicuv ay safguads i assisd suicid

lawsh bjciv f akig suicid avail-

abl all icludig h halhy bu dpssd.

Digias is culy ud ivsigai f as-

sisig a halhy, bu dpssd a cisuicid.33 I has als publicizd is ii

hlp a halhy wif ci suicid bsid h

ially-ill husbad.34 Swizlad pvids

h Uid Sas wih a vivid lss ha ii-

ially liiig assisd suicid h ially

ill is the necessary rst stepthe incremental

sp wad sciy accpig killig as a al-

aiv hua suffig

ev sikig, h nhlads claack cd sablishs ha assisd suicid

is siply h x sp wad uhaasia ad

ifaicid. PAS has b availabl i h

nhlads sic 1993.35 euhaasia is als

lgal f pais wh xplicily qus

b killd, as wll as f hs wih f

will, such as child, h svly ally

add, ad hs i psis ca. th

Netherlands was the rst nation to legalize

uhaasiafllwd by Blgiuad wpps f cy killigs a advcaig

f a igh uhaasia f ppl wihu

xplici qus. th pacic f uhaasia,

wih ad wihu qus, is w pi i

bh h nhlads ad Blgiu, ad ay

sis lik h fllwig hav sufacd:

o wa, uabl cp ay l-

g wih h illss f h husbad,

gav hi a uliau: uhaasia

adissi a h f h chical-ly ill. Faful f big lf al ad

a h cy f sags, h husbad

chs uhaasia. Dspi h fac ha

h dc was awa f h cci,

h uhaizd h a ayway.36

Af sabilizig a cac pai wh

did dsi uhaasia, a physicia

returned from the weekend to nd that

ah physicia had dd h pa-

is lif wihu h cs. thaphysicia adid h did s bcaus

sh was dyig quickly ugh

ad h dd spac f ah pa-

i.37

o physicia dd h lif f a u

wihu h cs bcaus sh was

i xcuciaig pai ad h dc

blivd h faih wuld phibi h

f askig f dah.38

A hspial dcidd adiis l-hal dss f sdaivs disabld ad

ially-ill wbs. th hspial

guidli pid uhaasia i-

fas wh h childs dical a

ad idpd dcs ag h

pai is uaabl, h is hp f

ipv, ad h pas hik i

bs. Sic h passag f h nh-

lads uhaasia bill i 1997, h Jus-

ic miisy has dcud 22 cassf wb uhaasia. Bu judicial

auhiis hav disissd all 22 cass

ad pscuis ccud v

hugh ifaicid is illgal. 39


13/34

Defending Life 2010

423

Whil hs sis s ighaish ad u-

likly happ i h Uid Sas, h ac-

cpac f PAS ad h akig f uha-

asia i og, Washig, maa, ad

acss h Uid Sas a alady fcig

u ially-ill pais i siilaly c-civ siuais.40 th slippy slp agu

is vy pi ad hs ais wh hav

g bf val h illusi f auy

ad chic wihi h assisd suicid v-

.Dah quickly bcs, ly a p-

i, bu h bs pi f h ldly, i-

ally ill, disabld, ad hs ha s d

why f lif f bih.

t cba his slid wad uhaasia, AULhas dvlpd h Assisd Suicid Ba

Ac.

Pain Management and Palliative Care

Lack f physicia kwldg ad skill i h

assss ad aag f pai is f

h s csisly cid bais ffc-

iv pai lif.41 Csid rb Wag, a

81-ya-ld usig h sid. H cidu i pai ad as wlld i his ys. thugh

h phhallgis had ly bupd rbs

lg, h cac i rbs fu had g u-

dcd, lagly bcaus his dcs ad h

usig h saff faild ic ha rb

was i pai.42 Ufualy, rb Wags

isudsd giac is a islad v.

tday, wh gd pai aag is s

ddi h usig hs, hspials, ad

hspic cs svig illis f Aicas,ay f wh di i hs placsgd pai

aag is ably lackig.

tially-ill pais padly ak pai

aag ad syp cl as a is-

su i hi cuss f a.43 Y, a 2004

sudy publishd i hJournal of the American

Medical Association pis u ha aly 25

pc f failis p hi lvd s did

civ gd ca a h d f lif, sp-

cially i aagig pai.44 I is hs bad x-pics ha ak ially-ill pais ad

hi failis csid h pssibiliy f PAS.

mv, pais a lagly ill-ifd

wh i cs h badh f pssibiliis i

d-f-lif ca.45

Addssig his pbl, s bliv h Su-

p Cu dcisis dyig a csiuial

igh PAS als cad a igh gd pallia-

iv ca.46 A v wad b plicisad discus i h dical cuiy

gadig hds f xcll d-f-lif

ca bdis his i. o h sa lvl,

the organizations exerting the most inuence

pai law ad plicy a h sa dical

bads ad h hspial accdiai agcis.

While signicant measures are underway to

shap plicy f b pai aag, sig-

nicant barriers still prevent many vulnerable

Aicas f civig adqua lif, s-pcially i d-f-lif ca. Ag h s

cid bais is h sipl uh ha dcs

ai uducad abu palliaiv ca ad

specically about the most current techniques

i pp pai aag.47 mdical schls

ad usig schls a achig palliaiv

chiqus suds, d xbks ad

lcus addss h us f pai dicais.48

As a sul, halhca pvids hi

pfssis ill-quippd aag chicpai.49

mv, isaig ad udaig pai

syps a ivial isaks wh halh-

ca css a csidd. Y h gas css


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424


f h ppuad igac ay b pais

livs. Sixy-i pc f chic pai suf-

fs wuld qus PAS if hy blivd hi

pai culd b aagd,50 ad ay wh

qus PAS wuld wihdaw ha qus

if hi dpssi ad pai w ad.51evidc supps ha wh suicid is a ac-

cpabl pi, lss gy is dvd uly

cpassia dical ca icludig pallia-

iv svics.52 Caig a sys f plicis

fcusd palliaiv ca is hf aihi-

cal a sys ha accps assisd suicid as a

a alaiv.53

Whil h dical pfssi is akig psi-

iv sps ipv is w pacics i paiaag, lgislai ca assis hs ffs

by cuagig ducai, pcig

dcs f liigai f pscibig cai

dicais f pai aag, ad fs-

ig cuicai bw dcs ad

pais abu palliaiv pis f as.

Such asus i h sas will accla h

ppula d wad cfig d-f-lif

issus wih phasis cpassi ad dig-

iy i lif hugh pai aag.

t cuag pai aag ducai,

AUL has dvlpd h Pai mdici edu-

cai Ac.

Nutrition and Hydration

I 2005, h cas f ty Schidl Schiav

brought the issue of articial nutrition and hy-

dai h aial spligh. ti suffda cadi-spiay as sulig i sv

ulgical ijuis i 1990 a h ag f 26.

Sh livd f h uil mach 2005 wih h

dlivy f h fd ad wa hugh a ub,

bu quid h lif-supp asus

susai h. Sh had civd ay habili-

aiv asus sic 1992 ad h faily was

sicd f caig f h i ay way. Sh

was ially ill ad did fac a cai

dah i h a fuu. Af a pii f

h husbad ad guadia, a cu dclad h b i a psis vgaiv sa ad -

dd h fd ad wa b wihhld. Sh

did 13 days af h xcui f h d

f dhydai. Sh was 41.54

I 1990, h Sup Cu hld ha a sa

culd chs df a hid-pays dcisi

fus dical a if h was

cla ad cvicig vidc f h pais

isuci d sh Csiui did qui h sa subsiu h wishs f

cls faily bs i h absc f xpss

pai wishs.55 ev hugh fd ad wa-

is a basic bdily cssiy f susai,

s dical pfssials, ad subsquly

sa lgislaus, w csid fd ad wa

b a f f dical a ha ay b

fusd by a pais xpss isucis. I

tis cas, h cu did ha sh was

i a psis vgaiv sa ad had adliabl al sas ha sh wuld wa

h fdig ub vd ud such cicu-

sacs.56

th issu is whh uii ad hydai

shuld b csidd a dical a ha

ca b fusd, ad if s, ud wha cicu-

sacs. th is disag v ag

lik-idd idividuals. S csid h

val f fd ad wa a ac f uhaasiaby savai ad dhydai; whil hs s

i as a dical a pissibly wihhld

wh a cai lif cdii is dd l-

g wh susaiig.


15/34

Defending Life 2010

425

ths i fav f lif a sachig f ways

pc vulabl idividuals wihi his

cx ad h bad cx f fuil ca

hy ha is apidly paig hspial ca

pcls. Fuil ca hy hlds ha a dc

ay uilaally wihhld dical abcaus h dc blivs h qualiy f lif

f h pai is whwhil is siply

cs ffciv, dspi h wishs f h pai

pais faily. this hy cadics h

chic ad pai auy agus,

bu is aki uhaasia as i jcs h hic

ha all huas a qual ad why f p-

ci ad adps wh dcs dcid

which livs a wh savig ad susaiig. 57

Alhugh s advac diciv iiiaivs

lik livig wills xacba hs issuspa-

iculaly wih h wihdawal f dical a-

s icludig fd ad wah pis

can provide some signicant protections. In

h absc f ay f f advac diciv,

s sas a caig buabl psup-

is i fav f ciuig fd ad wa ad

sicig h pws f halhca pxis

surrogates from removing articial nutritionad hydai.

Advance Directives

I dad y has bc a cssay

sa by h disabld ad hs facig p-

ially lif-haig cdiis. Chal

All shas h xpic wih udgig

sugy f a aly sag f bas cac. Sh

felt harassed by the hospital staff to ll out a liv-ig will isucig halhca pvids ud

wha cdiis sh wuld wa b susci-

ad, ad whh sh wuld wa a vila

fdig ub if i bca cssay.58 rah

ha assu a dc will d vyhig i his

pw sav ad susai yu lif, h livig

will asks a pai xpss wha ca a dc-

ay pissibly wihhld. th psis

ffs f h halhca cuiy, lawys,

ad plicyaks qui a livig will ay

b d wih gd iis, bu, i aliy, icas ad pjcs a aiud ha s livs

a wh savigv if d s ud

h guis f pai chic ad auy.

Advac dicivs a iid f a p-

s cl a cai dgfuu

halhca dcisis i h v h sh

later becomes unable to do so. The rst type

f advac diciv ipld was h liv-

ig will, which is a lgal dcu idicaigwha as ay b wihhld if a pai

faces a specied condition and is unable to

ak h dcisi. I was iducd ad

pd by ay uhaasia advcas a-

pig iiia discussi uhaasia

ad h i ha s livs a siply

wh savig.

A scd yp f advac diciv is a dua-

bl pw f ay f halhca dcisis.this lgal dcu pws a appid

ag ac h bhalf f h picipal i

akig halhca dcisis shuld h pi-

cipal b uabl ak hs dcisis. As-

suig slcs a ps wh shas h pa-

is valus lif ad lif-savig asus

ad is fidabl ugh b a ffciv ad-

vca, h ag is b abl addss fuu

halhca dcisi ha ay wi dcu

f isucis.

Advac dicivs sv a ipa pu-

ps i plaig f h fuu. Wihu a

healthcare proxy, patients will nd that many

halhca pvids ad isiuis will ak


16/34

426


ipa dcisis f h a cu ay

appi a guadia cplly ufailia wih

h pai hi wishs. th Iaial

task Fc euhaasia ad Assisd Suicid

cds a Pciv mdical Dcisi

Dcu, which as a duabl pw fattorney and specically prohibits euthanasia

ad assisd suicid.59

may sas ciu p advac di-

civs ad guidac f d suscia

orders some to the benet of patients and

hs h di. Y, a sudy publishd

by h Achivs f Ial mdici fud

ha 65 pc f physicias wuld c-

ssaily fllw a livig will if, f xapl,its instructions conicted with the doctors

w idas f h pais pgsis x-

pcd qualiy f lif.60 may sas cu-

ag advac dicivs ad s a caig

gisis p h adhc h

by h dical cuiy. As h culu f

dah bcs ad pvasiv, i

is ciical ak pciv asus agais

h udlyig psupi f wihhldig

cai dical as, iclusiv f u-ii ad hydai, ad h ppagai f

fuil ca hy.

KEY TERMS

Advance directive is a lgal dcu

xpssig a idividuals halhca

dcisi pfcs i h cicu-

sac wh h sh bcs ica-

paciad uabl ak hs d-cisis. A living will isa dclaai,

sigd ad wissd ( aizd),

isucig physicias ad halhca

pvids as wha as

wihhld wihdaw if h ps is

i a ial cdii ad uabl

ak h dcisi fus cai

dical a. A durable power

of attorney for healthcareis a dcu-

, sigd ad wissd ( a-

izd), dsigaig a ag akhalhca dcisis f h picipal

if h picipal is paily p-

aly uabl d s. A combi-

nation advance directive pvids a

agent specic instructions to follow in

halhca dcisis if h ps is

uabl s.

Assisted suicide is h ac f suicid

wih h hlp f ah pay. Phy-sician-assisted suicide (PAS) speci-

cally ivlvs h hlp f a physicia

i pfig h ac f suicid. Such

assisac usually ails h pscib-

ig dispsig f clld sub-

sacs i lhal quaiis ha has

dah.

Euthanasia ivlvs h killig f

ps by wih h physical assis-ac f ah. Voluntary euthana-

sia is h dig f lif by ah

a h pais qus. Nonvoluntary

euthanasia dscibs a physicias

dig h lif f a pai incapable

f givig fusig cs.61 In-

voluntary euthanasia dscibs h

iai f a cp pais

lif withouthis h cs.62

Futile care theory ppss ha phy-

sicias ay uilaally disgad -

quss f lif-susaiig a

ad by a pai a faily -

b if h qualiy f h pais lif


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Defending Life 2010

427

is dd wh livig. Adv-

casicludig bihiciss, -

bs f h dical acadis, ad

scial gishav dafd ad

ppsd aday a guid-

lis hw dy qusd lif-susaiig cawhich hav b

adpd ad pu i pacic by s

hspials.63

Pain is a uplasa ssy ad

ial xpic assciad wih

acual pial issu daag

dscibd i s f such da-

ag.64 Acute pain is a pay -

sult of identiable injury or disease.65Chronic pain is a sa i which pai

psiss byd h usual cus f a

acu disas halig f a ijuy,

ha ay ay b assciad wih

a acu chic pahlgic pcss

ha causs ciuus ii

pai v hs yas.66 Chic

pai ay b aligai.e., causd

by cac aliga.67

Palliative care is a appach [

dici] ha phasizs pai lif,

syp cl, ad spiiual ad

ial ca f h dyig ad hi

failis,68 ah ha cuig h u-

dlyig disas. I gally ails

h us f aalgsic dicais, such

as cdi ad phi.69 Hwv,

h pai lif chiqus, such as

physical hapy ad usugy, aals usd.70

Hospice is supp ad ca f p-

ss i h las phas f a icuabl

disas s ha hy ay liv as fully

ad cfably as pssibl.71 mdi-

ca gulais qui ha hspic

pais us hav a pgsis f lss

ha six hs if h disas us is

al cus.72 I h U.S., appx-

ialy 3,300 hspics sv abu950,000 ppl ach ya.73

Opioids asg pai dicais

divd f piu, syhsizd

bhav lik piu divaivs. ex-

apls f piids iclud phi,

cdi, xycd, had, ad

fayl.74

Palliative sedation ails adiis-aig sdaivs ially-ill, c-

scius pais whs pai ca b

hwis livd allvia suff-

ig, bu wih h ffc f iducig u-

csciusss. th phas palliaiv

sdai is pfd v ial

sdai i d ak cla h i-

f adiisig h dug is

iduc ucsciusss.75

Double effect is aadiial dci

jusifyig palliaiv sdai. th

dci hlds h quis: 1)

h aci islf (e.g., sdai) is

ally wg, 2) h scday ffc

(e.g., spiay dpssi dah)

is ly a as accplish

the intended benet (e.g., pai lif),

ad 3) ppialiy xiss bw

h idd ffcs ad h uiddscday ffcs (e.g., sablishd by

h cdii f h pai ad c-

s f h pai pxy.)76

Persistent vegetative state is a clii-


18/34

428


cal diagsis f a cdii i which

a idividual has ls cgiiv u-

lgical fuci ad awass f his

h suudigs wih cai cha-

acisics f aiaiig slp-wak

cycls, spdig siulai ionly a reexive way, and showing no

vidc f aigful sps

h vi.77

MYTHS & FACTS

Physician-Assisted Suicide and Euthanasia

Myth: Allwig assisd suicid will -

cuag h slid wad uhaasia. Saf-guads ad pcdus ca b pu i plac

su ha PAS is ly availabl f cp-

, ially-ill pais.

Fact: I addii h agic xapl f h

nhlads is h fac ha PAS is alady

availabl ially-ill pais i og

ha a duig ubaabl pai ad suf-

fig. F xapl, if PAS is accpd f

h ially-ill wihu iacabl pai, h

hs Aicas wih sv chic pai wh,ulik h ially-ill, us liv wih such

sv pai f ay yas c, wuld als

hav a lgiia clai PAS.78 thus, h is

as xpc PAS b availabl

sv chic pai suffs, h -sv

chic pai suffs, ad h hs suff-

ig f psychlgical pai disss, as i

h nhlads.79 Af xaiig h issus

suudig PAS ad vluay uhaasia, h

Biish Hus f Lds ccludd ha i wuld b pssibl scu liis is us.80 I

als ds appa ha baicadig gup

f pais f PAS whil allwig ah

gup f pais us PAS wuld pass c-

siuial us.81

Myth: PAS allws ially-ill pais a

chic ad psvs auy ad digiy.

Fact: PAS will ulialy wak h au-

y f pais a h d f lif.82 n ly

is hua digiy fud i ha a halhy

bdy ad auus lifsyl, bu h dig-iy f hua lif islf pcluds plicis ha

wuld allw i b dispsd f s asily.83

Addiially, ay PAS pais a ccd

i suicid bcaus f failial pssus ad

a dsi b a bud hi failis.84

thy f fl a d jusify hi dci-

sis say aliv.85 this is h ssc f

chic, auy, hua digiy.

Myth: t say ha h s-calld igh diall asily bcs a duy di86 is

hic.

Fact: th -paisa nw Yk Sa task

Fc Lif ad h Law issud ha sa-

af xaiig d-f-lif issus f

als 10 yas. th 25-b ask fc,

cpisd f pi physicias, uss,

lawys, acadics, ad psaivs f u-

us ligius cuiis, hld diffig

viws PAS ad uhaasia. Hwv, hgup uaiusly ccludd ha h dags

of PAS vastly exceed any possible benets.87

mv, h duy di is alady big

playd u i og, wh h sa is acivly

pig assisd suicid v dical ca.

I jus h i 2008, a las w diff-

ially-ill pais w did dical

a ud h sa halh isuac pla,

ad isad w ld ha h sa wuld payf h pais suicids.88 th ssag was

cla: W w a yu, bu w will hlp yu

di. th duy di ca b uch cla.


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Defending Life 2010

429

Pain Management and Palliative Care

Myth: th availabiliy f PAS will ihibi

h availabiliy f palliaiv ca.

Fact: Palliaiv ca acually laguishs as a

csquc f h asy availabiliy f PASad uhaasia.89 Physicias a likly ga

quss f PAS bf all avus f pallia-

iv ca hav b xpld.90 I addii,

physicias a pushd b duca

hslvs palliaiv ca, ad sachs

spd lss i lkig f b palliaiv

dicais ad chiqus.91

Myth: PAS is pfabl bcaus palliaiv

dicais sul i ubaabl sid ffcsad ay has dah ayway.

Fact: Fas abu sid ffcs ad h has-

ig f dah a ufudd.92 I fac, hs

pais wih sv pai acually bc l-

a f palliaiv dicis, iiizig sid

ffcs.93 th is als vidc ha pai

dicais has dah if such dicais

a usd ccly.94 I addii, dss ca b

increased to alleviate intensied pain as dis-

ass pgss.95

Myth: opiids ay caus addici, v i

pais xpicig sv pai.

Fact: [I] is a fac ha wh acics a p-

scibd f h lgiia pups f aig

pai, hy ssially v caus addici. I

sudis f addici wih a al ppulai f

v 24,000 pais, ly sv culd b dc-

ud as havig bc ally addicd as

a sul f civig piids f pai lif.96

Myth: opiids ps a ga isk f spia-

y dpssi ladig hasd dah, v

wh id cafully.

Fact: Wh h pai is wll-assssd ad

dsags a cafully id, h chacs

f causig a vds i a suffig pai

a xly ulikly.97 [e]piical sud-

is hav faild shw a assciai bw

icass i dss f sdaivs duig h las

hus f lif ad dcass i suvival. th-f, wh dsd apppialy liv sp-

cic symptoms, such palliative medications

d appa has dah.98 I fac, -

phi us ay plg lif by ablig a suf-

fig pai bah asily ad ffc-

ivly.99

Myth: ev a pai i sv pai ca ach

a axiu labl ds f phi.

Fact: Bcaus f dug lac ad idivid-ual spss hapy, ciligs dsag a

apppia.100

Myth: Bcaus pai is a subjciv xpi-

c, bad plicis ca ipv aag-

f idividual cass.

Fact: Whil pai is diff f ach idi-

vidual, h a bjciv ways valua a

pais suffig. By sablishig a sys

f pai aag, such as ha h JCAHosadads qui, b svics a pvidd.

objciv valuais f pai iclud: h c-

siscy f h pais cplais ad hisy

duig h valuai; h cus f h illss

as dcud i h dical cds; h x-

tent of objective ndings, if any, due to injury

or illness; ndings of physical capabilities that

cadic h pais ps f liiais;

and the presence of symptom magnication

ad saizai.101

Myth: Pai is a ufua ad uaabl

csquc f cai illsss.

Fact: m ha 90 pc f cac pai ca

b clld wih pp a102 ad ap-


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430


pxialy 95 pc f all chic pai i

h ially ill ca b likwis clld,103

cly hugh us f piids.

Myth: If a physicia pscibs adiis-

s high dss f dicai liv pai h discf i a ially ill pai,

sulig i dah, h sh will b ciially

pscud.

Fact: If h dah was idd, such a-

s a ud assisd suicid.104

Myth: I h sall pcag f cass wh

a pai ca b kp cscius whil ad-

iisig pai lif, h a lgal p-

is ad assisd suicid is cssay.Fact: Palliaiv sdai is lgal, v i sas

auhizig assisd suicid, liv i-

acabl syps.105

Nutrition and Hydration

and Advance Directives

Myth: Wh fd ad hydai is wihdaw,

h pai dis f a udlyig disas

cdii.Fact: Wh fd ad hydai a wihdaw,

h ps dis f savai ad dhydai.

I is ha hy a i h pcss f dyig,

bu a dliba dcisi is ad v

fd ad wa i d lg susai h

lif dd wh livig.

Myth: A psis vgaiv sa (PVS) is a

cai diagsis ad h ps has chac

f cvy.Fact: I is a cliical diagsis basd subjc-

iv asssss f a adig physicia.

Luis Vilj was diagsd as PVS i 1996

fllwig a accid ad h w ay

is wh his h wdd whh h

ly child wuld b b ff dad. Bu by

2005, h gaid csciusss, dsad

his gd ss f hu ad bd v-

yhig f bf his accid.106 I ay

isacs, pais will wak isaausly

without any warning within the rst month of big i a psis vgaiv sa. G-

ally, the rst year holds the best odds for pa-

is gig f PVS: Child hav 60

pc chac f cvy whil aduls hav a

50 pc chac.107

Myth: th fusal f dical a is al-

ways a h dcisi f h pai h pa-

is faily.

Fact: Fuil ca hy is bcig pval ag hspial plicis ad pc-

dus which ps uilaal dcisis by

adig physicias wihdaw wihhld

dical a if a lif is csidd u-

why f psvig agais h wishs f h

pai ad h pais faily.

Endnotes1Washington v. Glucksberg, 521 U.S. 702, 711 (1997).2 Cruzan v. Director, Mo. Dept. of Health, 497 U.S. 261, 269(1990).3SeeGlucksberg, 521 U.S. a 712.4Id. a 141.5Cruzan, 497 U.S. a 277.6Id. a 280-81.7 th Cu sad ha h lgical cllay f dci f i-

fd cs is ha h pai gally psssss h igh

cs, ha is, fus a. Id. a 270.8Id. a 284.9 521 U.S. 702.10 521 U.S. 793 (1997).11Glucksberg, 521 U.S. a 728 (ciig Cruzan, 497 U.S. a 282).12Id. a 702, 729-35.13Vacco, 521 U.S. a 800-01. See also id. a 808 (saig ha

h w acs a diff ad fig h disici as a

lgsadig ad aial disici).14Id. a 801, 807-809.15 Pub. L. n. 105-12, 111 Sa. 23-28, a 2(b).16Baxter v. State, n. ADV-2007-787 (2008).17 th iiiaiv was vd by og ciizs ad was ly


21/34

Defending Life 2010

431

awly appvd.18See Gonzales v. Oregon, 546 U.S. 243 (2006); Washington v.

Glucksberg, 521 U.S. 702 (1997); Vacco v. Quill, 521 U.S. 793

(1997).19 og Dah wih Digiy Ac, oR. Rev. stat. 127.800,

.805 (1997).20 I fac, i mach 2008 og disiguusly pd ha

pais i 2007 w ccd wih iadqua pai c-l ha i pvius yas. Hwv, if lks a h su-

ais f h pcdig yas, i 2007 h was acually a 15

pc dp f 2006 i pais xpssig a cc abu

pai cl. See, e.g., og Dpa f Hua Svics,

Summary of Oregons Death with Dignity Act2007 (2008),

availabl a hp://www.g.gv/DHS/ph/pas/dcs/ya10.

pdf (las visid Ju 11, 2009); og Dpa f Hua

Svics, Summary of Oregons Death with Dignity Act2006

(2007), availabl a hp://www.g.gv/DHS/ph/pas/dcs/

ya9.pdf (las visid Ju 11, 2009); og Dpa f

Hua Svics, Eighth Annual Report on Oregons Death

with Dignity Act 14 (2006), availabl a hp://www.g.

gv/DHS/ph/pas/dcs/ya8.pdf (las visid Ju 11, 2009); o-

g Dpa Hua Svics, Seventh Annual Report onOregons Death with Dignity Act15 (2005), availabl a hp://

gv.g.gv/DHS/ph/pas/dcs/ya7.pdf (las visid Ju

11, 2009); og Dpa f Hua Svics, Sixth Annual

Report on Oregons Death with Dignity Act14 (2004), availabl

a hp://gv.g.gv/DHS/ph/pas/dcs/ya6.pdf (las Ju

11, 2009).21 nia Shapi, Terminal Uncertainty: Washingtons new

Death With Dignity law allows doctors to help people commit

suicideonce theyve determined that the patient has only six

months to live. But what if they are wrong? seattLe weekLy, Ja

14, 2009, available atwww.salwkly.c/c/piV-

si/553991 (las visid Ju 9, 2009).22 Hb Hdi & Kahl Fly, Physician-Assisted Sui-

cide in Oregon: A Medical Perspective, 106 Mich. L. Rev. 1616

(2008).23 DHS, ogs Dah wih Digiy Ac: th yas f lgal-

izd physicia-assisd suicid, Fb. 22, 2001, tabl 3, avail-

abl a hp://gv.g.gv/DHS/ph/pas/dcs/ya3.pdf (las

visid Ju 9, 2009).24 th og bach f Cpassi & Chics ackwldgd

is ivlv i 79 pc f pd assisd-suicid dahs.

Cpassi i Dyig f og, Suay f Hasd Dahs,

Daa aachd Cpassi i Dyig f ogs IrS F

990 f 2003.25 Abu Us, og Dpa f Hua Svics available at

hp://www.g.gv/DHS/ph/pas/abu_us.shl (las visid

Ju 13, 2009).26oR. Rev. stat. 127.875.27 rpig rquis f h og Dah wih Digiy

Ac, og Dpa f Hua Svics available athp://

www.g.gv/DHS/ph/pas/as.shl (las visid Ju 13,

2009).28 oR. Rev. stat. 127.885.29oR. Rev. stat. 127.865.

30 naial Saisics, Aica Fudai f Suicid P-

vi (2006), available at hp://www.afsp.g/idx.

cf?fusaci=h.viwpag&pag_id=050FeA9F-B064-

4092-B1135C3A70De1FDA (las visid Ju 10, 2009).31 naial C eld Abus, A rsps h Abus f

Vulabl Aduls (Washig, DC 2000).32 naly all d-f-lif issusaccss cp halh ca,

adqua pai lif, i-h psal ca, p cuslig,faily supphav b issus f disabiliy ighs f d-

cads. Bif fAmici Curiae Disabiliy, al. a 3-4, Baxter v.

Montana, (n. 09-0051).33 Sv el,Dignitas Assisted Suicide Clinic in Switzerland

Probed, Killed Man With Depression, Lifnws.c, may 25,

2009, available athp://www.lifws.c/bi2858.hl(las

visid may 27, 2009).34 David Bw, Dignitas founder plans assisted suicide of

healthy woman, tiMesonLine, Ap, 3, 2009 available at

hp://www.isli.c.uk/l/ws/wld/up/ai-

cl6021947.c (las visid Ju 15, 2009).35 nw Yk Sa task Fc Lif ad h Law, Wh Dah

is Sugh: Assisd Suicid ad euhaasia i h mdical C-

x 2 (1994) [hiaf task Fc].36heRMan henDin, seDuceDBy Death: DoctoRs, Patients, anD

assisteD suiciDe 142 (1998).37Id. a 19.38Id. a 141.39 Alxada Cl, Dutch Government Sanctions Infanticide,

the BRusseLs JouRnaL, Sp 25, 2005 available athp://www.

busslsjual.c/d/297 (las visid Ju 16, 2009).40 I his bk seDuceD By Death, Hb Hdi las h

sy f Luis, wh suffd f a uad dgaiv

ulgical disd. Id. a 50-56. Dah appad ii,

ad Luis qusd ha h dc assis i h suicid. Wh

Luis had scd hughs, h h, a fid, h dc, a

p, ad a b f Cpassi i Dyig (w Cpas-

si & Chics) all acd convince h ha suicid was h

igh dcisi. Id.41 B A. rich, The Politics of Pain: Rhetoric or Reform?, 8

DePauL J. heaLth caRe L. 519, 523 (2005).42 Las Acs Pga f h rb Wd Jhs Fudai,

Means to a Better End: A Report on Dying in America Today 33

(2002), available at http://www.rwjf.org/les/publications/other/

asbd.pdf (las visid ocb 24, 2008).43 Ja e. Bdy, Facing Up to the Inevitable: In Search of a

Good Death,new yoRktiMes, Dc. 30, 2003, a F5.44 Ja m. t al.,Family Perspectives on End-of-Life Care

at the Last Place of Care, 291 JAmA 88 (2004).45 maia J. Silvia al.,Patients Knowledge of Options at the

End of Life: Ignorance in the Face of Death, 284 JAmA 2483(2000) (A aial pll cducd by h Aica mdical As-

sciai i 1997 fud ha 40% f spds did kw

i is lgal giv pai dici ha culd hav h addiial

ffc f hasig dah (dubl ffc), ad 35% w fa-

ilia wih h s hospice palliative care.) (phasis i

igial).46 mak e. Chpk,Responsible Public Policy at the End of Life ,


22/34

432


75 Det. MeRcy L. Rev. 557, 574-75 (1998).47 s. ReP.n. 106-299 (2000) (th pbl is ha d

dici is icapabl f cllig pai, bu ha ay clii-

cias a iadqualy aid i h s up--da chiqus.

I a suvy f 1,177 physicias wh had ad a al f

ha 70,000 pais wih cac i h pvius six hs, 76

pc cid lack f kwldg as a bai hi abiliy

cl pai.); Ada Ps,Negotiating the Terms of Your Death: Medical Advances Give Patients More Control Over

How and When they Die, waLL stReet JouRnaL, may 10, 2005,

a D1 ([A] ub f advacd pai as hav b

developed in recent years. And perhaps more signicantly, pal-

liative-care centers are nding success treating the dying with

dicais cssaily a f ial illsss.).48 See e.g.,s. ReP. n. 106-299,supra (Phaps h biggs

bsacl adqua pai a f pai . . . is igac:

Fw dical schls sidcy pgas qui aiig i

pain management, and many rank-and-le physicals [sic] are un-

awa f d advacs i palliaiv ca.);.49See e.g., rabw,supra, a 771 (I gal, suds ad phy-

sicias fl ill ppad pvid d-f-lif ca.) See also

Kwkkb al., supra, a 91 (I a c suvy f 352pacicig uss, 66% ad hi kwldg f d-f-lif ca

as fai p. . . .62% f clgy uss ad hi basic us-

ig schl ducai d-f-lif ca as iadqua.50 Jsph P. Psa, End-of-Life Care: Forensic Medicine v.

Palliative Medicine, 31 J.L. MeD. & ethics 365, 369 (2003).51 heRBeRt henDin, seDuceD By Death 24-25 (1997), cited in

Washington v. Glucksberg, 521 U.S. 702, 730 (1997).52 See e.g., Bif f Aicus naial Hspic ogaizai

a 18, Vacco v. Quill, 521 U.S. 793 (1997), ad Washington v.

Glucksberg, 521 U.S. 702 (1997) ([t]h accpac f assisd

suicid as a way dal wih ial illss wuld udcu

fuh ffs icas h publics awass f hspic as a

life-afrming option.); Chopko,supra, a 581-82 ([I]pv-

s [i pai lif chiqus] culd b daaically udcu

if assisd suicid w bc accpd pacic . . . .). See

also Hb Hdi, md. Di., A. Fud. Suicid Pvi,

Remarks for the Presidents Council on Bioethics (ma. 3, 2005),

availabl a hp://bihicspi.bihics.gv/ascips/

ach05/ach03full.hl (las visid oc. 24, 2008) (eu-

haasia, idd f h xcpial cas, bca a accpd

way f dalig wih sius ial illss i th nh-

lads. Palliaiv ca bca f h casualis. Hspic

care lagged behind that of other countries. Dutch deciencies

i palliaiv ca hav b aibud by Duch palliaiv ca

xps h asi alaiv f uhaasia.).53 See e.g., L. C. Kaldjia al., Internists Attitudes Towards

Terminal Sedation in End of Life Care, 30 J. MeD. ethics 499,499 (2004) (ms iiss wh supp aggssiv palliai

appa likly daw a hical li bw ial sdai

ad assisd suicid.).54 tis Sy, ti Schidl Schiav Fuai, available

at http://www.terrisght.org/pages.php?page_id=3 (last visited

Ju 11, 2009).55Cruzan, 497 U.S. a 286-87.

56 G, Gg W., Cicui Judg (2000-02-11). I : h

guadiaship f thsa mai Schiav, Icapaciad, Fil n.

90-2908GD-003. Flida Sixh Judicial Cicui. hp://absac-

appal.c/schiav/ialcd02-00.pdf. pp. 9-10 (las visid

Ju 11, 2009)57See wesLey sMith, foRceD exit euthanasia, assisteD suiciDe,

anDthe new Dutyto Die 176-191 (ecu Bks 1997).

58 Chal All, BACK OFF! IM NOT DEAD YET. I DontWant a Living Will. Why Should I? the washington Post, oc

14, 2007 B01 available athp://www.washigps.c/wp-

dy/c/aicl/2007/10/12/Ar2007101201882.hl (las

visid Ju 11, 2009).59 Advance Directives, Iaial task Fc euhaasia

ad Assisd Suicid available athp://www.iaialask-

fc.g/advdi.h (las visid Ju 11, 2009).60 rbi maaz Hig, Will We Ever Arrive at the Good Death?,

new yoRktiMes Magazine, Aug. 7, 2005 a 26.61henDin,supra, a 91 (phasis addd).62Id. a 92.63sMith,supra 57, a 177, 185.64 Fdai f Sa mdical Licsig Bads,supra, a 7.65 Wishik,supra, a 36.66 Fdai f Sa mdical Licsig Bads,supra, a 7.67 Wishik,supra, a 36.68 Hig,supra, a 26.69taskfoRce,supra, a 37.70 F a i-dph xplaai f palliaiv ca,see Ai-

cas Uid f Lif, Bif fAmicus Curiae i Supp f Pi-

is a 7-9, Gonzales v. Oregon (Sup. C. n. 04-623), avail-

abl a hp://www.aul.g/x_cli/cli_dcus/bifs/

Gzalsvog04-623.pdf (las visid oc. 24, 2008).71Center to Advance Palliative Care Manual: How to Establish

a Palliative Care Program (C. F. V Gu al., ds. 2001),

availabl a hp://64.85.16.230/duca/c/ls/hp-

codenition.html (last visited Oct. 24, 2008).72 Hig,supra, a 26.73Id.74 Las Acs Pga f h rb Wd Jhs Fudai ,

Means to a Better End: A Report on Dying in America Today 33

(2002), available at http://www.rwjf.org/les/publications/other/

asbd.pdf (las visid oc. 24, 2008).75 Bad L & Gd rubfld,Palliative Sedation in Dying

Patients: We Turn to It When Everything Else Hasnt Worked,

294 JAmA 1810, 1812 (2005).76Id.77 Kih Adws, Misdiagnosis of the vegetative state: retrospec-

tive study in a rehabilitation unit, BmJ 313: 13-16 (6 Jul 1996)

available at hp://www.bj.c/cgi/c/full/313/7048/13

(las visid Ju 11, 2009).78new yoRk state task foRce on Life anD the Law, when

Deathis sought: assisteD suiciDeanD euthanasiainthe MeDi-

caL context 5 (Supp. 1997) [hiaf task foRce suPP.].

Addd h pligh f h -ially-ill chic pai suf-

fs is h fac ha h pai f h ially-ill is acually

betteraagd ha ha f chic pai suffs. taskfoRce,

supra, a 23. A agu ca b ad ha such suffs acu-


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Defending Life 2010

433

ally hav a sg liby is i PAS ha ially-ill

pais. Yal Kaisa,The Right to Die: On Drawing (and

Erasing) Lines, 35 Duq. L. Rev. 481, 510 (1996).79See, e.g., h sy f ny Bsa i henDin,supra, a

76-83. Fw advcas f PAS agu ha h igh PAS shuld

b liid h ially-ill. taskfoRce,supra, a 74 .113.

o ppsd dl f PAS was liid hs wih icu-

abl, dbiliaig disas wh vluaily qus d hilivs. HenDin,supra, a 206. this wuld iclud pais wih

diabs ad ahiis. Id.80Report from the Select Committee on Medical Ethics, Hus f

Lds Sssi 1993-94, 238. o may 12, 2006, h Hus f

Lds agai jcd ppsd laws allw PAS.81 eic Chvl, The Limits of Prognostication, 35 Duq. L. rev.

337, 348 (1996). If auy is h guidig picipl ad h

diai f pai ad suffig is s subjciv, h ay

cp ps has h igh chs uhaasia. hen-

Din,supra, a 122. th nw Yk Sa task Fc ccludd

that it will be difcult, if not impossible, to contain the option to

such a liid gup. [n] picipld basis will xis dy

[h pais] his igh. taskfoRce suPP.,supra, a 5. th

task Fc xplais ha if h igh fus dical a

is liid h ially-ill, h PAS will b liiabl,

ih. Id. a 12-13.82taskfoRce suPP.,supra, a 18;see alsotaskfoRce,supra, a

134 (saig ha whil h auy f s pais ay b

xdd, h auy f ay hs wuld b cpisd

wih h lgalizai f PAS).83taskfoRce,supra, a 138.84See, e.g., henDin,supra, a 50-56, 61, 128-32, 142.85taskfoRce,supra, a 95. See also id. a 99 (saig ha h

s-calld igh di all asily bcs a duy di).86taskfoRce,supra, a 99.87Id. a ix, 120.88 Sv el, Oregon Tells Patients State Will Pay for As-

sisted Suicide, Not Health Care (July 30, 2008), availabl a

hp://www.lifws.c/bi2527.hl (las visid ocb 24,

2008) [hiaf el I]; Sv el, Oregon State Health

Care Plan Will Pay for Assisted Suicide, Not Treatment(Ju 23,

2008), availabl a hp://www.lifws.c/b139.hl (las

visid ocb 24, 2008). rady Sup, a pai wih psa

cac, was uisud ad dd xpsiv chhapy. See

el I,supra. H applid h og halh isuac pla

f hlp, bu was ld ha h sa wuld cv a,

bu wuld pay f a assisd suicid. Id.89henDin,supra, a 244.90taskfoRce suPP.,supra, a 4.91 th availabiliy f uhaasia appas hav cibud

h failu f palliaiv ca i h nhlads. HenDin,supra,a 15.92See, e.g., id. a 44; Kaisa,supra, a 497.93taskfoRce,supra, a162; Aica mdical Assciai,Re-

port 4 of the Council on Scientic Affairs: Aspects of Pain Man-

agement in Adults (1995), availabl a hp://www.aa-ass.g/

aa/pub/cagy/13672.hl (las visid ocb 24, 2008).94taskfoRce suPP.,supra, a 17.

95taskfoRce,supra, a 162. ev h w pc f pais -

quiig sdai ca di pacfully, wihu suffig. Aica

Giaics Sciy,supra, a III.D.; henDin,supra, a 14.96 rsay rya, Medical Practice: Palliative Care and Ter-

minal Illness, 26natL cathoLic Bioethics quaRteRLy 313, 316

(2001).97 Id. a 318. See also Bdy,supra, a F5 (Accdig eliza-

bh Fd Piak, dic f h Hspic Isiu f Hspicf h Ws rsv f Clvlad, vidc supps ha

such dugs has dah); Saah e. m. Buzz, C, The

Pain Relief Promotion Act: Congresss Misguided Interven-

tion into End-of-Life, 70 U. cin. L. Rev. 217, 242 (2001).L &

rubfld,supra, a 1815;see also L. C. Kaldjia al.,Inter-

nists Attitudes Towards Terminal Sedation in End of Life Care,

30 J. MeD. ethics 499 (2004) (Alhugh physilgical ccs

xis abu h pssibiliy ha piids ad bzdiazpis ay

has dah by suppssig spiais, h is a pauciy f

piical daa supp hs ccs. . . .ev pvca-

iv a suggsis ha sdai wad h d f lif ay ac-

ually plg lif ah ha has dah, du dapig

f icasd ablic dads causd by pai ad disss i

pais wh a fagil.).98 L & rubfld,supra, a 1815;see also L. C. Kaldjia al.,

Internists Attitudes Towards Terminal Sedation in End of Life

Care, 30 J. MeD. ethics 499 (2004) (Alhugh physilgical

ccs xis abu h pssibiliy ha piids ad bzdi-

azpis ay has dah by suppssig spiais, h is

a pauciy f piical daa supp hs ccs. . . .ev

pvcaiv a suggsis ha sdai wad h d

f lif ay acually plg lif ah ha has dah, du

dapig f icasd ablic dads causd by pai ad

disss i pais wh a fagil.).99 rya, supra, a 318.100 L & rubfld, supra, a 1815. See also rya, supra, a

317.101 Wishik,supra, a 24.102 Fuw,supra, a 29.103 Wishik,supra, a 23.104 misl,supra, a 2499. See also rya,supra, a 317.105 misl,supra, a 2499.106 Julia Sua,Back from the Dead: A cure for comas, Cpas-

sia Halhca nwk, mach 27, 2009 available athp://

www.chiaial.c/pvs_cvy.h (las visid Ju

16, 2009).107Persistent Vegetative State, Bai ad Spial Cd.og avail-

able at hp://www.baiadspialcd.g/cvy-auaic-

bai-ijuy/Vgaiv-sa-bi.hl (las visid Ju 16

2009).


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Defending Life 2010

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Every court of nal jurisdiction in the nation to consider the constitutionality of phy-

sicia-assisd suicid (PAS) has hld ha h sas is i psvig h livs f

its people justies its prohibition. Forty-one states have either an explicit or impliedphibii. th Sup Cu has ackwldgd h lgiia gv iss

i: 1) psvig lif; (2) pvig suicid; (3) avidig h ivlv f hid pa-

ties and use of arbitrary, unfair, or undue inuence; (4) protecting family members and

lvd s; (5) pcig h igiy f h dical pfssi; ad (6) avidig fuu

v wad uhaasia ad h abuss. Washington v. Glucksburg, 521 U.S.

702, 792-793 (1997).

The Oregon Death with Dignity Act exemplies how safeguards for legalized PAS

a iadqua ad big cicuvd allw suicid f h dpssd ad ivlu-

ay killig. I is ipssibl hld physicias accuabl wh pid assissuicid. th lack f aspacy i physicia slf-pig asus ad h failu f

h og Dpa f Hua Svics pig quis lav h ldly ad

disabld i dag.

th nhlads cclusivly dsas ha auhizig assisd suicid iviably

lads ivluay uhaasia. Viually vy safguad s up by h cuy has

faild pc pais. rgulai is ipssibl bcaus 60 pc f cass a

pd. 1 o sudy vald ha .08 pc f all dahs i h nhlads w a

sul f uhaasia pfd wihu a cpaus qus f h pai; i

h Uid Sas, ha wuld qual 16,000 dahs a ya f ivluay uhaasia.2

I h sudis, -fuh f physicias sad ha hy had iad h livs f

pais wihu a xplici qus.3 I ah sudy, qus f dah was ad

i v 80 pc f h cass.4

PAS is admittedly the rst step in accepting death as an alternative to sufferingin-

cludig dpssi ad al suffig. th Swiss xpic vals h abuss f

legal assisted suicide and the difculty in prosecuting violations of the law as advocates

challg h liis ad safguads. Digias, a Swiss assisd suicid faciliy, is u-

d ivsigai f assisig a halhy, dpssd a ci suicid,5 as wll as,

publicizig is ii hlp a halhy wif ci suicid wih h ially-illhusbad.6

PAS is aihical h pups ad au f h dical pfssi. th Aica

mdical Assciai, h Aica Psychiaic Assciai, h Aica Cllg f

Physicias, ad h Aica Acady f Giaics ad h Aica Pai Sciy,

ed o L Talkg Pots


26/34


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Defending Life 2010

437

A pais pai ad suffig is ihly subjciv ad ca b usd as a gaug f

wh shuld b ligibl f PAS.14 Suffig is a disicly hua, a dical, cdi-

i.15 As such, public plicis ha hig h i f pai ad suffig a uc-

aiabl.16 I addii, ay valuai f pai ad suffig wuld b lf a dcs

assss which, iically, dpls a pais auy ah ha psvs i.

I cas usig clld subsacs f assisig suicid, usig h cl

pai is a lgiia dical pups ud h fdal Clld Subsacs Ac

ad siila sa saus. th pvisi f pai dicai ad sdai is lgally,

dically, ad hically accpabl if i is idd allvia pai ad is pvidd i

accdac wih accpd dical sadads.

th pp sps pai ad suffig is aiig f halhca pfssials i h

wid us f ffciv palliaiv chiqus ad ducai pais addss uwa-

ad fas h liiai f h suff. 17

Endnotes1 Hb Hdi, Sducd by Dah: Dcs, Pais, ad Assisd Suicid 20, 136 (1998).2new yoRkstate taskfoRceon LifeanDthe Law, when Deathis sought: assisteD suiciDeanD euthanasiainthe MeDicaL con-

text 134 (1994) [hiaftaskfoRce]; henDin,supra, a 91.3henDin,supra, a 139. I 48 pc f hs cass h was qus f ay kid. Id.4Id. a 140.5 Sv el,Dignitas Assisted Suicide Clinic in Switzerland Probed, Killed Man With Depression, Lifnws.c, may 25, 2009,

available athp://www.lifws.c/bi2858.hl(las visid may 27, 2009).6 David Bw,Dignitas founder plans assisted suicide of healthy woman, tiMesonLine, Ap, 3, 2009 available athp://www.

isli.c.uk/l/ws/wld/up/aicl6021947.c (las visid Ju 15, 2009).7taskfoRce,supra, a 9, 13, 72; henDin,supra, a 34. tially-ill pais accu f ly w fu pc f all suicids.

henDin,supra, a 34 .8taskfoRce,supra, a x, 13, 26, 108, 126. ta f dpssi suld i 90 pc f pais casig hi dsi f suicid.

I sudy, vy ially-ill pai wh xpssd a wish di was suffig f aj dpssi. henDin,supra, a 240.9 Willia Biba, mD, Bay D. rsfld, PhD & Sv D. Passik, PhD,Interest in Physician-Assisted Suicide Among Ambula-

tory HIV-Infected Patients, A J Psychiay 1996; 153:238-242.10Id.11 naly all d-f-lif issusaccss cp halh ca, adqua pai lif, i-h psal ca, p cuslig, faily

supphav b issus f disabiliy ighs f dcads. Bif fAmici Curiae Disabiliy, al. a 3-4,Baxter v. Montana, (n.

09-0051).12 tihy e. Quill & Chisi K. Cassl, Pfssial ogaizais Psii Sas Physicia-Assisd Suicid: A Cas f

Sudid nualiy, annaLsof inteRnaL MeD. 138:3:208 (2003); rb A. Bu, Csiuializig Physicia-Assisd Suicid: Will

Lighig Sik thic?, 35 Duq. L. Rev. 159, 166 (1996); s als Aicas Uid f Lif, Bif f Aicus Cuia i Supp

f Piis a 6-7, Gzals v. og (Sup. C. n. 04-623), availabl a hp://www.aul.g/x_cli/cli_dcus/bifs/

Gzalsvog04-623.pdf (las visid ocb 29, 2009).

13 Aica Giaics Sciy, Bif asAmicus Curiae Ugig rvsal f h Judgs Blw a Pa I.B, Vacco v. Quill, 521 U.S.793 (1997); wesLey J. sMith, foRceD exit: the sLiPPeRy sLoPefRoM assisteD suiciDeto LegaLizeD MuRDeR207 (1997).14Id. a 132.15Id. a 22.16henDin,supra, a 192. Suffig ay ais f a ub f -dical causs, such as scial islai, fa, ad fusai

f a gal, which a bviusly uaccpabl ass allw PAS. taskfoRce,supra, a 21, 135.17 C bais palliaiv ca a h widespreadlack f aiig f physicias i palliaiv ca ad fas abu h sid f-

fcs f palliaiv ca dicais. Aicas Uid f Lif,supra, a 10-15. thus, ducai f bh physicias ad pais is


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a pp sps h pai ad suffig f h ially-ill.


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Defending Life 2010

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Laws rgadg Assstd Sucd

Thirty-ve states expressly criminalize assisted suicide:

AK, AZ, Ar, Co, Ct, De, FL, GA, IL, In, IA, KS, KY, LA, me, mD, mI,

mn, mS, mo, ne, nH, nJ, nm, nY, nD, oK, PA, rI, SC, SD, tn, tX, VA,ad WI.

Six sas phibi assisd suicid ud c law f cis judicial

ipai f hicid saus: AL, ID, mA, nC, Vt, ad WV.

tw sas appvd assisd suicid by sau: or ad WA

o sa has pdig csiuially-dclad igh di wih physicia-

assisd suicid: mt

o sa xpssly ciializs assisd suicid, bu als quis physicias

cusl pais hw ci suicid, gig s fa as qui physicias

pvid pscipis f hs pais wishig sav dhyda

dah: CA


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440


Pa Mdc educato

oly sa has add is dical schl cuiculu quis addisuci pai aag ad d-f-lif issus: CA

o sa quis aual aiig i pai cgii ad aag f usig

h saff: Ct

Fu sas fd advisy cucils Pai maag ak cdais

dical schl cuicula, ciuig ducai, ad h guidlis f pai

aag: Ar, mI, mo, ad nm

o sa passd lgislai cuagig licsig bads idividual physicias

pusu ipvig pai aag ducai ad a: ne


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2009 Stat Lgslatv Sssos rvw:End of Life

By Jssca J. Sag

Staff Counsel, Americans United for Life

i s yas, lgislaiv ad h saasus lad h d f lif a fwi ub ad d civ uch ai,

xcp wh, as i la 2008, Washig sa

vs appvd physicia-assisd suicid

(PAS) ad a maa disic cu dclad

h sas csiuial ighs idividual

pivacy ad hua digiy iclud h igh

f a pai us h assisac f h phy-sicia bai lhal dicai ad ci

suicid.

Jus as i 2005 wh h ti Schidl-Schi-

av cas cadd h publics ai

wh a cu dd h fdig ad hyda-

i ub vd, h c dah f Lida

Fleming, the rst woman to commit suicide

ud h w PAS law i Washig, dw

siila ai ad uch sw f p-lif advcas. Ufualy, vicis i

Washig ad maa hav gizd h

p-uhaasia v ad bldd i

iduc PAS lgislai ad h d-f-

lif lad lgislai acss h cuy.

I 2009, appxialy 140 asus lad

d-f-lif issus w csidd i 44

statesa signicant increase in activity from

lvls s i 2008. this daaic u-f-vs dads a aigful public dba

about PAS and euthanasia, the afrmative act

f vig fd ad hydai f vul-

abl pais, h scp ad ffcivss f

advac dicivs f halh ca ad siila

lgal dcus, ad palliaiv ca ad pai

aag pis.

Assisted Suicide and Euthanasia

naly a qua f sas dal wih PAS iiia-

ivs i h las w lgislaiv yas. I 2009,

akig us f ils such asDeath with Digni-

ty, Compassionate Choices, Right to Die, adPatient ControlChoice, a las igh sas

icludig Ccicu, Hawaii, massachuss,

maa, nw Hapshi, nw mxic, ad

V csidd asus lgaliz (,

i h cas f maa, gula) PAS.

Ipaly, uhaasia ad PAS advcas

hav a aggssiv agda s PAS lgal-

izd i all 50 sas. Dfa ds d

h; ah, i causs h -sagizabu hw gai accpac f PAS ad

h -aack. Duig h 2009 sa lgisla-

iv sssis, hy did s by pusuig asus

ha advac hi idlgy, icludig lbby-

ig sa dical bads pass sluis

pvid psii sas f ualiy

or afrmation for PAS, as well as promoting

advac dicivs f idividuals xplicily

fus lif-savig dical as ad sus-

ac ds if hy bc icapaciad.I his vi, maylad acd a asu add-

ig a usig h idusy psaiv

is Sa Advisy Cucil Qualiy Ca a

ed f Lif.


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442


Cvsly, Wyig csidd a asu

ciializ assisd suicid.

Advance Directives, Living Wills,

Healthcare Powers of Attorney,

and Related Documents

th vas ajiy f d-f-lif asus c-

sidd i 2009 dal, i vayig ways, wih

advac dicivs, d suscia (Dnr)

ds, lif-susaiig as, ad h

pp appi f guadias ad halh-

ca ags. I 2009, 12 sas acd w

visd cu laws dalig wih advac

dicivs.

Aiza acd w asus ad x-

isting statutes: First, to prohibit a duciary or

us whs lics has b vkd f

svig as a ag ud a halhca pw

f ay ulss h p-

s is lad h pici-

pal; ad scd, qui

h cu giv appid

guadias auhiy wih-

hld wihdaw lif-sus-aiig a, icludig

articial food and uids.

th scd asu fuh

cad a buabl psupi i fav f

food and uids if no advance directive exists,

and provided clarication for the process and

sadad f viw bu ha psupi.

Akasas acd w asus visig sa-

us lii h pw f h Sa Dpaf Hua Svics as cusdia f wih-

hldig lif-susaiig a wihu x-

pss cu appval; ad claify Dnr p-

cdus f usig faciliy plys.

Luisiaa passd sluis f w sudis.

The rst study requests the State Department

f Halh ad Hspials sudy h us f liv-

ig wills ag mdicaid cipis, whil h

scd cas a sudy ci lk a

physicia ds f lif-susaiig ca.

Maine enacted two measures, with the rst de-

vlpig w ducai pgas abu d-

f-lif dicivs f h public ad h lgal

cuiy ad h scd caig Uif

Pw f Ay Ac laig duabl

halhca pws f ay.

misa add applicabl saus p-

i h las f dical cds halhcaags.

maa visd is guadiaship law p-

hibi a guadia f givig a Dnr d if i

conicts with an incapaci-

ad pss wishs.

Bh nh Daka ad

oklaha acd a-

sus caig gisisf advac dicivs f

halhca.

og add is laws f advac dic-

ivs, givig h halhca psaiv h

auhiy appv sh- hspializai

f dia pais.

txas add is Halh ad Safy Cd

allw f lcic sigaus advac di-civs ad pi aizai f Dnr -

ds (as a alaiv w wisss).

Uah add is Advac Halh Ca Di-

civ Ac xpad h lis f halhca


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Defending Life 2010

443

pfssials auhizd di a pa-

is dcisi-akig capaciy ad ffcua

a pais halhca diciv.

Fially, Vigiia acd asus caig a

Uif Pw f Ay Ac, claifyigh pcss f diig whh a pai

lacks dcisi-akig capaciy, ad spcify-

ig hw a pais Dnr ds ay b ffc-

ivly vkd.

Preventing Starvation and Dehydration

A las igh sasicludig Aiza, A-

kasas, mississippi, maa, nw Yk,

ohi, og, ad txascsidd a-sus lad lif-susaiig as, i-

cluding articial food and hydration.

Aiza cad a buabl psupi i

favor of the continued provision of articial

food and uids in the absence of an advance

diciv.

Akasas add is Adul mala

Cusdy Ac lii h Sa Dpaf Hua Svics wh fuciig as a pa-

is lgal cusdia f akig ay dci-

si wihhld lif-susaiig a wih-

u xpss cu appval.

maa visd is guadiaship law p-

hibi a guadia f wihhldig wihdaw-

ing life-sustaining treatment if it conicts with

icapaciad pss wishs.

Pain Management

A las 10 sasicludig Califia,

Ccicu, Flida, Hawaii, Kasas, mas-

sachuss, mississippi, txas, V, ad

Ws Vigiiacsidd asus lad

pp pai aag. S asus

cuagd aiig i ad awass f pai

aag, pvidd pci f physi-

cias plyig accpd pai aag

chiqus, acd a pais bill f ighs,whil hs sugh gula pai aag-

cliics ad h clld subsacs usd

a pai.

Califia sablishd Spb 2009 as

Pai Awass mh if halhca

pvids f h d f ffciv pai

aag.

Ccicu acd a asu quiig di-c-ca usig h saff cpl au-

al aiig i pai cgii ad h adiis-

ai f pai aag chiqus.

Flida acd h Pscipi Dug mi-

ig Pga i us f clld

subsacs i a lcic daabas sys.

txas acd a asu ca licsig

ad gulai f pai aag cliics.

Ws Vigiia ad i chags is ma-

agement of Pain Act, specically amending

its denitions of pain and pain-relieving

clld subsacs.

Palliative Care

A las fu sasicludig Clad, Il-

liis, nw Yk, ad Vcsiddlgislai cuag aiig i ad fud-

ing of palliative care. Illinois specically con-

sidd pdiaic palliaiv ca; whil nw

Yk sugh qui halhca paciis

pvid palliaiv ca ifai ad


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444

cusl pais diagsd wih a ial ill-

ss cdii hi pis.

Clad passd a slui f a Hspic

Palliaiv Ca Ii sudy.

V acd a Pais Bill f righs f

Palliaiv Ca ad Pai maag -

su halhca pvids if pais f all

hi a pis.