Right to Die

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The term right to die refers to the issue of whether a person who has a terminal illness, or who is facing a lingering death, should be permitted to end his life on his own terms. Someone’s “right to die” sums up all of the decisions involved in such a complex issue. Examples of right to die decisions include whether or not the person should live on life support, and whether or not the person should go on living if his life is going to be of a diminished quality.

Someone who is suffering from a terminal illness may wish to commit suicide; to be able to choose the time and method of death, rather than enduring prolonged suffering before finally meeting the same end. To explore this concept, consider the following right to die definition.

Definition of Right to Die

Noun

  1. A person’s right to refuse life-prolonging medical treatment in the face of terminal illness;
  2. The right of a family to allow their loved one to die, by terminating life support measures in an irreversible coma.

Origin

1975-1980    Americanism

What is Right to Die

Someone’s “right to die” is self-explanatory, in that the term refers to all of the decisions that go into whether or not someone should be permitted to die before natural causes ultimately end his life. Examples of right to die situations include those involving patients suffering from cancer or some other long-term illness where the suffering gradually increases until the person finally dies.

In these situations, the person may opt for suicide so that he can decide when he dies and how without the need for immense suffering before ultimately reaching the same end. Suicide, in these cases, does not always involve a self-inflicted gunshot wound, or jumping off of a bridge. All it may take is the withdrawal of feeding tubes or other artificial means of keeping the body alive. If the body cannot survive on its own, the person will die, though sometimes it may take a little time.

Another example of a right to die situation may occur when a person is stuck in a long-term coma with no serious possibility of his ever regaining consciousness. In such cases, the family may wish to make the decision to end his life prematurely since he is unable to make the decision himself.

The idea of having a “right to die” is equivalent to the idea of “dying with dignity.” Anyone can make such a decision before he is actually in the situation, by listing his preferences in a Living Will, or a Do Not Resuscitate (“DNR”) order. These are especially helpful in the case of the long-term coma patient.

Usually, those patients who have exercised their “right to die” will explicitly state that they do want to continue receiving pain medication to alleviate their symptoms, but that they do not want the underlying cause of their pain to be treated. This is known as “palliative care,” and the patient may include such a provision in his Living Will or DNR, so as to prevent treatments like chemotherapy from prolonging their lives when there is no hope that such an extension of life will be of good quality.

Right to Die Methods

The phrase “right to die” can refer to a number of different ways to die, including suicide, passive euthanasia, active euthanasia, and assisted suicide.

  • Suicide – Suicide is defined as the taking of one’s own life. There are innumerable ways in which a person can end his own life, such as by ingesting poison, overdosing on drugs or medications, shooting or cutting himself, jumping off of a building, or hanging himself.
  • Passive Euthanasia – Passive euthanasia is the election to refuse life-sustaining treatment, by signing a DNR form, or Living Will. This is the practice of allowing a person to die not doing what is necessary to keep him alive. Passive euthanasia also occurs when medical professionals cease doing what they were doing previously in an effort to keep the patient alive, such as CPR, or disconnecting a respirator.
  • Active Euthanasia – Active euthanasia is defined as an action by a suffering patient’s doctor to proactively end the patient’s life. Typically, active euthanasia in a human is much the same as euthanizing an animal. Here, the patient is given with a lethal injection of medications that ends his life without further suffering. In this situation, it is the doctor who administers the medication, ending the person’s life.
  • Assisted Suicide – Assisted suicide is defined as a patient committing suicide by ingesting a lethal dosage of medications, as prescribed to him by his doctor for this purpose. Also known as “physician-assisted suicide,” this is illegal in most states.

Right to Die Laws

While every U.S. state has recognized a person’s right to die by choosing to refuse treatment, or to discontinue treatment at any point, the issue of helping someone to die has been a hotly debated topic for decades. Because of this, right to die laws vary greatly, depending on the part of the world in which the patient lives. Active euthanasia is banned country-wide in the U.S., but assisted suicide is legal in some states.

According to Washington law, affirmed by the Supreme Court in 1997, anyone found guilty of practicing assisted suicide may be charged with a felony, carrying a maximum punishment of five years’ imprisonment and a $10,000 fine.

Right to Die Requirements

In states that allow assisted suicide, the law spells out a rigid set of instructions that must be followed. In order for a physician to help someone end his life “in a peaceful, humane, and dignified manner,” The patient must meet a set of strict right to die requirements.

Right to die requirements that will entitle a patient to receive a prescription for lethal medications generally include:

  • The patient must be a resident of a right to die state; and
  • The patient must be 18 years of age or older; and
  • The patient must be mentally capable of making and communicating healthcare decisions; and
  • The patient must have been diagnosed with a terminal illness that will, in a medical expert’s opinion, ultimately result in death within six months; and
  • The patient must be able to both self-administer and ingest the medication that is prescribed to him or her.

There are no exceptions to these right to die requirements. Simply being elderly, or suffering with a disability, is not enough to qualify someone for a right to die prescription. Additionally, in most states, a minimum of two qualified physicians must review the patient’s case to ensure that each and every one of the legal criteria has been sufficiently met.

Should a patient be denied physician-assisted suicide, or if a patient does not live in a right to die state, and is not physically well enough to travel to one, the following suggestions are offered as alternatives to ending one’s life:

  • Ending a current course of treatment, or opting out of a new life-prolonging treatment
  • Palliative sedation (i.e. the use of medications to essentially put the patient into a coma so as to not have to deal with the pain)
  • Voluntary discontinuation of eating and drinking (or sustenance through a feeding tube or IV)

Right to Die States

The laws in right to die states require a certain protocol be followed by those engaging in physician-assisted suicide. All right to die states allow terminally ill patients to receive prescriptions for lethal medications from their doctors. They can then make the personal decision, with their families, about when to take those medications.

As of 2016, only five states in the U.S. have passed “right to die,” or assisted suicide, laws: California, New Mexico, Oregon, Vermont, and Washington. Assisted suicide is also legal in only one county in New Mexico. In 2009, the Montana Supreme Court ruled that there is no state law prohibiting physicians from facilitating suicide. In fact, it held that physicians in that state are legally protected if they provide a prescription for lethal medication at a patient’s request.

In 2014, a New Mexico district court judge ruled that terminally ill patients are protected under the state’s constitution insofar as having the right to request their doctor’s help dying. As of 2016, this would make it legal in New Mexico for a doctor to prescribe lethal doses of medication to a terminally ill patient, though the issue is on hold while the state’s Attorney General’s office appeals.

In 2015, California’s governor signed a controversial bill supporting assisted suicide, effectively turning California into a right to die state. Interestingly, the bill had been defeated during the normal legislative session and only passed because it was attached to a special legislative session that was established to address funding for California’s Medi-Cal program. Because the bill was passed during a special session, it did not take effect until three months after the session had ended. Therefore, physician-assisted suicide became affective in California in June of 2016.

Right to Die Example in Assisted Suicide Legislation

In 1997, Dr. Harold Glucksberg, and a group of other doctors, three terminally ill patients, and a nonprofit organization that provided counseling to individuals who were contemplating their right to die, filed a civil lawsuit against the state of Washington. In the lawsuit, the plaintiffs challenged the state’s ban on physician-assisted suicide.

The state of Washington had, in the past, been known for banning patients “right to die” by criminalizing the act of a physician’s “knowingly causing or aiding” their patients in committing suicide. Glucksberg’s claim was that this ban that Washington had implemented was unconstitutional.

The question here became whether or not Washington’s ban violated the Fourteenth Amendment’s Due Process Clause by denying terminally ill patients – who were of sound mind and could make the decision themselves – the right to choose an easier death in the face of terminal illness and great suffering.

The Supreme Court’s answer to that question made it clear that the right to die is not one of the freedoms protected by the Due Process Clause. Further, the Court held that the practice is considered to be nationally “offensive,” that the state’s ban was rational, and that it served the state’s legitimate interest in protecting the medical ethics. The Court also expressed its opinion that Washington was committed to protecting disabled and terminally ill patients from being encouraged to commit suicide, and that the “preservation of human life” should be held sacred.

Related Legal Terms and Issues

  • Do Not Resuscitate Order (or DNR Order) – A legal order, written by a physician, that no attempt at resuscitation – that is cardiopulmonary resuscitation (CPR) and/or advanced cardiac life support (ACLS) – be performed should the patient stop breathing, or should his heart stop beating.
  • Living Will – A document in which a person gives explicit instructions about medical treatment to be administered or withheld if he or she becomes terminally ill or permanently incompetent.