In March of 2005, she was finally removed from life support and died thirteen days later. The case had 14 appeals, numerous motions, petitions and hearings in Florida courts, five suits in the Federal District Court; Florida legislation struck down by the Supreme Court of Florida; a subpoena by a congressional committee in an attempt to qualify Terri for witness protection; federal legislation and four denials of certiorari from the Supreme Court of Florida (Jacoby 2005). The courts continued to hold that Terri was in a permanent vegetative state (PVS), and an autopsy showed that most of Terri's brain had atrophied.
Leeb outlines the responsibility of social workers to be knowledgeable in policy and law concerning end of life decisions. Sensitivity to ethical and moral considerations is also urged. Cultural differences may be encountered in such situations, as well.
A final discussion of the Oregon Death With Dignity Act reminded the reader that the bill is important for having been passed by a majority of the voting public, and for giving terminally ill patients choices about whether they can end their life or not if they wish. The bill reflects the ambivalence of society on the subject of whether an individual has the right to control the time and manner of their death, and whether society needs to upheld sanctity of life at all times.
Dr. Jack Kevorkian
Dr. Jack Kevorkian is currently serving out a 10-25-year sentence for assisting the death of a terminally ill patient in Michigan. In 1987 he advertised in Detroit papers that he would help other ill patients to commit suicide, although he himself would not kill them. He subsequently assisted nearly 100 patients in voluntary euthanasia, by attaching them to a device that released drugs into the patient's system. The patients themselves pushed the button that allowed this to happen. He was hindered in his attempts by the medical profession that revoked his medical license after the first two deaths.
1990 article by Kevorkian was entitled "The Last Fearsome Taboo: Medical Aspects of Planned Death" appeared in Medicine and Law. In it, he argued that modern society, facing the longstanding prohibition against planned death, was "subjected to unrelenting paternalistic control based on moral codes that are rapidly becoming obsolete." He called the medical profession "physically (philosophically) retarded, drifting aimlessly without a coherent or even workable ethical code." It was Kevorkian's theory that the medical profession did not have an ethical code at all, but should because it should allow the death of those who suffer, rather than trying to keep them alive. (Betzold, 1993, p. 14)
In 1998 the broadcast of 60 Minutes featured a film of Kevorkian administering a lethal injection to Thomas Youk, an adult male with full decisional capacity in the final stages of ALS (Lou Gehrig's Disease) who had provided his fully-informed consent on the day of his death. Following the broadcast, the district attorney brought murder charges against Kevorkian, claiming he had single-handedly caused the death.
Kevorkian had been tried numerous times in Michigan for assisting in suicides, but had been acquitted before the Youk case. He had also gained public support for his cause. In this 1999 case involving the death of Youk, he was charged with second-degree homicide and for delivery of a controlled substance. He was not tried for assisted suicide, which was an area of law in flux, but for homicide, which is an area of law that is relatively fixed. During the trial, Kevorkian dismissed his attorneys and represented himself (pro se). The judge ordered a criminal defense attorney to remain available for information and advice, as Kevorkian encountered great difficulty in presenting evidence and arguments because of his inexperience with law.
The Michigan jury found him guilty as it was proven he had directly killed a person, as his patient was unable to do it himself because of his debilitating illness. On September 29, 2005, MSNBC aired an interview with Kevorkian indicating that if he was granted parole he will not resume directly helping people die and will restrict himself to campaigning for a change in the laws. He has been denied a parole and is seeking a pardon. Recently, an ABC interview with Kevorkian's lawyer revealed that Kevorkian is terminally ill with Hepatitis C, which he contracted during a blood transfusion and is expected to die within the year.
Ironically, in 1988, Dr. Kevorkian, in an interview with Michigan investigator, Svoboda, said he had planned to assist in a suicide when he was living in California but "there was an attempt to get euthanasia on the ballot and he was asked to refrain from performing the illegal act."
Continuing the interview, Kevorkian said, to qualify for his help in dying, a patient "would have to be terminally ill and would have to be met by the attending physician four or five times" and that "an attempt should be made to dissuade the person." Later in the interview, Svoboda noted "he said it should take only one meeting by a bioethicatrist. The second meeting could last five seconds but at least it would be in the records."
Svoboda noted that Kevorkian "fashions much of his thinking on the way these deaths are prepared for and done in Holland."
Dr. Kevorkian does not believe laws should rule or guide morality," Svoboda concluded. "Dr. Kevorkian maintains he is law-abiding but cannot agree or condone how law does not represent the consensus of society. He is making every effort to change laws and at the same time fulfill the demands of society. Dr. Kevorkian writes about his opinions -- he has not acted on them." (Betzold, 1993, p. 20)
The Federal Government and States Treat Physician-Assisted Suicide in the Courts
In 1997, the U.S. Supreme Court unanimously upheld decisions in New York and Washington State that affected assisted suicide and made it illegal. They overturned rulings in the 2nd and 9th Circuit Courts of Appeal striking down state statutes banning physician-assisted suicide. Those statutes, which prohibited doctors from prescribing lethal medication to competent, terminally ill adults, were found to violate the 14th Amendment. In striking the appellate decisions, the U.S. Supreme Court basically declared that no constitutional "right to die" existed, but individual states might enact legislation permitting or prohibiting physician-assisted suicide.
In April 1999, physician-assisted suicide was still illegal in almost all states. Over 30 states have statutes prohibiting assisted suicide, and a number of states that do not have statutes prohibit it through common law. Jack Kevorkian was initially charged with violating Michigan's state statute, as well as being charged with first-degree murder and violating drug laws for delivering a controlled substance without a license. However, when he was convicted of second degree murder and delivering a controlled substance without a license, the assisted suicide charge was dropped.
The only legislation addressing this issue on a federal level came in April of 1999 with the Assisted Suicide Funding Restriction Act. This 1999 Act prohibited federal money from being used to support physician-assisted suicide. In 1998, Henry Hyde (House Judiciary Chairman) and Senator Don Nickles introduced bills in the House and Senate to revoke the license of any doctor to prescribe federally controlled drugs if they participated in an assisted suicide. If such legislation had passed, doctors in any state, even those that legalized assisted suicide, such as Oregon, would have been subject to the federal sanction, though their actions were permitted under state law. (Law, 2005)
In June of 1997 (Vacco v. Quill and Washington v. Glucksberg) the Supreme Court found that there was no constitutional right to die with the help of a physician and upheld the state bans on assisted suicide. The vote was 9 to 0. At issue was whether assisted suicide is protected by the Constitution and whether criminal penalties for those who aid in assisted suicide violate the 14th Amendment's Due Process Clause. (Physician, p. E1)
Shortly after the Schiavo case, in 2001, there was a possibility that a ruling by the U.S. Supreme Court during its next term could effectively invalidate the controversial Oregon law known as the Death with Dignity Act, as U.S. Attorney General John Ashcroft brought a federal suit against the State of Oregon.
In February of 2005, the Court considered the legality of the Bush administration's effort to outlaw physician-assisted suicide in Oregon. The events leading to the death of Terri Schiavo had focused national attention on end-of-life decisions and the Court's acceptance of the case formerly known as Oregon v. Ashcroft reflected the public debate on assisted suicide. The justices heard oral arguments in the case, now known as Gonzales v. Oregon, in October of 2005.
A timeline of the case follows:
On November 6, 2001, Attorney General John Ashcroft issued a Directive stating that a doctor could lose his or her federal registration to prescribe controlled substances if that registration is used…