Nirma University of Science and
Technology
Institute of Law I Semester B.A.LL.B. (Hons.!ourse A "rief socio#legal research in the su"$ect of sociology as a Term Assignment II for the academic year %&&'#& )n the to*ic of
“Euthanasia or Mercy Killing"
(+uration of the ,ro$ect- th Se*tem"er/ %&&' to th )cto"er/ %&&'
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2.2 Introduction of the to*ic 2
Euthanasia Euthanasia
Euthanasia Euthanasia (from Ancient Greek : ευθανασία, "oo! !eath" #$% is the &ractice of en!in the 'ife of 'ife of a termina'' i'' &erson in &erson in a &ain'ess a &ain'ess or or minima'' &ainfu' )a, for the &ur&ose of 'imitin 'imitin sufferin* sufferin* +a)s aroun! the )or'! ar reat' )ith rear! to euthanasia an! are constant' su-.ect to chane as cu'tura' a'ues shift an! an! -etter -etter &a''iatie care care or treatments -ecome aai'a-'e* #t is 'ea' in some nati nation ons, s, )hi'e )hi'e in others others it ma ma -e crimina'i/e!* crimina'i/e!* Euthanasia Euthanasia is the !e'i-erate !e'i-erate -rinin a-out a ent'e an! eas !eath, makin the 'ast !as of the &atient as comforta-'e as &ossi-'e* 0his is to ensure a ca'm an! &eacefu' !eath, )ithin the cont conte ett of re'i re'iei ein n incur incuraa-'e 'e suff suffer erin in in term termin ina' a' i''n i''nes esss or !isa !isa-i -i'i 'it t** Euth Eu thana anasi siaa is o'u o'unt ntar ar, , )hen )hen reue reuest ste! e! - the the suff suffer erer er33 ino' ino'un unta tar r or com&u'sor if it is aainst the )i'' of the &atient3 an! &assie )hen !eath is hastene! - !e'i-erate )ith!ra)a' of effectie thera& or nourishment*
2.% Nature 3 Sco*e of the study
Terminology
Euthanasia can -e con!ucte! in arious )as* #n or!er to !istinuish certain metho!s, more s&ecific termino'o ma -e use! )hen )h en !iscussin euthanasia*
Euthana Euthanasia sia ma -e con!uct con!ucte! e! &assi &assie' e',, non4ar non4aress essie ie' ',, an! ares aressi sie' e'** 5assi 5assiee euthan euthanasi asiaa entai' entai'ss the )ithho )ithho'!i '!in n of common common treatm treatments ents (such (such as anti-i anti-ioti otics, cs, !rus, !rus, or surer surer% % or the !istri !istri-ut -ution ion of a me!icat me!ication ion (such (such as mor&hine% mor&hine% to re'iee re'iee &ain &ain,, kno)in that it ma a'so resu't in !eath ( &rinci&'e ( &rinci&'e of !ou-'e effect%* effect%* 5assie euthanasia euthanasia is the most acce&te! acce&te! form, an! it is a common common &ractice in most hos&ita's* 6on4aressie euthanasia entai's the the )ith!ra)in of
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'ife su&&ort su&&ort an! is is more controer controersia' sia'** Aressie Aressie euthanasi euthanasiaa entai's the the use of 'etha' 'etha' su-stances or force to ki'' an! is the most controersia' means*
Euthanasia Euthanasia by consent consent
Euthanasia Euthanasia ma -e con!ucte! )ith or )ithout consent* #no'untar #no'untar euthanasia is con!ucte! aainst someone8s )i'' an! euates to mur!er * 0his &ractice is a'most a')as consi!ere! )ron an! is rare' !e-ate!* #no'untar euthanasia can -e a!ministere! )hen the &erson is inca&a-'e of makin a !ecision an! it is thus 'eft to a &ro* 9ne recent eam&'e of non4o'untar euthanasia is the 0erri chiao case* 0his is hih' controersia', es&ecia'' -ecause mu'ti&'e &roies ma c'aim the authorit to !eci!e for the &atient* ;o'untar euthanasia is euthanasia )ith the &erson8s !irect consent, -ut is sti'' controersia' controersia' for reasons !iscusse! -e'o)*
Other designations
ome im&ortant im&ortant !esinations of euthan euthanas asia ia cons consis ists ts of merc ki'' ki''in in,, anima' euthanasia,, an! euthanasia an! &h &hsi sici cian4 an4as assi sist ste! e! suic suici! i!ee )hic )hich h is a term term for for ar ares essi sie e o'untar euthanasia* 0he
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2.% Historical "ac4ground5 )rigin 3 +evelo*ment %
1939 Nazi Germany
"#n 9cto-er of 1?7? ami! the turmoi' of the out-reak of )ar @it'er or!ere! )i!es&rea! "merc ki''in" of the sick an! !isa-'e!*
"0he 6a/i euthanasia &roram uick' e&an!e! to inc'u!e o'!er !isa-'e! chi'!ren an! a!u'ts* @it'er8s !ecree of 9cto-er, 1?7?, t&e! on his &ersona' stationer an! -ack !ate! to e&t* 1, en'are! 8the authorit of certain &hsicians to -e !esinate! - name in such manner that &ersons )ho, accor!in to human .u!ment, are incura-'e can, u&on a most carefu' !ianosis of their con!ition of sickness, -e accor!e! a merc !eath*8"
istory3
0he term euthanasia comes from the Greek )or!s "eu" an! "thanatos" )hich com-ine! means "oo! !eath"* @i&&ocrates mentions euthanasia in the @i&&ocratic 9ath, )hich )as )ritten -et)een =CC an! 7CC D*<* 0he oriina' 9ath states: "0o &'ease no one )i'' # &rescri-e a !ea!' !ru nor ie a!ice )hich ma cause his !eath*" es&ite this, the ancient Greeks an! Bomans enera'' !i! not -e'iee that 'ife nee!e! to -e &resere! at an cost an! )ere, in conseuence, to'erant of suici!e in cases )here no re'ief cou'! -e offere! to the !in or, in the case of the toics an! E&icureans, )here a &erson no 'oner care! for his 'ife* 0he En'ish
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suici!e an! assistin suici!e* @o)eer, in the 1>CCs, 0homas ore, in !escri-in a uto&ian communit, enisae! such a communit as one that )ou'! faci'itate the !eath of those )hose 'ies ha! -ecome -ur!ensome as a resu't of "torturin an! 'inerin &ain"*
!ost#ar history$
ue to outrae oer 6a/i euthanasia, in the 1?=Cs an! 1?>Cs there )as er 'itt'e &u-'ic su&&ort for euthanasia, es&ecia'' for an ino'untar, euenics4-ase! &ro&osa's*
A ke turnin &oint in the !e-ate oer o'untar euthanasia (an! &hsician assiste! !in%, at 'east in the Lnite! tates, )as the &u-'ic furor oer the case of Maren Ann Nuin'an* 0he Nuin'an case &ae! the )a for 'ea' &rotection of o'untar &assie euthanasia* #n 1?OO,
#n 1??C, r* Jack Meorkian, a ichian &hsician, -ecame infamous for encourain an! assistin &eo&'e in committin suici!e )hich resu'te! in a ichian 'a) aainst the &ractice in 1??2* Meorkian )as trie! an! conicte! in 1??? for a mur!er !is&'ae! on te'eision* #n 1??C, the u&reme
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#n 1??=, 9reon oters a&&roe! !octor4assiste! suici!e an! the u&reme
#n 1??7, the 6ether'an!s !ecrimina'i/e! !octor4assiste! suici!e, an! in 2CC2, restrictions )ere 'oosene!* urin that ear, &hsician4assiste! suici!e )as a&&roe! in De'ium* Austra'ia8s 6orthern 0erritor a&&roe! a euthanasia -i'' in 1??>, -ut that )as oerturne! - Austra'ia8s Ke!era' 5ar'iament in 1??O*
ost recent', ami! oernment roa!-'ocks an! controers, 0erri chiao, a K'ori!ian )ho )as -e'iee! to hae -een in a eetatie state since 1??C, ha! her fee!in tu-e remoe! in 2CC>* @er hus-an! ha! )on the riht to take her off 'ife su&&ort, )hich he c'aime! she )ou'! )ant -ut )as !ifficu't to confirm as she ha! no 'iin )i'' an! the rest of her fami' c'aime! other)ise*
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Modern history%
ince the 1?th
Euthanasia societies )ere forme! in En'an! in 1?7> an! in the L**A* in 1?7P to &romote aressie euthanasia* A'thouh euthanasia 'eis'ation !i! not &ass in the L** or En'an!, in 1?7O, !octor4assiste! euthanasia )as !ec'are! 'ea' in
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o!ern histor3 )))*euthanasia*com
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)it/er'an! as 'on as the &erson en!in the 'ife has nothin to ain* urin this &erio!, euthanasia &ro&osa's )ere sometimes mie! )ith euenics* Ihi'e some &ro&onents focuse! on o'untar euthanasia for the termina'' i'', others e&resse! interest in ino'untar euthanasia for certain euenic motiations (e**, menta'' "!efectie"%* urin this same era, mean)hi'e, L** court tria's tack'e! cases ino'in critica'' i'' &eo&'e )ho reueste! &hsician assistance in !in as )e'' as "merc ki''ins", such as - &arents of their seere' !isa-'e! chi'!ren*
5rior to Ior'! Iar ##, the 6a/is carrie! out a controersia' an! no)4con!emne! euthanasia &roram* #n 1?7?, 6a/is, in )hat )as co!e name! Action 0=, ino'untari' euthani/e! chi'!ren un!er three )ho ehi-ite! menta' retar!ation, &hsica' !eformit, or other !e-i'itatin &ro-'ems )hom the consi!ere! "'ife un)orth of 'ife"* 0his &roram )as 'ater eten!e! to inc'u!e o'!er chi'!ren an! a!u'ts*
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2.6 Legislative ,rovisions '
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0he co'our &ortion of the ma& sho)s the &'ace )here the euthanasia is 'ea'*
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&egal
dilemmas
0uthanasia (eu 7 good/ Thanatos ' death( dre) attention o* +ndian doctors and sociologists in ,-ril .//.0 )hen the utch !arliament legalised it 2actually in -ractice there *or t)o decades( maing the Netherlands the only country in the )orld to do so4 Earlier0 Oregon became the only 5tate in the 6454 to -ass the "eath )ith ignity ,ct" in 1997 enabling -atients to administer lethal in8ections themseles4 ere the -atient 2instead o* doctor( -ractises euthanasia
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)ith
legal
sanction4
0uthanasia is of three ty*es- active (stic4ing a lethal in$ection/ *assive (withdrawing of life su**ort systems and death "y dou"le effect (through heavy doses of *ain 4illers hastening the end. Any one of the a"ove is in vogue
in
many
countries.
The Hindu editorially o"serves (A*ril %2/ %&&%- 8Surveys in 0uro*ean countries indicate that many thousands of *eo*le are routinely assisted to die "y
doctors
in
one
of
the
two
latter
ways
every
year.8
In certain cases/ there is the seal of a**roval too. 9or instance/ recently a U.:. family court granted the right to die to a ;6#year old woman/ *aralysed from the nec4 downwards/ who wanted to have her ventilator switched off.
This is yet another case of granting legal sanction to *assive euthanasia/ a $udicial euest for mercy 4illing. Among the *ro*onents of euthanasia/ +r. ?ac4 :evor4ian (4nown as +r. +eath who claimed that he had hel*ed more than 26& *eo*le die since 2@@& is uni>ue. In an e
*u"lic
trust
in
medical
*rofeF
5sion4!eo-le is naturally a--rehensie that the ongoing ha--enings else)here
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)ill
hae
a
ri--le
e**ect
in
+ndia
too4
Two cases of Indian courts turning down re>uests of the *atients to die were re*orted in the year %&&2. The ,atna High !ourt dismissed Tara4eshwar !handravanshi=s *lea see4ing mercy 4illing for his %#year#old
wife
:anchan/ who had "een comatose for 2 months. Again the :erala High !ourt said no to the *lea of B: ,illai/ who had a disa"ling illness/ to die. In s*ite of clear legal mandates/ *assive euthanasia/ although s*oradic/ is *revalent in India. Here is an illustrative re*ort from India Today (A*ril 2/ %&&%-
8)ne case was of @ year#old Neena Bonar$i/ an international "ridge *layer who was suffering from *rogressive lung disease for three years and was "eing treated at +elhi=s Ganga 1am hos*ital/ had instructed her daughter Nisha Bham"ani to *ut her off the ventilator when the time came. Dhen my mother sli**ed to 2&& *er cent su**lementary su**ort/ we did what she had wished for/= says Bham"ani. ithin an hour/ Bonar$i *assed away.8
Although mercy 4illing a**ears morally $ustifia"le (es*ecially in "rain dead *atients whose organs can "e donated to save other lives in case of incura"le diseases/ doctors should "e dou"ly careful/ since they run the ris4 of attracting *unishment for murder under section 6&% of the Indian ,enal !ode. +r. ,.:. +ave/ former director of the All India Institute of Eedical Sciences (AIIES/ New +elhi/ em*hasised- 8even if the relatives insist/ we never
o*t
for
it.8@
The legal -osition 1/
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0he 'ea' &osition3 )))*euthanasia*com
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Euthanasia is i''ea' in most countries, a'thouh !octors !o sometimes carr out euthanasia een )here it is i''ea'*
Euthanasia is i''ea' in Dritain* 0o ki'' another &erson !e'i-erate' is mur!er, een if the other &erson asks ou to ki'' them*
#t is a'so a crimina' offence in Dritain, &unisha-'e - 1= ears8 im&risonment, to assist ai! or counse' some-o! in re'ation to takin their o)n 'ife*
(+ea' &osition state! at arch 2CC2% 5u-reme court cases 11
Supreme Court Backs Oregon Assisted Suicide Law
0ues!a, Januar 1O, 2CCH
0he Su*reme !ourt on Tuesday let stand )regon=s *hysician#assisted suicide law/ o*ening the door to many more such laws across the nation for ending the lives of the terminally ill.
#n a H47 ote, .ustices ru'e! that a fe!era' !ru 'a) cou'! not -e use! to &rosecute 9reon !octors )ho &rescri-e! oer!oses inten!e! to faci'itate the !eaths of termina'' i'' &atients* 0he Dush a!ministration in 2CC1 souht to o after 9reon !octors )ho inoke! the 'a), sain that in!uce! suici!e )as not a "'eitimate me!ica' &ur&ose*"
Dut !urin ora' aruments 'ast 6oem-er, seera' .ustices seeme! ske&tica' of the oernment8s &osition* Justice an!ra a 98
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Supreme Court Holds Hearing on Assisted Suicide Dispute
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by
Steven
Ertelt
Lifeews!com
Editor
October "# $%%"
#ashington0 : 2&i*eNe)s4com( ## 0he u&reme
hearins on a !is&ute -et)een the state of 9reon, the on' one to 'ea'i/e assiste! suici!e, an! the Dush a!ministration on )hether fe!era'' contro''e! !rus
can
-e
use!
in
assiste!
suici!es
there*
0he &resi!ent -e'iees
0he case is Gon/a'es s* 9reon an! the 5acific state sas the Dush a!ministration has no riht to intru!e on the riht to &riac of e'!er' an! !isa-'e! &atients there* Attorne Genera' A'-erto Gon/a'es counters that the fe!era' oernment can 'imit the use of !rus un!er the 1?O1
o'icitor Genera' 5au' <'ement to'! .ustices that the "most natura' rea!in" of the 'a) )ou'! !isa''o) the !rus use in assiste! suici!es*
0he .ustices aske! iorous uestions that suest the hae not ma!e u& their min!s a-out the case*
Justice an!ra a 98
5ro4'ife rou&s sa the Dush a!ministration is riht* A!ministration has &ro&er' !etermine! that fe!era'' contro''e! me!ica' !rus shou'! -e use! to hea' an! he'&, not to ki''," sai! Durke Da'ch, J**, !irector of the 6B+< Bo-ert 5o)e''
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6e)'4confirme!
Bo-erts an! other .ustices sai! that 9reon8s 'oic that a state shou'! !etermine the use of fe!era'' contro''e! !rus )ou'! neate ke fe!era' anti4!ru 'a)s if a state !etermine! some narcotics )ere a''o)a-'e*
eera' .ustices re&eate!' !isaree! )ith 9reon8s contention that a&&'in fe!era' 'a) to a'' fift states )ou'! mean arin stan!ar!s in each state*
hou'! the court si!e )ith the Dush a!ministration, 9reon8s 'a) a''o)in assiste! suici!e )ou'!n8t -e taken off the -ooks, -ut it )ou'! -e cri&&'e! -ecause !octors )ou'! not -e a-'e to use an !rus to he'& &atients ki'' themse'es*
#n a 1??O case, the u&reme
Legislative ,ro*osals26
"#n )hat states shou'! &ro&osa's to 'ea'i/e assiste! suici!e -e e&ecte!R" is a fair' common uestion* 0he ans)er is sim&'e* "Eer state is 'ike' to -e face! )ith such a measure, sooner rather than 'ater*"
ince &assae of the 9reonSs assiste!4suici!e 'a) in 6oem-er 1??=, at 'east >= assiste! suici!e an!For euthanasia measures hae -een intro!uce! in 21 states* 6ot one has &asse!* 9n the other han!, -et)een 1??> an! 1???, seen states &asse! 'a)s &rohi-itin assiste! suici!e*
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su&reme court cases3 )))*euthanasia*com 'eis'atie &ro&osa'3 #nternationa' 0ask Korce on Euthanasia an! Assiste! uici!e
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@o)eer, &assae is not a')as the oa' of &ro&osin a 'a) to &ermit assiste! suici!e* 0hose )ho faor the &ractice ackno)'e!e that the mere intro!uction of a 'eis'atie &ro&osa' is -eneficia' since, )hen a "!eath )ith !init" -i'' is intro!uce!, me!ia coerae fo''o)s* 0his &resents an o&&ortunit to feature an emotiona' a&&ea' from a &atient )ho &'ea!s for the "riht" to assiste! suici!e*
0hen, after the initia' f'urr of stories, most -i''s 'iner in committee unti' their !emise at the en! of a 'eis'atie session an! coerae fa!es* Dut, the ene'o&e has -een moe!* A ste& has -een taken to -ui'! &u-'ic su&&ort - creatin the i''usion that 'ea'i/ation of assiste! suici!e is a com&assionate so'ution to a heart4 )renchin situation*
6onethe'ess, the constant -arrae of &ro&osa's a'on )ith their accom&anin attention4ra--in stories creates the i''usion that assiste! suici!e is ineita-'e, that itSs not oin to o a)a, an! that the rest of the countr )i'' eentua'' fo''o) 9reonSs 'ea!*
#t is true that attem&ts to 'ea'i/e assiste! suici!e )i'' continue* Dut it is not true that the rest of the countr )i'' ineita-' fo'! un!er the &ressure* 9ther states )i'' not re&eat 9reonSs traic mistake if those )ho seek to &rotect societ from the !aners of assiste! suici!e !ee'o& coa'itions to o&&ose such measures*
A 1???
Strong
&rassroots
Opposition
Defeats
California
Bill'(
#n 1???, the makeu& of the
1=
tron Grassroots 9&&osition efeats
1P
Ke-ruar 2?, 1???, Assem-')oman ion Aroner intro!uce! AD 1>?2, the "
0he &ro&osa' )as irtua'' i!entica' to the 9reon 'a)* #n fact, Aroner &ointe! to this as a -enefit sain, "AD 1>?2 is -ase! on the same 'a) that )as &asse! - oters in the state of 9reon a cou&'e of ears ao* 0he oo! ne)s is that )eSre 'uckier than 9reon -ecause )e hae their e&erience to consi!er*"
@o)eer, )hen the -i'' )as intro!uce!, o&&onents imme!iate' -ean the task of contactin communit 'ea!ers a-out its im&'ications* uch to the sur&rise of assiste!4suici!e &ro&onents, the &oints raise! in o&&osition )ere not -ase! on riht4to4'ife or re'iious aruments* #t !i!nSt take 'on -efore Aroner an! her -i'' encountere! storm )aters in the form of stron rassroots o&&osition*
D the time hearins an! committee otes on AD 1>?2 took &'ace, &eo&'e from across the state T those )ho )ere &oor, in!ii!ua's from !ierse ethnic rou&s, !isa-'e! &ersons an! the e'!er' T )ere &resent to stae &rotests outsi!e the ca&ito' an! in front of AronerSs Derke'e office*
5etitions o&&osin the measure, circu'ate! )ithin the African4American communit, )ere sine! - thousan!s of &eo&'e* 0he +eaue of Lnite! +atin American
#t conc'u!e!, "Ie ure a U69S ote on AD 1>?2 -ecause )e -e'iee it is unconsciona-'e to ta'k a-out 'ea'i/in &hsician4assiste! suici!e )hen 'o)4 income &eo&'e !o not hae access to com&rehensie me!ica' care inc'u!in &ain manaement an! hos&ice care*"
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Aroner ha! fai'e! to consi!er the !a4to4!a o-stac'es face! - minorities an! the &oor )hen the nee! hea'th care* As !isa-i'it rihts 'ea!er iane
Kor man &eo&'e, ineuit in hea'th care is a harsh rea'it, as i''ustrate! - !ocumente! !is&arities in treatment an! &ain contro':
African4American &atients )ith a -roken arm or 'e are 'ess 'ike' to -e ien &ain me!ication in emerenc rooms than )hite &atients )ho hae simi'ar in.uries an! com&'aints of &ain*
African4American cancer &atients in nursin homes are seere' un!ertreate! for &ain 4 some !on8t een et as&irin*
9ut&atients )ith cancer )ho )ent to c'inics that sere! minorit &atients )ere three times more 'ike' to -e un!er4me!icate! for &ain than )ere &atients in other settins*
Amon minorit rou&s, 7>V of @is&anics 'ack hea'th insurance, fo''o)e! - 22V of African4Americans, an! 21V of Asians* 0hose )ho 'ack insurance are three times more 'ike' than those )ho are insure! to -e in &oor hea'th, hae a hiher morta'it rate, an! sinificant' re!uce! access to &reentatie me!ica' care* 1>
African4Americans are >CV 'ess 'ike' to et heart -4&ass surer an! 2>V 'ess 'ike' to et &ain me!ication than their counter&arts in other races* An! ten !ifferent stu!ies in the L** hae sho)n that the !is&arities cannot -e e&'aine! a)a - the fact that, as a rou&, African4American &atients ten! to -e &oorer, sicker an! hae 'ess hea'th insurance than )hite &atients*
African4American aca!emics )ho stu! -ioethica' issues hae e&resse! concern that &ermittin assiste! suici!e, a'on )ith ne) 'imits on hea'th care, &resents
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tron Grassroots 9&&osition efeats
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ne) o&&ortunities to ictimi/e minorities: "5eo&'e kno) the !on8t et the hea'th care the nee! )hi'e the8re 'iin* o )hat makes them think anone8s oin to -e more sensitie )hen the8re !in*"
Een actiists in AronerSs Derke'e an! 9ak'an! !istrict actie' o&&ose! the -i''* 0he Derke'e
9&&osition from those on )hom Aroner ha! re'ie! for su&&ort -rouht her to tears at one &oint in the !e-ate oer the measure* Dut it !i! nothin to 'essen her a!ocac of her -i''* he ma!e it a-un!ant' c'ear that she )as committe! to seein assiste! suici!e 'ea'i/e!, no matter )hat the conseuences* "#t8s a er &ersona' issue," she to'! re&orters* "#tSs not a uestion of )hat is oo! &o'itics or oo! &o'ic*"
A'thouh some 'ast minute maneuerin an! committee mem-ershi& chanes &ermitte! its &assae at the committee 'ee', it soon -ecame c'ear that AD 1>?2 )ou'! not &ass the fu'' Assem-' -efore the session en!e!* 0he -i'' )as chane! into )hat is kno)n as a "t)o ear -i''," &ermittin it to -e consi!ere! aain in Januar 2CCC an! Aroner ste&&e! u& attem&ts to arner su&&ort for it - !o)n&'ain &u-'ic fears*
0he -i'' AD 1>?2$ sas to the eecuties )ho run @9s: "Qou !onSt et to ta'k a-out &hsician4assiste! !in in our -oar!rooms, or in the -ack rooms of )here ou !o -usiness, or in our ha'')as* 0he on' time ou et to ta'k a-out
1H
tron Grassroots 9&&osition efeats
21
&hsician4assiste! !in is )hen a &atient asks ou a-out the &roce!ure* 0hat is the on' time* 9ther than that, ou are committin a fe'on*
#n sain this, Aroner )as either uninforme! a-out the content of her -i'', or she )as -ein !e'i-erate' !ece&tie* AD 1>?2 !i! not a''o) anone to "coerce" or use "un!ue inf'uence" to o-tain a reuest for assiste! suici!e* @o)eer, there )as a-so'ute' not)ing in the measure that )ou'! hae &reente! @9s, manae! care com&anies, !octors or anone e'se from suestin, encourain, offerin, or -rinin u& assiste! suici!e )ith a &atient )ho ha! not aske! a-out it*
Qet, re'in on AronerSs assertions, rather than on the -i''Ss content, ne)s&a&ers re&eate! the fa'se assurances* 0he San *rancisco Bay &uardian re&orte!, "0he -i'' )ou'! make it a fe'on for anone T @9s, fami' mem-ers, !octors T to encourae a &atient to take the me!ication*" imi'ar', an e!itoria' in the Sacramento Bee state!, "#n an effort to ensure that the action )ou'! -e com&'ete'
o'untar on the &art of the &atient, AD 1>?2 )ou'! make it a fe'on for an !octor or @9 or insurance com&an to suest the i!ea* 0he reuest )ou'! hae to -e initiate! - the &atient*"
As 'ate as ecem-er 1???, !urin a &resentation at Derke'eSs A'ta Dates e!ica' ?2, &re&are! - Americans for eath )ith init an! !istri-ute! - AronerSs office at her A'ta Dates &resentation state!, "0he &atient must initiate the reuest for me!ication*"
Aroner &ersiste! in misstatin the content of her -i''* @o)eer, her c'aims !i! not o unans)ere!* At each an! eer &resentation, in!ii!ua's )ho ha! carefu'' stu!ie! the &ro&osa' refute! her c'aims an! stresse! her -i''Ss !aner to the communit* 1O
0he stron rassroots o&&osition ha! an im&act* AD 1>?2 !ie! from 'ack of su&&ort* #t )as not -rouht to the f'oor of the Assem-' - the !ea!'ine of
1O
tron Grassroots 9&&osition efeats
22
Januar 71, 2CCC* An!, a'thouh Aroner 'ater sai! she inten!e! to intro!uce another assiste!4suici!
;ro)nbac +ntroduces ;ill to
#,5+NGTON = 6454 enator am Dro)n-ack ester!a intro!uce! the
Assiste! uici!e 5reention Act, )hich )ou'! &rohi-it !octors from &rescri-in fe!era''4contro''e! su-stances for the &ur&ose of &hsician4assiste! suici!e*
+,)en t)e law permits killing as a medical -treatment#. society.s moral guidelines are blurred# and killing could gain acceptance as a solution for t)e c)ronically ill or vulnerable#/ said Brownback! +Doctor0assisted suicide could actually create a financial incentive for insurance companies to encourage prematurely ending t)e lives of t)ose in need of long0term care!/
+ast a Dro)n-ack chaire! a Ju!iciar artic'e in the L*M* me!ica' .ourna' 0he +ancet re&orte! that ha'f of the ne)-orn -a-ies )ho !ie! in K'an!ers, De'ium -et)een Auust 1??? an! Ju' 2CCC )ere +)elped/ in that rear! - their !octors*
Dro)n-ack continue!, +1)e American 2edical Association and disability rig)ts groups are strongly opposed to p)ysician0assisted suicide because it is antit)etical to t)e doctor.s role as a )ealer and it 3eopardi4es t)e ability of t)e infirm and )elpless to defend t)emselves! 5 doubt Americans want t)e government to decide w)en life is wort) preserving and w)en life can be destroyed!/ '6
#n ;acco * Nui'' an! Iashinton * G'ucks-er the u&reme
1P
enator Dro)n-ack8s 9fficia' Ie-site: -ro)n-ack*senate*o*
27
fun!amenta' 'i-ert interest &rotecte! - the
+Once establis)ed t)e rig)t to p)ysician0assisted suicide would create profound danger for many ill persons wit) undiagnosed depression and inade7uately treated pain# for w)ic) p)ysician0assisted suicide rat)er t)an good palliative care could become t)e norm! At greatest risk would be t)ose wit) t)e least access to palliative care8t)e poor# t)e elderly# and members of minority groups!/
D on' &ena'i/in !octors for usin a fe!era''4contro''e! su-stance for the state! or un!is&ute! &ur&ose of assiste! suici!e, an! - &'acin the -ur!en of &roof on the Attorne Genera', the -i'' !oes not constrain !octors from offerin &a''iatie care that -rins &ain re'ief to &atients, een if such treatments cou'! hasten !eath*
Dro)n-ack chairs the Ju!iciar u-committee on the
0he -i'' after the 6oem-er 2CCC e'ection, she has not !one so et*
ouse ,gain ,--roes !ain >elie* !romotion ,ct 2@
Iashinton, < 44 9cto-er 2CCC 44 0he 5ain Be'ief 5romotion Act, &ro4'ife 'eis'ation that )ou'! 'imit the a-i'it of !octors to &rescri-e fe!era''4contro''e! !rus to -e use! in assiste! suici!es, aain c'eare! the @ouse of Be&resentaties* 0he 'eis'ation came in a !ifferent form as &ro4'ife 'ea!ers in the @ouse attache! the -i'' to 'eis'ation concernin ta reform*
0he ictor ma -e short4'ie!, ho)eer, -ecause 5resi!ent <'inton has threatene! to eto the -i'' oer issues unre'ate! to assiste! suici!e*
1?
@ouse Aain A&&roes 5ain Be'ief 5romotion Act3 )))*euthanasia*com
2=
em-ers of
I!en is mu''in his o&tions fo''o)in the @ouse ote, sai! Josh Mar!on, I!en8s chief of staff*
A'' =7 &eo&'e )ho !ie! un!er 9reon8s first4in4the4nation assiste! suici!e 'a) since it took effect in 'ate 1??O use! fe!era''4contro''e! !rus -anne! - the 'eis'ation* aine oters )i'' consi!er 'ea'i/in assiste! suici!e !urin the 6oem-er Oth e'ection*
5ro4'ife @ouse a.orit +ea!er ick Arme (B40W% sai! in a statement that the -i'' ")i'' uarantee that no American suffers the in!init of an aoni/in !eath )hi'e a'so insurin that America !oes not start !o)n the &ath to)ar! euthanasia*"
5ro4'ife en* on 6ick'es (B49M% authore! the 5ain Be'ief 5romotion Act* Arme inserte! it in the ta re'ief -i'', )hich net oes to the enate*
<'inton8s 'etter to Be&u-'ican 'ea!ers threatenin the eto !i! not mention the assiste! ssue* Dut Ihite @ouse s&okesman E''iot iriner sai! 0hurs!a that <'inton has concerns a-out the 'eis'ation an! sai! it shou'! -e consi!ere! on its o)n an! not as &art of a 'arer -i''*
u&&orters sa the -i'' makes it c'ear that aressie &ain treatment is a 'eitimate me!ica' &ractice, een if such treatment increases the risk of !eath* 0he -i'' )ou'! authori/e X> mi''ion in annua' rants for me!ica' schoo's to teach !octors -etter )as to treat &ain*
"0he -i'' has 'o&si!e! su&&ort in -oth houses," sai! ou'as Johnson, 'eis'atie !irector of the 6ationa' Biht to +ife
2>
o to the &resi!ent se&arate' is that I!en )as a-'e to um it u& )ith unre'ate! issues*"
octors )ho !e'i-erate' ai! a &atient8s !eath )ou'! 'ose their 'icense to &rescri-e !rus an! cou'! face a 2C4ear &rison sentence un!er the -i''*
0he American e!ica' Association, the American Aca!em of 5ain anaement an! oer >C other rou&s hae -acke! the 'eis'ation* 0he @ouse has &asse! the 5ain Be'ief 5romotion Act once, on 9cto-er 2O, 1???, - a ote of 2O1 to 1>H* , 5tate o* :haos./
A )ise man once sai!, "on8t -e'iee eerthin ou rea! in the &a&ers*" 0hat is oo! a!ice, es&ecia'' for stories that ino'e assiste! suici!e*
0ake the me!ia8s re&ortin a-out the 'a)suit -et)een the tate of 9reon an! Lnite! tates Attorne Genera' John Ashcroft (Oregon * As)croft %, )hich has enera'' -een a-sma'* Iith re&orters enera'' 'ookin )ith faor u&on 'ea'i/in assiste! suici!e an! &erha&s motiate! - a !esire to sim&'if the com&'e an! &o&u'ari/e arcane issues ino'e! in the 'itiation, me!ia re&orts a'most a')as manae to et the ist of the case utter' )ron*
A c'assic eam&'e of this &henomenon occurre! ear'ier this month* Ihen the e&artment of Justice fi'e! an a&&e''ate -rief in the case (a non ne)s eent%, the Associate! 5ress misre&orte! the stor from the er first sentence, )hich rea!, "0he Dush A!ministration aske! a fe!era' a&&ea's court on!a to strike !o)n 9reon8s assiste! suici!e 'a)*"
6ot on' !i! the Dush a!ministration not ask the fe!era' a&&ea's court to oerturn the 9reon 'a), it has neer aske! an court an)here to strike !o)n 9reon8s 'a)* #n!ee!, een if Ashcroft &reai's in the case, !octors cou'! sti'' assist &atient suici!es un!er state 'a)* oreoer, if !octors &rescri-e! !rus to cause !eath not
2C
A state of
2H
coere! - the
sanction*
o if the case isn8t the 'ea'it of assiste! suici!e in 9reon, )hat is it a-outR 6o, not "states8 rihts" as the me!ia an! assiste!4suici!e a!ocates c'aim, -ut somethin )e !on8t often hear much a-out Y "fe!era' rihts" Y s&ecifica'' the a-i'it of the Lnite! tates oernment to enforce a uniform an! nationa'' consistent stan!ar! oernin the 'eitimate me!ica' use of narcotics reu'ate! un!er the <A*
@ere8s the histor: Ihen 9reon8s assiste!4suici!e4'ea'i/ation statute )ent into effect in 1??O, it soon -ecame c'ear that !octors in the state inten!e! to &rescri-e fe!era'' contro''e! su-stances Y not to treat &atients or &a''iate their &ain as the me!ica' uses of these !rus )ere tra!itiona'' &ermitte! un!er fe!era' 'a) Y -ut to intentiona'' ki''*21
6ot sur&risin', the ru Enforcement A!ministration (EA% reacte! neatie'* 9ne of the &ur&oses for reu'atin !rus contro''e! - the <A is to ensure that their use is 'imite! to 'eitimate me!ica' &ur&oses, )hich has neer heretofore inc'u!e! en!in &atient 'ies - intentiona' &rescri-e! oer!ose* Dut -ecause the )or!in of the reu'ations !o not actua'' mention assiste! suici!e, the EA issue! a reu'ator "inter&retation" informin !octors that &rescri-in fe!era'' reu'ate! su-stances to assist suici!es )ou'! not -e a "'eitimate me!ica' &ur&ose" un!er fe!era' 'a)* (An a!ministratie inter&retation esta-'ishes officia' &o'ic for enforcin oernment reu'ations )hen the )or!s of a &ertinent reu'ation are uns&ecific or aue a-out the matter -ein inter&rete!*%
Dut Attorne Genera' Janet Beno !isaree! )ith the EA* 5u''in rank, )hich )as her riht, she )rote a 'etter to Be&resentatie @enr @!e, ia )hich she issue! a ne) an! !ifferent reu'ator inter&retation* Ln!er Beno8s &o'ic, a !octor )ho &rescri-e! contro''e! su-stances to faci'itate a suici!e in a state that ha! "not authori/e! the &ractice," )ou'! -e su-.ect to fe!era' sanction un!er the <A Y
21
A state of
2O
.ust as the EA ha! state!* @o)eer, Beno &ermitte! states to o&t their !octors out of the enera' fe!era' a&&roach - e&ress' 'ea'i/in assiste! suici!e* 0hus, in effect, Beno permitted eac) state to regulate federal law, meanin that there cou'! -e !ifferent fe!era' reu'ator &o'icies in effect un!er the <A in !ifferent states*
Be'in on Beno8s inter&retation, a han!fu' of 9reon &hsicians -ean to &rescri-e fe!era'' contro''e! su-stances for use in assiste! suici!e* 0hen t)o eents occurre! in 2CC1 that in!uce! the ne) attorne enera', John Ashcroft, to reise Beno8s reu'ator inter&retation* Kirst, in a case c'ear' &ertinent to the case at han!, the L** u&reme
0he
9+<
&erforme!
masterfu'',
&ro!ucin
a
274&ae,
sin'e4s&ace!
memoran!um that etensie' reie)e! the histor an! 'a) of suici!e an! assiste! suici!e* Qes, the re&ort conc'u!e!, "the tates are the primary reu'ators of the &ractice of me!icine," -ut "the are not its ec'usie reu'ators*" ince fe!era' &u-'ic &o'ic an! a'most a'' state 'a)s hae 'on o&&ose! assiste! suici!e, the re&ort o&ine!, &rescri-in fe!era'' contro''e! su-stances to intentiona'' en! 'ife )as not a "'eitimate me!ica' &ur&oseZ for the use of !rus reu'ate! - the <A* (0he 9+< 9&inion has -een &u-'ishe! in fu'' in the &rin 2CC2 5ssues in Law and 2edicine*% 5roin that the Ashcroft a&&roach )ou'! not nu''if the
9reon 'a), the 9+< memo a'so conce!e! that "metho!s of assistin in suici!es
22
A state of
2P
in )hich an 9reon &hsician !oes not !is&ense a contro''e! su-stance entai's no io'ation of the <A*" (Em&hasis )ithin the tet*%
Be'in on Oakland Cannabis Buyers Cooperative an! the 9+< o&inion, Ashcroft !eci!e! that the &ro&er 'ea' course )as to return nationa' uniformit to the fe!era' enforcement of the <A, )hich, after a'', is a federal 'a)* 0o)ar! that en!, he &u-'ishe! an inter&retation in the *ederal :egister , informin !octors that, henceforth, &rescri-in fe!era'' contro''e! su-stances for use in assiste! suici!e cou'! cost them their fe!era' &rii'ee to &rescri-e <A4reu'ate! !rus* oreoer, in 'etters to me!ica' associations, Ashcroft ma!e it c'ear that !octors )ho ha! re'ie! on Beno8s &reious inter&retation )ou'! not face fe!era' sanction for &reious acts of &rescri-in fe!era'' contro''e! su-stances for use in assiste! suici!e* 27
0o the sur&rise of no one, 9reon fi'e! suit* 0he tria' court ru'e! that as a matter of 'a), Ashcroft )as )ron, that the states hae the ec'usie riht to contro' the &ractice of me!icine )ithin their -or!ers* An! since 9reon ha! 'ea'i/e! assiste! suici!e, that !etermination must &reai' oer an fe!era' ie) to the contrar Y een )ith rear! to !eterminin the &ro&er me!ica' uses of fe!era'' contro''e! su-stances* 0his is no sma'' matter* #f the tria'4court ru'in is u&he'! on a&&ea', the &o)er to !etermine )hat constitutes a "'eitimate me!ica' &ur&ose" for the use of fe!era'' contro''e! su-stances )i'' -e stri&&e! from the fe!era' oernment an! han!e! to each of the >C states* uch a resu't cou'! 'ea! to chaos Y at 'east in the me!ica' contet Y since there cou'! -e "% different federal policies )ith rear! to contro''e! su-stances an! assiste! suici!e a&&'in in each
of the >C !ifferent states*
Kor eam&'e, assume the 9reon eath )ith init Act remaine! in effect unchane!, a''o)in assiste! suici!e for termina'' i'' &atients* Assume further that Iashinton tate continue! to out'a) assiste! suici!e a'toether -ut that
27
A state of
2?
a'so for the seere' !isa-'e! an! for the e'!er' )ho are "tire! of 'iin*" #n 9reon, a !octor cou'! 'etha'' &rescri-e for a &atient )ith a termina' i''ness, -ut if she &rescri-e! -ar-iturates in 'etha' !osae for a non4termina'' i'' !isa-'e! &erson, she cou'! face a!erse action from the EA* At the same time, in
6or, it is im&ortant to stress, )ou'! such chaos -e 'imite! to the use of contro''e! su-stances for assiste! suici!e* Kor eam&'e, )hat if a state &asse! a 'a) &ermittin mor&hine to -e use! to create eu&horia as a "treatment" for !e&ression or aniet* #f states tru' hae the un'imite! riht to im&ose their ie) on the fe!era' oernment as to )hat constitutes a 'eitimate me!ica' use of fe!era'' contro''e! su-stances, the fe!era' oernment )ou'! -e -oun! to res&ect een the most i!iosncratic &o'ic* 0he resu't cou'! -e the utter !isinteration of the <A an! a tota' fracturin of nationa' !ru &o'ic* 2=
Oregon * As)croft is one of the most im&ortant &u-'ic4&o'ic cases in recent
ears* #t isn8t in the 'east a-out the 'ea'it of assiste! suici!e in 9reon* #t isn8t a fiht oer "states8 rihts*" Bather, the u'timate ru'in in this case )i'' !etermine )hether the courts )i'' im&ose u&on the nation John
2=
,55+5TE 56+:+E &,#5 5T,TE ;? 5T,TE
A state of
2>
Associate! 5ress* 5roi!e! - #nfo net +ist is a !ai' com&i'ation of &ro4'ife ne)s an! e!ucationa' information*
7C
A'aska, Ari/ona, Arkansas,
6#6E states crimina'i/e assiste! suici!e throuh common 'a): A'a-ama, #!aho, ar'an!, assachusetts, ichian, 6ea!a, outh
0@BEE states hae a-o'ishe! the common 'a) of crimes an! !o not hae statutes crimina'i/in assiste! suici!e:
6orth
#n ;irinia, there is no rea' c'ear case 'a) on assiste! suici!e, nor is there is a statute crimina'i/in the act, a'thouh there is a statute )hich im&oses cii' sanctions on &ersons assistin in a suici!e*
2H
9n' 9reon &ermits &hsician4 assiste! suici!e*
Een )here itAs legal0 la)s ary )idely
A 'ook at 'a)s oernin euthanasia throuhout the )or'!:
OregonB 0he 9reon eath )ith init Act (9A% &asse! in 1??=, a&&'ies
on' to &eo&'e )ho hae reache! the ae of ma.orit ('ea' ae% an! hae -een !ianose! as -ein termina'' i''* #t offers the successfu' a&&'icant assiste! 2H
LA to!a*com )e-site
71
suici!e3 a !octor ies the &atient a &rescri&tion for a fata' !ose of -ar-iturates that the &atient can take* 0he 'a) is -ein reie)e! - the L** u&reme
NetherlandsB #n 2CC2, the oernment 'ea'i/e! assiste! suici!e an! euthanasia
(the !octor a!ministers a fata' in.ection of !rus%* 0he 'a) is not 'imite! to a!u'ts, nor !oes an a&&'icant for euthanasia hae to -e termina'' i''* 0he main -asis for a reuest is ho&e'ess an! un-eara-'e sufferin, rear!'ess of 'ife e&ectanc*
A'' cases are reie)e! - me!ica' committees, an! instances of sus&ecte! )ron!oin are referre! to .u!icia' inestiators* 0he utch oernment is reie)in a &rotoco' to a''o) euthanasia, )ith &arenta' consent, for infants -orn )ith termina' an! &ainfu' i''nesses*
5)itzerlandB Artic'e 11> of the )iss 5ena'
suici!e for honora-'e moties, such as to he'& -rin an en! to sufferin* )it/er'an! a'so a''o)s o'untar orani/ations to he'& &eo&'e, inc'u!in foreiners, en! their 'ies* Ihere 'etha' me!ication is reuire!, a !octor8s &rescri&tion is o-taine!* A'' acts of assiste! suici!e are re&orte! to the &o'ice an! inestiate!*
;elgiumB 0he De'ian Act on Euthanasia, &asse! in 2CC2, !efines euthanasia as
"intentiona'' terminatin 'ife - someone other than the &erson concerne! at the 'atter8s reuest*" Assiste! suici!e remains i''ea'* Beuirements inc'u!e that the &atient shou'! hae attaine! the ae of ma.orit, )hich the reuest -e "o'untar, )e''4consi!ere! an! re&eate!" an! the &atient -e "in a futi'e me!ica' con!ition of constant an! un-eara-'e &hsica' or menta' sufferin that cannot -e a''eiate!*" A'' acts of euthanasia must -e re&orte! to the authorities*
;ritainB A -i'' )as intro!uce! this month in the @ouse of +or!s that )ou'! a''o)
a com&etent an! termina'' i'' &erson )ho has reache! the ae of ma.orit an! is sufferin un-eara-' to reuest either assiste! suici!e or o'untar euthanasia* #t sets reuirements inc'u!in an assessment - an atten!in &hsician that the
72
&atient is 'ike' to !ie of natura' causes )ithin a fe) months, that the &atient is com&etent to make the reuest an! that he or she is sufferin un-eara-'* 0he &atient must sin a )ritten !ec'aration of intent* #f this has not -een reoke! )ithin 1= !as of the !ate on )hich the reuest )as first ma!e, the &atients can receie the means to take his or her o)n 'ife or, if the &atient is &hsica'' una-'e to !o that, hae his or her 'ife en!e! throuh o'untar euthanasia* A me!ica' committee )ou'! reie) a'' cases* 2O
;ritish
ethicist
calls
*or
legalizing
nonconsensual
euthanasia
JLB#0$ A &rominent Dritish me!ica' ethicist is a!ocatin the 'ea'i/ation of euthanasia, inc'u!in for &atients inca&a-'e of consent* +en oa' <;, 5K$, emeritus &rofessor of me!ica' ethics at Nueen ar, Lniersit of +on!on, )rites in this month8s issue of Clinical Et)ics .ourna' )e-site$ that &hsicians cause some &atients to suffer a "s'o) an! !istressin !eath" - )ith!ra)in fee!in tu-es*
oa' su&&orts the Assiste! in for the 0ermina'' #'' Di'' tet$, )hich is sta''e! in 5ar'iament, een thouh it )ou'! not a''o) nonconsensua' euthanasia* 0he -i'', )hich Annetts he'&e! to !raft usin 9reon8s eath )ith init Act tet, 5K$ as a mo!e', )ou'! &ermit assiste! suici!e for &atients )ith 'ess than si months to 'ie )ho are e&eriencin "etreme sufferin* 0he 'eis'ation )as ta-'e! for si months JLB#0 re&ort$ - the @ouse of +or!s officia' )e-site$ in 2O
.urist 'ea' ne)s research )e-site
77
a after t)o &hsicians rou&s came out aainst it JLB#0 re&ort$* 0he Dritish e!ica' Association orani/ation )e-site$ !ro&&e! its o&&osition to the -i'', instea! takin a neutra' stance* 0he &uardian has more* DD< 6e)s has a!!itiona' coerae*
2P
0erri
chiao:
Ju!icia'
ur!er
@er crime )as -ein !isa-'e!, oice'ess, an! at the !is&osa' of our me!ia -
6at
@entoff
arch 2?th, 2CC> 1C:>? A Kor a'' the )or'! to see, a =14ear4o'! )oman, )ho has committe! no crime, )i'' !ie of !eh!ration an! staration in the 'onest &u-'ic eecution in American histor*
he is not -rain4!ea! or comatose, an! -reathes natura'' on her o)n* A'thouh -rain4!amae!, she is not in a &ersistent eetatie state, accor!in to an increasin num-er of ra!io'oists an! neuro'oists*
Amon man other io'ations of her !ue &rocess rihts, 0erri chiao has neer -een a''o)e! - the &rimar .u!e in her caseYK'ori!a
Greer has !ec'are! 0erri chiao to -e in a &ersistent eetatie state, -ut he has neer one to see her* @is eesiht is er &oor, -ut sure' he cou'! hae isite! her a'on )ith another mem-er of his staff* Ln'ike &eo&'e in a &ersistent eetatie state, 0erri chiao is in!ee! res&onsie -eon! mere ref'ees*
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Ihi'e 'a)ers an! .u!es hae enae! in a minuet of !eath, the American
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+i-erties Lnion, )hich )ou'! -e &assionate' critici/in state court !ecisions an! !eman!in !ue &rocess if 0erri )ere a conict on !eath ro), has shamefu'' sere! as co4counse' for her hus-an!, ichae' chiao, in his insistent !esire to hae her !ie*
onths ao, in !iscussin this case )ith A<+L eecutie !irector Anthon Bomero, an! 'ater rea!in A<+L statements, # sa) no sin that this -astion of the Di'' of Bihts has eer eamine! the facts concernin the ereious conf'icts of interest of her hus-an! an! uar!ian ichae' chiao, )ho has -een 'iin )ith another )oman for ears, )ith )hom he has t)o chi'!ren, an! has io'ate! a 'on 'ist of his 'ea' res&onsi-i'ities as her uar!ian, some of them !irect' &reentin her chances for im&roement* Ju!e Greer has inore! a'' of them*
#n Ke-ruar, K'ori!a8s e&artment of
ichae' chiao, )ho sas he 'oes an! continues to -e !eote! to 0erri, has &roi!e! no thera& or reha-i'itation for his )ife (the 'ea' one% since 1??7* @e !i! hae her teste! for a time, -ut sto&&e! a'' testin in 1??7* @e insists she once to'! him she !i!n8t )ant to surie - artificia' means, -ut he !i!n8t mention her a''ee! )ishes for ears after her -rain !amae, )hi'e sain he )ou'! care for her for the rest of his 'ife*
0erri chiao has neer ha! an B# or a 5E0 scan, or a thorouh neuro'oica' eamination* Be&u-'ican enate 'ea!er Di'' Krist, a s&ecia'ist in heart4'un trans&'ant surer, has, as 0he 6e) Qork 0imes re&orte! on arch 27, "certifie! in his
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&ractice$ that &atients )ere -rain !ea! so that their orans cou'! -e trans&'ante!*" @e is not .ust "&'ain !octor" on this case*
urin a s&eech on the enate f'oor on arch 1O, Krist, s&eakin of Ju!e Greer8s !enia' of a reuest for ne) testin an! eaminations of 0erri, sai! reasona-', "# )ou'! think ou )ou'! )ant a com&'ete neuro'oica' eam" -efore !eterminin she must !ie*
Krist a!!e!: "0he attornes for 0erri8s &arents hae su-mitte! 77 affi!aits from !octors an! other me!ica' &rofessiona's, a'' of )hom sa that 0erri shou'! -e re4 ea'uate!*"
#n !eath &ena't cases, !efense counse's for retar!e! an! other)ise menta'' !isa-'e! c'ients su-mit etensie me!ica' tests* #norin the a-sence of com&'ete neuro'oica' eams, su&&orters of the !ea!' !ecisions - Ju!e Greer an! the trai' of a&&e''ate .urists kee& remin!in us ho) etensie the 'itiation in this case has -eenY1? .u!es in si courts is the mantra* An! more hae -een a!!e!* o too in man !eath &ena't cases, -ut increasin', c'ose to eecution, inmates hae -een sae! - 6A* 7C
As ai! Gi--s, the 'a)er for 0erri8s &arents, has &ointe! out, there has -een a manifest nee! for a ne) fe!era', Kourteenth Amen!ment reie) of the case -ecause 0erri8s !eath sentence has -een -ase! on seen ears of "fata'' f'a)e!" state court fin!insYa'' -ase! on the ininci-'e ne'ect of e'ementar !ue &rocess - Ju!e Geore Greer*
# )i'' -e returnin to the 'eac of 0erri chiao in the )eeks ahea! -ecause there )i'' certain' -e 'on4term reer-erations from this case an! its fracturin of the ru'e of 'a) in 7C
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the K'ori!a courts an! then the fe!era' courtsYas )e'' as the !isracefu'' inorant coerae of the case - the reat ma.orit of the me!ia, inc'u!in such &i''ars of the tra!e as 0he 6e) Qork 0imes, 0he Iashinton 5ost, 0he iami @era'!, an! the +os Ane'es 0imes as the co&ie! each other8s misinformation, 'ike 0erri chiao -ein "in a &ersistent eetatie state*"
o ou kno) that near' eer ma.or !isa-i'it rihts orani/ation in the countr has fi'e! a 'ea' -rief in su&&ort of 0erri8s riht to 'ieR
Dut -efore # o -ack to other +i-ert DeatsYthe <#A8s torture ren!itions an! the )hite)ashin of the 'an!mark A<+L an! @uman Bihts Kirst8s 'a)suit aainst ona'! Bumsfe'! for his accounta-i'it in the )i!es&rea! a-use of !etainees, inc'u!in ei!ence of tortureY# must correct the me!ia an! arious "ua'ifie! e&erts" on ho) a &erson !ies of !eh!ration if he or she is sentient, as 0erri chiao !emonstra-' is* 71
9n arch 1>8s 6iht'ine, in an a&&a''in' one4si!e!, !istorte! account of the chiao case, 0erri8s hus-an!, ichae'Y)ho8! 'ike to marr the )oman he8s no) 'iin )ithYsai! that once 0erri8s fee!in tu-e is remoe! at his insistent comman!, 0erri ")i'' !rift off into a nice 'itt'e s'ee& an! eentua'' &ass on an! -e )ith Go!*"
As an atheist, # cannot s&eak to )hat he !escri-es as his a-an!one! )ife8s u'timate !estination, -ut # can te'' ho) Ies'e mith (consu'tant to the
#n his -ook Korce! Eit (0imes Dooks%, Ies'e uotes neuro'oist Ii''iam Durke: "A conscious &erson )ou'! fee' it !eh!ration$ .ust as ou an! # )ou'!* * * * 0heir skin cracks, their tonue cracks, their 'i&s crack* 0he ma hae nose-'ee!s -ecause of the !rin of the mucous mem-ranes, an! heain an! omitin miht ensue
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-ecause of the !rin out of the stomach 'inin*
"0he fee' the &ans of huner an! thirst* #maine oin one !a )ithout a 'ass of )ater[ * * * #t is an etreme' aoni/in !eath*"
9n arch 27, outsi!e the hos&ice )here 0erri chiao )as ro)in stea!i' )eaker, her mother, ar, sai! to the courts an! to anone )ho )ou'! 'isten an! ma-e someho) sae her !auhter:
"5'ease sto& this crue't["
Ihi'e this crue't )as oin on in the hos&ice, ichae' chiao8s ser&entine 'a)er, Geore Ke'os, sai! to one an! a'': "0erri is sta-'e, &eacefu', an! ca'm* * * * he 'ooke! -eautifu'*"
urin the arch 21 hearin -efore Ke!era' Ju!e James * Ihittemore, )ho )as soon to -e another accom&'ice in the !eh!ration of 0erri, the re'ent'ess r* Ke'os, antici&atin the en! of the !eath)atch, sai! to the .u!e:
"Qes, 'ife is sacre!, -ut so is 'i-ert, our honor, es&ecia'' in this countr*"
#t )ou'! -e use'ess, -ut nonethe'ess, # )ou'! 'ike to inform Geore Ke'os that, as u&reme
"As to 'ea' concerns," )rites Ii''iam An!ersonYa senior &schiatrist at assachusetts Genera' @os&ita' an! a 'ecturer at @arar! LniersitY"a uar!ian ma refuse an me!ica' treatment, -ut !rinkin )ater is not such a &roce!ure* #t is not )ithin the &o)er of a uar!ian to )ithho'!, an! not in the &o)er of a rationa'
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court to &rohi-it*" 72
Ba'&h 6a!er arees* #n a statement on arch 2=, he an! Ies'e mith (author of, amon other -ooks,
"#f this )ere a !eath &ena't case, this ei!ence )ou'! !eman! reconsi!eration* Qet, an innocent, !isa-'e! )oman is receiin 'ess .ustice* * * * 0his case is rife )ith !ou-t* Justice !eman!s that 0erri -e &ermitte! to 'ie*" (Em&hasis a!!e!*%
Dut the &o''s aroun! the countr crie! out that a consi!era-'e ma.orit of Americans )ante! her to !ie )ithout
A arch 2C AD< &o'' sho)e! that HC &ercent of the >C1 a!u'ts consu'te! o&&ose! the u'timate' unsuccessfu' fe!era' 'eis'ation, an! on' 7> &ercent a&&roe!* oreoer, OC &ercent fe't stron' that it )as )ron for
Dut, as
"0he &o'' uestions$ sa she8s 8on 'ife su&&ort,8 )hich is not true since a'' she nee!s is )ater$, an! that she has 8no consciousness,8 )hich her fami' an! !o/ens of !octors !is&ute in s)orn affi!aits*"
an rea!ers of this co'umn are &ro4choice, &ro4a-ortion rihts* Dut )hat choice !i! 0erri chiao hae un!er our aunte! ru'e of 'a)Y)hich the &resi!ent is eaer'
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trin to e&ort to the rest of the )or'!R he ha! not 'eft a 'iin )i'' or a !ura-'e &o)er of attorne, an! so cou'! not s&eak for herse'f* Dut the American sstem of .ustice )ou'! not s'ake her thirst as she, on te'eision, )as !in in front of us a''*
Ihat kin! of a nation are )e -ecominR 0he <#A outsources tortureYin io'ation of American an! internationa' 'a)Yin the name of the free!oms )e are fihtin to &rotect aainst terrorism* An! )e hae )atche! as this )oman, )hose on' crime is that she is !isa-'e!, is torture! to !eath - .u!es, a'' the )a to the u&reme
An! kee& in min! from the Ba'&h 6a!er4Ies'e mith re&ort: "0he courts * * * hae a'so$ or!ere! that no attem&ts -e ma!e to &roi!e her )ater or foo! - mouth* 0erri s)a''o)s her o)n sa'ia* &oon fee!in is not me!ica' treatment* 0his outraeous or!er &roes that the courts are not mere' &ermittin me!ica' treatment to -e )ithhe'!, the hae or!ere! her to -e ma!e !ea!*"
#n this countr, een con!emne! seria' ki''ers are not eecute! in this )a* 77 Artic'e
#as the ,uto-sy the
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iana
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#n the min!s of man Americans, the resu'ts of the auto&s &erforme! on 0erri chiao sere! as the fina' )or! on the !e-ate oer )hether the =14ear4o'! -rain4!amae! K'ori!a )oman shou'! hae -een !eh!rate! to !eath &er court or!er* 6e)s out'ets across the -oar! !e'iere! the resu'ts re'ease! June 1> to their au!iences as "in!ication" for ichae' chiao for hain fouht seen 'on ears in court for the riht to remoe his )ife8s fee!in tu-e an! en! her 'ife* At the same time, .ourna'ists i'ifie! the chin!'ers, 0erri8s &arents an! si-'ins, for hain o&&ose! him* "En! of stor," man sa, )hi'e others -e to !iffer*
0he -o! of 0erri chiao )as )hiske! to the coroner8s office on arch 71 )ithin hours of her succum-in to 17 !as )ith neither f'ui!s nor foo! after 5ine''as
6ear' 11 )eeks 'ater, 5ine''as45asco
0homartin cou'!n8t &roi!e an ans)er for the XH=,CCC !o''ar uestion, a'thouh the me!ia )ere 'are' &ersua!e! he ha! an! arious' re&orte! the auto&s "-acke! chiao" in his 'ontime assertion that his )ife )as in a &ersistent eetatie state, or 5;*
0homartin an! consu'tin neuro&atho'oist r* te&hen 6e'son stresse! in the auto&s re&ort that 5; is a c'inica' !ianosis ma!e throuh &hsica' eamination of a 'iin &atient not a &atho'oica' !ianosis ma!e &ostmortem* ti'', 6e'son re&orte! that &atho'oica' an! anatomica' fin!ins, such as her shrunken -rain an!
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!i'ate! entric'es, )ere "consistent" )ith the 5; !ianosis reache! in the court* @e &ointe! out that 0erri8s -rain )eihe! H1> rams, )hich is 'ess than ha'f of the e&ecte! )eiht for an a!u't her ae* @e a'so &ointe! out 0erri8s -rain )eihe! 'ess than her famous eetatie &re!ecessor Maren Ann Nuin'an*
0homartin conce!e! it is unkno)n ho) much the 'on !uration of !eh!ration contri-ute! to the shrinkae of 0erri chiao8s -rain*
At the &ress conference he'! to announce the auto&s fin!ins, 6e'son )ent further in 'en!in su&&ort for the court8s !ianosis of 5;* @e em&hasi/e! the &atho'oica' fin!ins )ere "er consistent" )ith 5;, -ut a!mitte! he cou'! not ru'e out the &ossi-i'it 0erri chiao )as in a minima'' conscious state, or <, -ecause there are no &u-'ishe! stu!ies on &atho'oica' corre'ations to the c'inica' !ianosis of <*
5eo&'e Iho Attem&t uici!e 9n' 9nce6;
an &eo&'e )ho attem&t suici!e are sto&&e! - others* an then seek counse'in an! o on to 'ea! ha&&ier an! -etter 'ies* #f the ha! -een "assiste!" in their attem&ts the )ou'! neer hae ha! that chance* @ere are the resu'ts of a cou&'e of stu!ies:
9ne stu! of PPH &eo&'e )ho )ere rescue! from attem&te! suici!es foun! that fie ears 'ater on' 7*P= &ercent ha! one on to ki'' themse'es*
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2.; Government res*onse5 $udicial res*onse
6o) this !a in #n!ia euthanasia is not 'ea'* #f it -ecomes 'ea' then )hat ha&&ens -e'o) artic'e sa some thin a-out it*
5* 2E:C; <5LL5& BECO2ES LE&AL
an &eo&'e su&&ort the riht of a termina'' i'' &atient to !ie 4 -ut )hat if the riht -ecomes an o-'iationRRR An! )hat of the &otentia' for a-use - im&atient heirsRRR
hou'! !in &atients hae the riht to or!er their !octors not to start or continue me!ica' treatmentR hou'! !octors -e &rotecte! from &rosecution if the shorten a &atient8s 'ife e&ectanc )ith &ain4ki''in !rusR
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ost of us )ou'! ans)er es to -oth uestions* Dut !oes this mean )e nee! a "riht to !ie" 'a)R 9r is there more to the issue than first meets the eeR
5u-'ic !iscussion of the treatment of !in &atients often confuses t)o se&arate issues* Kirst, is the riht of the termina'' i'' &erson to -e a''o)e! to !ie )ithout -ein su-.ecte! to inasie me!ica' &roce!uresR econ!, is the uestion of )hether a !in &erson shou'! a'so hae the riht to hasten his or her o)n !eath, an! reuire the he'& of !octors an! nurses to !o so*
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#t is often oer'ooke! that &atients hae the common 'a) riht to refuse an me!ica' treatment* A !octor )ho treats a &atient aainst his or her e&ress )ishes can -e chare! )ith assau't* #t )ou'! -e )ise to e!ucate &eo&'e as to their riht to refuse treatment* 0here is no nee! to conert this )e'' esta-'ishe! 'ea' &rinci&'e into 'eis'ation*
Bear!'ess of the intention of "riht to !ie" or "ai! in !in" 'a)s, the cou'! er easi' o&en the !oor to actie euthanasia*
#n the &resent c'imate of o&inion, it is eas to imaine a !octor iin a 'etha' !ose of &ain4ki''in !ru an! then c'aimin that !eath )as the -est )a to e'iminate &hsica' sufferin* #f the !octor cou'! a'so sho) that the &atient ha! reueste! the 'etha' !osae, the court miht )e'' inter&ret the 'a) in the !octor8s faor*
an !o not fin! the &ros&ect of 'ea' o'untar actie euthanasia in an )a a'armin* Dut t)o thins shou'! ie us &ause*
Kirst, as a soon4to4-e4&u-'ishe!
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reconi/e that if &ain is contro''e!, as it can -e in irtua'' a'' cases, er fe) termina'' i'' &eo&'e ask to -e &ut to !eath* econ!, e&erience in @o''an! te''s us that o'untar Euthanasia can uick' -ecome ino'untar euthanasia*
D91CH E>=E:5ECE ,51H E91HAAS5A3%
@o''an! is )i!e' rear!e! as one of the )or'!8s most cii'i/e! countries* Actie euthanasia is 'ea' there, -ut for the &ast !eca!e the oernment has not &rosecute! !octors )ho re&ort hain assiste! their &atients to commit suici!e*
A recent utch oernment inestiation of euthanasia has come u& )ith some !istur-in fin!ins* #n 1??C, 1,C7C utch &atients )ere ki''e! I#0@9L0 0@E#B <96E60* An! of 22,>CC !eaths !ue to )ith!ra)a' of 'ife su&&ort, H7V (1=,1O> &atients% )ere !enie! me!ica' treatment I#0@9L0 0@E#B <96E60* 0)e'e &er4cent (1,OC1 &atients% )ere menta'' com&etent -ut )ere 690 <96L+0E*
0hese fin!ins )ere )i!e' &u-'ici/e! -efore the 6oem-er 1??1 referen!um in Iashinton tate an! contri-ute! to the !efeat of the &ro&osition to 'ea'i/e 'etha' in.ections an! assiste! suici!e*
0he utch e&erience seems to !emonstrate that the "riht to !ie" can soon turn into an o-'iation* 0his conce&t is !anerous, an! ou cou'! fin! ourse'f the ictim if Euthanasia -ecomes 'ea' in 6orth America*
Ie hae a'' hear! an! some of us hae e&erience!, moin stories of e'!er' &eo&'e in reat &ain, una-'e to &erform een the most -asic human functions, )ho hae aske! to !ie, or hae &erha&s -rouht a-out their o)n !eaths*
Ihat these stories oer'ook is that to!a, in a'most a'' cases, it is &ossi-'e to ki'' &ain )ithout ki''in the &atient* Ihen someone8s &ain is re'iee! that &erson usua'' )ants to o on 'iin* Ie nee! to ref'ect carefu'' on the conseuences of 'ea'i/in actie euthanasia* #f )e enshrine the a-so'ute riht to !ie, )i'' it then
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-ecome i''ea' to interene to o-struct )ou'!4-e suici!eR Ii'' &harmacists -e o-'iate! to se'' a 'etha' !ose of hem'ock to anone )ho is tem&orari' !e&resse!R
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Ie nee! to think of the &otentia' for a-use if merc ki''in -ecomes 'ea'* Ihat if someone stan!s to inherit one mi''ion !o''ars )hen Aunt G'a!s !iesR iht the heir not fin! it tem&tin to nu!e her in the !irection of acce&tin a 'etha' in.ectionR 9r, if she !i!n8t et the hint, to make her misera-'e enouh to )ant itR
#f o'untar euthanasia is ma!e 'ea' for "&ersons of soun! min!" there )i'' ineita-' -e tremen!ous &ressure to &roi!e it for those )ho ")ou'! reuest it if the )ere a-'e to" 4 the menta'' i'' or han!ica&&e!, the seni'e, etc* 7O
Kina'', !es&ite enuine com&assion for the sufferin of !in &eo&'e, !oes there not a'so 'urk in man hearts a 'ess a!mira-'e motieR Ke) &eo&'e are so taste'ess as to 'ink euthanasia an! hea'th care costs in the same -reath, -ut there is a )i!es&rea! fe) that me!ica' care for the e'!er' costs more than )e can affor!* 0hese financia' &ressures )i'' mu'ti&' in the comin ears as our &o&u'ation aes*
an e'!er' &eo&'e are a'rea! res&on!in to this not4so4su-t'e messae - !ec'arin their )i''inness to !ie )hen their 'ies are no 'oner &ro!uctie* 0heir re'uctance to -e a financia' -ur!en on the oun is a!mira-'e, -ut the 'on term conseuences cou'! -e -ruta'*
Ihat )i'' ha&&en to the trust that &eo&'e sti'' fee' to)ar! their !octors if our countr fo''o)s @o''an!R Ihat emotion )i'' e'!er' or serious' i'' &atients fee' )hen the nurse a&&roaches them )ith a fu'' srineR @o) soun!' )i'' the s'ee& in the hos&ita'R
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0he a'ternatie to 'ea'i/e! euthanasia is not etraor!inar, futi'e treatment to ho&e'ess' !in &atients* 0he a'ternaties are a&&ro&riate me!ica' care 4 inc'u!in 1% the )ith!ra)a' of treatment u&on &atient reuest, or if that treatment seres no thera&eutic &ur&ose3 an! 2% !is&ensin !rus as necessar to contro' &ain* 6o !octors, 'a)s, or orani/ations o&&ose ceasin care )hen the time to !ie has arrie!*
,HA1 CA 5 DO@
Each of us shou'! ta'k to our 'oe! ones o&en' a-out these su-.ects* 0a'k to ur !octor, an! if ou are not comforta-'e )ith his or her a&&roach, chane !octors* Kin! out a-out &a''iatie care an! @os&ice &rorams in our communit* 0hese em&hasi/e care an! comfort for the !in* u&&ort their ro)th, as this )i'' re!uce the attractieness of 'ea'i/e! euthanasia* Mee& informe! a-out the issue of euthanasia an! make our ie)s kno)n to &o'iticians an! the me!ia* Qour actions can he'& sha&e the )a ou an! our 'oe! ones )i'' -e treate! in our 'ast !as* 7P
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0he con!ition of the &atient*
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0he chi'! )ith his foo! )ith &oison*
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&hotora&hs of the euthanasia &atients3 )))*euthanasia*com
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.% collection of data for this research wor4 to collect the data we have ta4e the visit of different *ersons li4e- doctors /lawyers/ *olice/ teacher/ and also try to cover the o*inion of common *eo*le.in this *art of activity we have ta4e 2 o*inions. The data analyses of the data are as under. .6 Analyses of the data 2. Is 0uthanasia good for ill *atients 6.+onJt you thin4 that 4ee*ing alive the terminally ill *atient/ whose chances of recovery not *ossi"le/ multi*lying his sufferings
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