The debate on euthanasia is certainly a charged one. Who can forget the tension of the Terri Schiavo case, so well publicized in the late 1990s and early 2000s? That very public battle over the fate of a single woman who would certainly never achieve a quality of life most would consider worth living was something that many Americans experienced in a far-too-personal way. In the end, her husband, Michael, was granted the legal right to remove her feeding tube, despite the objections of her parents. They were very much opposed to any such assisted death, although, to be honest, some would have said her state of being at that point was much more along the lines of “assisted living”- and in this case we’re not talking about group homes where you can play Mah Jong until 10pm and call it a night. No, in this case, we are talking about when, in fact, does someone, or the loved one responsible for it, have the right to say no more, this isn’t what I want or what that person would have wanted.
Luckily for some, the Schiavo case led to a much greater public awareness of what people need to do to ensure that their wishes are respected should they become brain dead, enter into a coma from which they cannot recover, etc. After the incident, many people immediately made living wills, in essence, a will which dictates the kind of treatment you would wish for were you to be unconscious, unrecoverable, and faced with a state where you would never, in all medical likeliness, be able to return to a state in which you would be not even just a baseline functioning member of society, rather a vegetable for the rest of your natural life. Most would agree that such a situation not only takes away any quality of life the victim might have, but also creates an unfair burden on close family members. If there is no hope whatsoever, they need to be allowed the freedom to move on, not solely because it increases their productivity over time, but also because it affords them the freedom to deal with the matter and then move on, as they need to to continue their lives.
This study will examine the role that assisted suicide, or euthanasia, plays currently in United States politics. We will look at the prevailing opinions on it, upon legal decisions made based upon it, and upon how it impacts policy. It is unquestionably a very controversial topic, and one which has a heavy impact upon politics in the United States. No one likes to lose a loved one; but sometimes, as hard as it is, we know when it reaches the point where they themselves would no longer like to live the life that could be expected after causes such as serious brain damage, prolonged coma, or even incurable degenerative diseases. Thankfully, many people now do have living wills that cover much of this. Still, there remains much gray area policy-wise and legally. We will proceed to examine this, particularly on the basis of Supreme Court decisions that have dealt with the matter. In any event, it would seem that this is a particularly private decision on the whole. I would suggest that, in the absence of a living will, the decision be left up to the family, as it is they who are presumably the closest to the person in question, who are the ones charged with the legal responsibility, and who likely have the most emotionally invested in the decision (one would hope).
Where do you draw the line? What constitutes assisted suicide vs. natural death? Is a brain dead patient who is taken off oxygen and IV being assisted in death even though they would continue to live if these were provided? What was Terri Schiavo's status the decade and more she spend subsisting only on a feeding tube without significant brain activity? Both of these actions are now standard medical practice, as long as the family allows it.
Where things get very complicated is when a patient is conscious but is dying from something which is incurable. If they are suffering horribly, can they get relief from physician injected drugs which, while they will cure them, will also aleve the suffering and let them die in peace? In all eligible cases, their condition would ultimately cause them to die anyway, many of them suffering greatly in the process.
B. History and Scope of the Issue:
Euthanasia, while discussed prior to World War II, really only came into the center of American politics in recent decades. The Karen Ann Quinlan case, in which the New Jersey Supreme Court ruled in 1976 that a young woman in a persistent vegetative state be allowed to be taken off a ventilator. The court found that:
This case is not to be considered euthanasia in any way; that would never be licit.
The interruption of attempts at resuscitation, even when it causes the arrest of
circulation, is not more than an indirect cause of the cessation of life, and we must
apply in this case the principle of double effect.' (New Jersey Supreme Court, 1976).
The Nancy Cruzon case, In 1989 and 1990, was another important case involving the “right to die”. In this case, the court found that the family needed to provide sufficient evidence that the patient, who could not decide for herself due again to a persistent vegetative state, would have wanted.
In Washington v. Glucksberg, the United States Supreme court found that the right to die was not protected as part of the 14th amendment. They also relied heavily into the history of common law to support this decision, arguing that common law, the basis of the American legal system, has traditionally frowned upon assisted suicide.
The Terri Schiavo case, a long and drawn-out battle involving several court cases on many levels and congressional and presidential intervention, resulted in a major political and legal battle. The decision to remove Shiavo’s feeding tube was upheld several times in court, despite massive political involvement, particularly from the right. This case brought the issue of right-to-die into the living rooms of most Americans due to the massive media coverage surrounding the event. Legally, though, it differed from the other cases by being a clarification of the details right-to-die (in essence, it was a struggle over guardianship between her husband and her parents) rather than breaking new ground on the issue. Its primary significance was the media coverage it received and the polarization of opinion on the matter.
All of these cases lay the foundation for assisted suicide, which involves direct intervention from a doctor rather than merely removing life-sustaining equipment.
The famous case of Dr. Kevorkian, who assisted in the suicides of 130 terminally ill patients in the 1990s, was another highly-publicized case. He was convicted of second degree murder in 1999. One main criticism of Kevorkian’s actions was that it was argued that many of the patients were not, in fact, terminally ill. Kevorkian, in turn, argued that the three U.S. states where it is legal, Oregon, Montana, and Washington, did not go far enough and that patients did not need to be terminal to qualify for assisted suicide as long as they were suffering. This is a very unconventional, not to mention unpopular, stance on the topic, and in general public opinion, it is held that Kevorkian’s views on the matter go a bit too far.
The Oregon Death with Dignity act, passed in 1994, was the first true law allowing assisted suicide in the United States. It does so under a strict framework of conditions to ensure that the patient is terminally ill and is choosing assisted suicide of their own volition. It allows patients whose death is already inevitable the right to a comfortable death at the time of their choice rather than a long and drawn-out battle ending up in a death which likely would cause them greater and unnecessary suffering. Washington state and Montana have also enacted similar laws.
C. Perspectives and Analysis of Policy
The topic of assisted suicide is certainly one of the most politically polarizing of recent years. The extreme right, particularly the religious right and the right-to-life movement, is strongly opposed. The extreme left tends to be open to it, but they do not generally react to the topic with the same fervor expressed by those against it. Curiously, much of public opinion on the matter appears to revolve around how the matter is phrased- a 2005 gallup poll found that 75% of Americans supported euthanasia, but only 58% supported doctor-assisted suicide. Since the two are basically the same thing, it is important that language be used carefully when dealing with the topic. In any event, both of these polls showed support of well over 50%, demonstrating that public opinion is very much in favor of allowing assisted suicide in terminal cases. These numbers have likely increased since 2005, but that is also hard to judge, as the 2005 numbers could easily have been influenced by the Schiavo case, which was highly publicised at that time.
D. Impact of Policy and Analysis
As medical care improves, more and more Americans are faced with the decision to have to end a loved one’s life by removing life support equipment. This means that more and more people have faced the decision of whether a loved one would want to live in a vegetative state or to confront a life of ever-decreasing quality on a day-to-day basis. This means that more and more people can genuinely empathize with the terminally ill who are still in a position to make the decision for themselves, and public opinion on the right to die is likely increasing annually.
The policy seems successful and popular in the states of Oregon, Washington, and Montana, where it has been in place for several years. It is also an option available abroad, notably in Switzerland, where commercial companies advertise the service. While support of this policy may incur the wrath of the extreme right, including the Tea Party Movement, this should not be a deterrent, as it would be difficult if not impossible to gain their trust, or indeed avoid their outright hatred, given our stance on other issues. It is also only fair to note that the number of people actually affected by the program is small; in Oregon, only 595 people had died due to prescriptions written under the act through 2011. The number of people who would actually qualify is also low. The issue, for most Americans, is more of an issue of having the right to do it if ever put in the unlikely position where one would be faced with such a choice at all rather than an issue which affects them or family members currently.
E. Judgement
It is my opinion that supporting assisted suicide, if directly confronted with the issue, is important. It is gaining in acceptance among the American people, and the programs already in place in Oregon, Washington and Montana, while strict and small-scale, have met with great success. Death is a very personal issue, one which affects us all, and when facing a terminal end, it is important that people be allowed the dignity they deserve when facing it. The strides made over the years by the right-to-die movement, starting with resistance to removing feeding tubes and going to what is now a rather common practice in cases of extreme brain injury and unresponsiveness, are a blueprint for the next phase, assisted suicide. While it may not be an issue we want to bring up on our own and is certainly one which must be handled with care, it is my opinion that, if the campaign is confronted directly with the issue, it is important that we give it our full support.
References:
Moore, David W. (2005). “Three in Four Americans Supports Euthanasia”. Gallup.
Retrieved from http://www.gallup.com/poll/16333/three-four-americans-support-euthanasia.aspx.
“Terri Schiavo Case Resources”. University of Miami Ethics Program. Retrieved from
http://www.miami.edu/index.php/ethics/projects/schiavo/ on 2/17/2012.
Oregon Public Health Division (2011). “Oregon’s Death with Dignity Act- 2011”.
Retrieved from http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year14.pdf on 2/17/2013.
Pickert, Kate (2009). “A Brief History of Assisted Suicide”. Time Magazine. Retrieved
Gupta, Sanjay 2010. “Kevorkian: I Have No Regrets.” CNN Health. Retrieved from
http://www.cnn.com/2010/HEALTH/06/14/kevorkian.gupta/index.html on 2/17/2013.
