Constitutional and legal perspectives on physician-assisted suicide

¶ … Constitution and the Declaration of Independence Should a Qualified Individual Be Allowed to Assist Another in a Suicide

Should a qualified individual be allowed to assist another in a suicide?

One of the most difficult decisions facing both the courts and individual citizens is the question of when life begins. In Roe v. Wade the U.S. Supreme Court found, given the penumbra or unstated but still-present protected right to privacy within the fabric of the U.S. Constitution, that individuals should have the right to privately decide when life begins regarding their own future offspring. The court must face this same question when it considers the constitutionality of physician-assisted suicide. The decision to terminate one's own life, under reasonable circumstances, should also be part of the right to privacy of all individuals under law.

The right to privacy is implied in the U.S. Constitution in many instances, most notably in the First Amendment, which guarantees freedom of belief. The Constitution also upholds the freedom to be safe in one's home, protected from government impositions upon one's personal property in the Third Amendment and from unreasonable searches and seizures in the Fourth Amendment. Given that many people believe that they have the right to decide when their life is a life of quality, and is 'worth living,' and when it is not worth living the First Amendment supports the practice of physician-assisted suicide and protects citizens from unreasonable impositions upon their property and person in the Third and Fourth Amendments.

The citizen's right to make this medical decision does not encroach upon the beliefs or the safety and security of others or infringe upon the rights of others. Furthermore, the Ninth Amendment prohibits the use of the Constitution from denying people additional rights, simply because they are not explicitly articulated within the document. It states that the "The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people." Merely because the Constitution does not specify the right to die does not mean that it should be used as a way of denying people a right that is clearly in the spirit of the other amendments in the Bill of Rights.

Although not a legal document, the Declaration of Independence states that all citizens are entitled to life, liberty, and the pursuit of happiness. If both an individual and a physician decide together that the person's life is not worth living, and can give no joy to the patient, should the two of them not be allowed to make such a decision privately? We trust physicians to make decisions every day about making health priorities and balancing emotional and physical care. Regarding health, there are often no clear answers, and a physician may agree to perform a mastectomy on a healthy woman without breast cancer but with a history of the disease while allow a cancer patient to refuse another round of chemotherapy, because he or she decided that 'enough was enough' in terms of fighting the disease. How can we trust physicians to weigh pros and cons of so many health decisions, but impose judicial authority upon them on end-of-life issues?

Of course, opponents argue that this will be a slippery slope to allowing rampant assisted suicide. However, with any freedom, there are always some limitations. Giving individuals freedom of speech has not created a 'slippery slope' where individuals can be slandered. Even regarding First Amendment free speech, there are limits upon citizens in terms of revealing state secrets or using speech as a weapon -- the example of calling 'fire' in a crowded theater comes to mind. There could be limits upon the circumstances to ensure physicians could not assist severely depressed or mentally incompetent individuals to commit suicide, for example.

There are also practical considerations which the court does take into consideration when deciding many issues of social policy, as it did in Brown v. Board of Education. The advantage of physician-assisted suicide is that it occurs under a physician's discretion, and encourages patients to speak freely about end-of-life issues with their doctors, rather than to seek out and perhaps fail in a suicide attempt on their own that is painful and merely worsens their illness. In fact, it might prevent suicides in cases where things are not hopeless, given that it opens up the lines of communication rather than uses the law to close them down.

Should an individual be allowed to voluntarily end his or her life?