Death with Dignity Comes to the Rockies
In a November vote to approve physician-assisted suicide, Colorado joined the growing number of states permitting the practice.
By Jonathan Kim, University of Texas at Dallas
On November 8, when the nation was scampering to cast its 2016 presidential ballot, the residents of Colorado also voted on a bonus referendum: Should Colorado pass Proposition 106 to legalize physician-assisted suicide?
Colorado residents voted overwhelmingly in the affirmative, with 65 percent in favor of the proposition. By the end of Election Day, Colorado had become the sixth state (after Oregon, Washington, California, Montana and Vermont) to legalize physician-assisted suicide in cases in which the patient is terminally ill and mentally competent.
Proposition 106, which is modeled after Oregon’s Death with Dignity Act, makes clear in its stringent codes how the assisted death must take place. Two doctors must agree that the patient has fewer than six months to live, which disqualifies those with chronic but non-fatal disabilities. The patient must be over 18 years of age, mentally competent and must knowingly self-administer a lethal dose of the prescribed secobarbital.
(In the 1999 cause célèbre, Dr. Jack Kevorkian, dubbed the “Angel of Death and “Dr. Death,” assisted the suicide of Thomas Youk, a Detroit man with Lou Gehrig’s disease, by lethal injection. Authorities did not prosecute Kevorkian at the time of the perpetration. But Kevorkian, by his own fancy, decided to videotape himself injecting Youk and sent the tape to the CBS news program “60 Minutes.” He was shortly found guilty of second-degree murder.)
In the U.S., the most recent surge of public interest on the “right to die” issue, which includes euthanasia and assisted suicide, began with the 1977 New Jersey case of Karen Ann Quinlan.
A few days after her 21st birthday, Quinlan went to a party, took diazepam (Valium) and drank alcohol, all while on a radical diet, and consequently fell into a coma. She lapsed into a vegetative state that persisted for ten years. Her parents pleaded with the doctor to remove Quinlan’s life-saving ventilator, but the doctor refused in fear of a murder charge. Quinlan’s parents eventually appealed to the New Jersey Supreme Court, who permitted the removal of the ventilator.
The Quinlan case was a legal landmark and attracted worldwide attention, but was ruled by a state supreme court. The U.S. Supreme Court first heard its own “right to die” case in “Cruzan v. Director, Missouri Department of Health (1990).” In 1983, Nancy Cruzan lost control of her car, was thrown out of the window and landed in a water-filled ditch. Cruzan fell into a coma and was later diagnosed with persistent vegetative state. Only a feeding tube kept her alive.
Her parents, for reasons similar to Quinlan’s, wanted the feeding tube removed. They eventually appealed to the U.S. Supreme Court, who, in a split 5-4 decision, held that the 14th Amendment protects the right of an individual to refuse life-saving treatment.
In cases involving an incompetent individual, although the refusal of treatment is permitted, states have power to impose their requirements for surrogacy and establish their own standard of what constitutes as “clear and convincing” evidence that the patient wanted to die.
The Quinlan and Cruzan cases regard passive and non-voluntary euthanasia, but not assisted suicide. In 1997, the U.S. Supreme Court decided, on the same day, two cases that involved physician-assisted suicide: “Washington v. Glucksberg (1997)” and “Vacco v. Quill (1997).” Although “Vacco” is considered the landmark case (according to Wikipedia), the Court held the same rationale in both; the right to suicide, and thus assisted suicide, is not fundamental, and so is not protected by the Constitution.
Since the Court could neither ban nor approve aid in dying, the issue turned over to the states, with Oregon becoming the first to legalize physician-assisted suicide, marketing it as “death with dignity,” only a few months after the Court’s decision in 1997.
More states have since passed similar bills, and the issue is only gaining traction. According to the Death with Dignity National Center, 19 states, including Alaska and Hawaii, are currently working to enact legislation for physician-assisted suicide. (Not surprisingly, most states with no current legislative activity tend to be conservative. My state of Texas is no exception. In fact, it has never even tried.)
Hawaii began its efforts almost two decades ago, in 1998, though its most recent 2016 hearing failed to meet deadline. But the prospects seem bright for assisted dying in Hawaii; in a 2016 poll, 80 percent of Hawaiians believe that a “death with dignity” option should at least be made available for those who find no palatable alternative.
This option for the terminally ill to opt out of hopeless suffering should be motive enough for state legislation. Otherwise, many victims of forlorn torment resort to suicide by means more violent, usually purposeful starvation or dehydration. There is even a nurse in New York who coaches people through death by starvation since her state does not yet permit a physician’s aid in dying.
Granted, many of the cases that involve intentional death by starvation or dehydration would not qualify anyway as operating under a “terminal illness.” But, without the option to decide a peaceful end to one’s fate, those who are terminally ill and live by happenstance in any of the 44 passive states will be denied a safe and humane option to pass into the afterlife; without sanction from the state, those who would have qualified under Colorado’s Prop 106, and whose only sin is their location of residence, will be forced to explore other suicidal means that could be inhumane, ineffective and more painful.
The countervailing forces to assisted dying are usually from religious groups, especially Catholics, whose casuistries in argument against the “right to die” are more or less scions of their religious dogmas. But there is reason as to why, according to a 2016 Gallup poll, the “right to die” hits a chord with 69 percent of Americans.
Inherent in our right to live is the right to decide what makes our life worth living, and thus the right to decide when our life is not worth living. Are we not the most qualified arbiters of the quality of our own lives? And if it’s true that our right to die inheres in part to our right to live, do we also have the right to die in peace? The right to die with dignity?