"Medical aid in dying" cannot be compared to option of refusing care at end of life, panel says.
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There is no constitutional right to physician-assisted suicide, Massachussetts’ highest court ruled this week.
The Supreme Judicial Court of Massachusetts on Monday rejected a challenge to the state’s ban on the practice, saying there is no right to it in the state’s constitution.
“Although we recognize the paramount importance and profound significance of all end-of-life decisions, after careful consideration, we conclude that the Massachusetts Declaration of Rights does not reach so far as to protect physician-assisted suicide,” said its published opinion, written by Justice Frank Gaziano and signed by all seven members of the court. “We conclude as well that the law of manslaughter may prohibit physician-assisted suicide, and does so, without offending constitutional protections.”
The court, however, acknowledged that the legislative process might eventually legalize the practice in the Bay State.
“These questions are best left to the democratic process, where their resolution can be informed by robust public debate and thoughtful research by experts in the field,” it said.
The case concerned Dr. Roger Kligler, 70, who was diagnosed several years ago with prostate cancer and sought “medical aid in dying,” and Dr. Alan Schoenberg, who was willing to prescribe lethal drugs for Kligler to take his own life. Kligler claimed to be terminally ill when the case began in 2016, but is still alive today.
Another plaintiff was Alan Steinbach, a physician who wanted to be able to prescribe lethal drugs to terminal patients who request them without fear of being prosecuted for involuntary manslaughter.
Kligler and Schoenberg argued that doctors cannot be prosecuted for prescribing lethal drugs for assisted suicide to a competent terminally ill person under the Massachusetts state constitution.
“Our case law demonstrates that knowingly providing someone who has expressed an interest in ending his or her life with the means to do so may be considered wanton or reckless behavior,” the high court said. “That a doctor’s intent in providing the lethal medication was to alleviate a patient’s suffering is irrelevant, as conduct may be wanton or reckless even where the actor ‘meant no harm to the victim.’ … (motive is irrelevant to crime of manslaughter).”
As to whether the Massachusetts Constitution could be interpreted to include a right to assisted suicide, the Supreme Court of Massachusetts said that the history of suicide in general and physician-assisted suicide in particular “provides no support for the conclusion that physician-assisted suicide is an individual right protected by the Massachusetts Declaration of Rights.”
Passive vs. active
Steinbach argued that the right to assisted suicide is a natural outgrowth to the right to refuse medical treatment. The court did not agree, saying there’s “an important distinction between the refusal of medical treatment and physician-assisted suicide, which lies in fundamental legal principles of cause and effect; whereas withdrawing or withholding medical care is not the primary cause of a patient’s death, physician-assisted suicide is.”
In medical ethics, “the right of competent, informed patients to refuse life-prolonging interventions … is firmly established,” whereas the right to physician-assisted suicide is a matter of “ethical … controversy.”
The court cited the American Medical Association, which says that although physicians should “honor patients’ informed decisions to refuse life-sustaining treatment,” physician-assisted suicide “is fundamentally incompatible with the physician’s role as healer.”
Though the court’s opinion does not cite Church teaching, Catholic bioethics recognizes the right of patients to forego extraordinary medical treatment if it is overly burdensome and promises little improvement or extension of life. It recognizes, on the other hand, that euthanasia and assisted suicide, which are active means to end life, are radically different from the passive acceptance of the inevitable.