Assisted-Suicide Issue Moves to the Next Level

Last June, as it unanimously rejected arguments that the Constitution embodies a right to assistance in dying, the U.S. Supreme Court acknowledged that the “earnest and profound debate” over the “morality, legality and practicality” of the practice would continue. “The states are currently engaged in serious, thoughtful examinations of physician-assisted suicide and other issues,” Chief Justice William H. Rehnquist wrote in that case. “Our holding permits this debate to continue, as it should in a democratic society.”

Tuesday the court decided, in effect, that Oregonians will be the ones to move that debate to the next level. Without comment, the court cleared the way for Oregon’s 3-year-old law allowing physician-assisted suicide, the only such law in the country, to take effect. The justices turned down an appeal that had kept the law tied up in federal court.

In 1994, the people of Oregon passed the Death With Dignity Act by a 51% vote. The law permits patients to ask a doctor to prescribe a lethal medication. In other states, a physician who gives a patient drugs for the purpose of ending his or her life faces criminal charges.

Earlier this year, the Oregon Legislature decided to take the question to the voters a second time. Oregonians, who can vote by mail, began balloting Wednesday; voting concludes Nov. 4. As a practical matter, then, the Oregon law will take effect if voters approve it again. If that happens, as expected, other states are likely to follow Oregon’s lead.

The agonizing ethical and moral dilemmas that arise with the issue of assisted suicide are at base not ones that courts are well-equipped to solve. The fine points of case law and constitutional interpretation will never provide satisfactory answers to dying patients wrestling with long-shot therapies or racked with unrelenting pain.

Courts can ultimately do little more than set broad guidelines for states to follow. The Oregon law includes safeguards to prevent abuse by doctors and hospitals that might be pressured by relatives, insurance companies or their own financial concerns. Patients must be competent and terminally ill. They must consult with two doctors and then wait 15 days before obtaining assistance to carry out their wish to die. But the application of those guidelines, in this domain as in others, will be left to doctors, hospitals and other very human institutions.