Disability group welcomes ruling against right to assisted suicide in Mass.

Boston, Mass., Jan 14, 2020 / 17:01 pm

Second Thoughts Massachusetts, a disability rights group, has praised a recent ruling that there is not a right to assisted suicide in the state's law or its constitution.

In a decision dated Dec. 31, 2019, Justice Mary Ames of the Suffolk Superior Court ruled that physicians who prescribe lethal medication for assisted suicide in Massachusetts can be prosecuted for involuntary manslaughter, but that physicians may provide information and advice on assisted suicide to terminally ill, competent adults.

"We are gratified that the court reaffirmed the law against assisted suicide, and referred the matter to the legislature where lawmaking belongs. Disability rights advocates will continue to press the legislature that assisted suicide is just too dangerous," John Kelly, director of Second Thoughts, commented Jan. 13.

The case on which Ames ruled was brought by Dr. Roger Kligler, who has prostate cancer, and Dr. Alan Steinbach, who treats patients considering end-of-life problems.

Among the arguments Kligler and Steinbach made were that prosecution of a physician for manslaughter who prescribes medication for assisted suicide "impermissibly restricts a patient's constitutional right to privacy" and their "fundamental liberty interests."

They also argued that the prosecution of such physicians "violates the constitutional right to the equal protection of law by treating differently terminally ill adults who wish to receive [assisted suicide] and terminally ill adults who wish to hasten death by the voluntarily stopping of eating and drinking (VSED), withdrawal of life support, or palliative sedation."

Ames wrote in her decision that "any physician is free to provide information on the jurisdictions where [assisted suicide] is legal, guidance and information on the procedures and requirements in those jurisdictions, and referrals to physicians who can provide [assisted suicide] in those jurisdictions. Such conduct, without more, does not constitute involuntary manslaughter."

She also wrote that the Massachusetts Supreme Judicial Court had taken pains "to preserve what it viewed as a meaningful distinction between death that results naturally from the withdrawal of medical equipment and death that results from affirmative human efforts," and that it had said the law "does not permit suicide" or "unlimited self-determination."

Ames said that neither of two relevant SJC decisions suggest "that the principles that underlie the right to refuse medical treatment apply to the affirmative act of taking one's own life with the assistance of a willing physician," and that the SJC would likely maintain "a strong distinction between [assisted suicide], and the withdrawal of treatment and palliative care."

Compassion & Choices, an assisted suicide advocacy group, has said they plan to appeal the ruling, WBUR reported Jan 10.

Ames wrote that the state legislature could "conclude that difficulty in determining and ensuring that a patient is 'mentally competent' warrants the continued prohibition" of assisted suicide.

She added that the legislature could conclude that "predicting when a patient has six months to live is too difficult and risky for the purposes of" assisted suicide. She noted that the state "put forward expert testimony that while doctors may be able to accurately predict death within two or three weeks of its occurrence, predictions of death beyond that time frame are likely to be inaccurate."

Moreover, Ames said the legislature could also conclude that "a general medical standard of care is not sufficient to protect those seeking" assisted suicide, noting  that the state provided testimony that assisted suicide "is neither a medical treatment nore a medical procedure and thus there can be no applicable medical standard of care" and that the legalization of assisted suicide "is an attempt to carve out a special case outside of the norms of medical practice."

The legislature could, too, conclude that assisted suicide "is not equivalent to permissible alternatives," citing the difference between assisted suicide and voluntary cessation of nutrition and hydration, withdrawal of life support, or palliative sedation.

Ames concluded that "there appears to be a broad consensus that this issue is not best addressed by the judiciary," and that there are strong arguments for prohibiting assisted suicide or ensuring it "occurs in an environment in which clear, thoughtful, and mandatory standards are in place to protect terminally ill patients who wish to make an irreversible decision. The Legislature, not the Court, is ideally positioned to weigh those arguments and determine whether and if so, under what restrictions, [assisted suicide] should be legally authorized."

There are bills in both houses of the state legislature to legalize assisted suicide. The bills are due to be considered by the Joint Committee on Public Health next week.

Ruthie Pool, president of MPOWER, a group of people who have experienced mental health diagnosis, trauma, or addiction, commented Jan. 13 that "as someone who has been suicidal in the past, I can relate to the desire for 'a painless and easy way out.' However, depression is treatable and reversible. Suicide is not. The current bill in the legislature pretends otherwise."

In 2012, Massachusetts voters narrowly rejected a ballot initiative that would have legalized assisted suicide.

At the time, Cardinal Sean O'Malley of Boston commented that "it is my hope and prayer that the defeat of Question 2 will help all people to understand that for our brothers and sisters confronted with terminal illness we can do better than offering them the means to end their lives."

The 2012 initiative was opposed by both the Massachusetts Medical Association and the Boston Herald.

In the US, assisted suicide is legal in California, Colorado, Hawaii, Maine, New Jersey, Oregon, Vermont, Washington, and the District of Columbia; and in Montana by a court ruling.