Death with Dignity Laws May Spread in 2013

Dr. Jack Kevorkian speaking

Dr. Jack Kevorkian, well-known supporter of aid in dying laws

As many as six states this year could advance death with dignity laws that would allow individuals to take their own lives with the help of doctor-prescribed medication.

Currently, only Oregon and Washington have statutes allowing physicians to aid people with dying, while Montana allows the practice through court precedent.

Varying polls show majority support for death with dignity laws. Last year 84 percent of Americans polled agreed that “How a terminally ill person chooses to end his/her life should be an individual decision and not a government decision.” And a recent New Jersey poll found 63 percent of respondents in favor of legally allowing terminally ill people to take their own lives.

In a pair of cases, Washington v. Glucksberg and Vacco v. Quill, the U.S. Supreme Court ruled in 1997 that individuals have no constitutional right to assisted suicide, leaving the matter up to the states to decide.

Oregon was the first, legalizing physician-assisted suicide via popular ballot in 1994. Washington followed suit in 2008. Montana doesn’t have an aid in dying law per se but does allow doctors to offer an affirmative defense of consent in court if they get charged, thanks to a 2009 state Supreme Court decision. The state legislature in 2011 and again this year tried to pass a bill that would send doctors to prison for 10 years for assisting patients who want to end their lives, but the measure was recently defeated for the second time. A number of other states do have laws that specifically prohibit doctors aiding patients in dying.

Another state, Hawaii, doesn’t have an aid in dying law one way or another but allows doctors to assist terminally ill patients with death as a matter of policy.

“There has not yet been a state that has enacted a statutory permission through the traditional legislative process,” notes Kathryn L. Tucker, legal affairs director for advocacy group Compassion & Choices. “It may happen in Vermont in the next couple weeks.”


Death with Dignity

Kathryn L. Tucker

More states are likely to have death with dignity laws soon. Massachusetts placed the issue before its voters in November, but they rejected it by a 51 to 49 tally. The state is considering trying again this year, and as many as five other states could also enact measures to legalize it. The New Jersey Assembly Health & Human Services Committee has already approved a death with dignity bill, and the Vermont Senate has also passed a similar bill, which awaits house action. Connecticut, Kansas and Hawaii are also considering similar laws.

Under any set of statutes, patients must be the ones who take the deadly dose themselves — doctors can only prescribe and supervise.  Dr. Jack Kevorkian famously assisted over 40 people end their lives in Michigan. Because the state had no law specifically against the practice at the time, murder charges against him were initially dropped until he showed a video of him administering a lethal injection to a patient himself. Kevorkian then spent eight years in prison on a second-degree murder conviction.

The Oregon statute, precursor to all the aid in dying laws, has fairly stringent requirements, mandating that a patient be diagnosed with less than six months to live, and be considered mentally capable of making decisions for him or her self. After an initial request, a 15-day waiting period kicks in. For patients who fit the criteria, doctors may prescribe medication that will end their lives, which may be taken in the doctor’s presence or not, at the discretion of the patient.

“The experience in Oregon has been closely examined now for 15 years,” Tucker says. “It shows that the practice is fairly rarely used but it raises the floor for good end-of-life care for all patients. Doctors took more training in pain, referred people to hospice care more often and it resulted in better end-of-life care for everyone.”

Oregon requires extensive reporting by doctors that has been used to document its experience, which may not be the path that other states follow. “It’s pretty unusual for medicine to be governed by a particular statute,” says Tucker. “I would say the Oregon statute served its purpose. It’s not necessary for other states to continue to replicate that fairly elaborate statutory scheme.”

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