Vacco V Quill and Physician Assisted Suicide

Dennis C. Vacco Attorney General of New York, et al. v. Timothy E. Quill et al.

How does the U.S. Supreme Court answer the question, "Is withdrawing lifesaving medical treatment a form of assisted suicide?"

In their decision in Vacco v. Quill, the U.S. Supreme Court held that despite the compelling and legitimate claims advanced by assisted-suicide proponents that terminally ill patients have a right to hasten their deaths through physician-assisted means, laws prohibiting physician-assisted suicide do not violate the Fourteenth Amendment's equal protection clause; however, everyone who is mentally competent does have a fundamental constitutional right to refuse any type of undesired medical intervention, even those that are intended to prolong their lives. In this regard, the Supreme Court emphasized that, "Everyone, regardless of physical condition, is entitled, if competent, to refuse unwanted lifesaving medical treatment" but "no one is permitted to assist a suicide."

Therefore, this case drew the important distinction between "letting a patient die" and actually "making that patient die." This distinction is important because it formed the basis of the petitioners' claims of protections under the Fourteenth Amendment's equal protection clause. As the Court's decision made clear, though, withholding lifesaving medical treatment is not a form of assisted suicide because of its passive nature while administering life-ending drugs would be an aggressive intervention. In sum, the Fourteenth Amendment's equal protection clause protections do not extend to actively assisting terminally ill patients die but merely withholding lifesaving medical treatment at the direction of terminally ill patients is consistent with best medical practices and the vast majority of state legislatures.

Is a patient who refuses life-sustaining treatment committing suicide?

There are a wide range of variables that determine how and when people seek or refuse medical care. In some cases, this decision may be influenced by powerful cultural factors that will influence patients' decision to pursue aggressive lifesaving interventions such as chemotherapy for end-stage cancer despite the well-known adverse side effects that are involved. In other cases, this decision may be heavily influenced by religious beliefs, with some faiths believing that medical care of any type is inappropriate while others subscribe to differing views about suicide being a mortal sin. Against this backdrop, it would be inappropriate to pigeonhole everyone who refuses life-sustaining treatment as committing suicide simply because some people may view their terminal condition as a fitting and natural end to a life well lived and no further lifesaving interventions are needed.