Is There a Constitutional Right to Physician-Assisted Suicide?

A loved one with a terminal illness may wish to end their suffering through physician-assisted suicide. But the United States Constitution does not provide the right to physician-assisted suicide. The statutes and case law on whether doctors can administer treatment to assist with ending a life, often referred to as the "right to die" or "death with dignity," laws vary from state to state.

A growing list of states have enacted laws granting the right to die. These states have determined that the right to die is central to an individual's right to personal autonomy and bodily integrity. This should not be confused with euthanasia. Euthanasia is when another individual takes the patient's life. Physician-assisted suicide legally requires the terminally ill person to self-administer the drugs that end their life.

The Right to Refuse Medical Treatment

The U.S. Constitution guarantees many of the individual rights of citizens and legal residents. These rights include free speech, religion, and due process. Under the Fourteenth Amendment's due process clause, a U.S. citizen cannot lose their life, liberty, or property without notice and the opportunity to be heard.

In a famous court decision, Cruzan v. Director, Missouri Department of Health, the United States Supreme Court established that patients have a liberty interest in refusing medical treatment. Even if that refusal would lead to the patient's death. But in a later case, the Supreme Court held in Washington v. Glucksberg that the due process clause does not allow medical intervention to assist terminally ill patients to end their lives.

One of the best ways to clarify your wishes on end-of-life decisions and medical care is to spell it out in a living will or advance directive. Justice Sandra Day O'Connor emphasized the importance of written advance directives in a concurring opinion in Cruzan. Advance directives inform the medical staff about whether you want life-sustaining treatment or palliative care at the end of your life. An extra step you may take is to appoint a trusted person to be your decision-maker through a durable power of attorney for health care.

The Right to Die: A Brief Legal History

Physician-assisted suicide laws and lower court battles are steeped in politics, public health, and religious arguments. The U.S. Supreme Court has declined to rule that the right to die is a fundamental right under the Constitution. But it stopped short of declaring the practice illegal. This makes it a state issue.

In 1997, the Supreme Court issued two decisions on the same day on the right to die:  Washington v. Glucksberg, and Vacco v. Quill. The two cases ruled that both a Washington state law and a New York state law banning assisted suicide did not violate the Due Process or Equal Protection Clauses. The decisions were both written by Chief Justice William Rehnquist. They overturned federal courts of appeals holdings from Washington and New York.

The Court held that the government's interest in protecting life and preventing intentional killing outweighed the patient's interest in the liberty to choose to die. But the Court ruled that refusing life-saving medical aid, including nutrition and hydration, differs from asking a physician to end a patient's life. The rulings gave the green light for states to determine the legality of physician-assisted suicide and the right to die.

State Death-With-Dignity Laws: Overview

A growing number of states have enacted laws that protect a patient's right to die. In those states, doctors may provide lethal doses of certain drugs at the request of their patients. But patients control the act of administering those doses. Most state right-to-die laws require the patient to ask their doctor several times before a doctor can prescribe lethal drugs. They also require patients to have six or fewer months to live, among other regulations.

In 1997, Oregon enacted the Oregon Death with Dignity Act, the first in the United States. Soon after, former Attorney General Alberto Gonzales filed a lawsuit. Gonzales argued that the federal Controlled Substances Act prohibited physicians from prescribing controlled substances that would assist with hastening the death of terminally ill patients. The Supreme Court sided with Oregon.

Below are a few examples of states with physician-assisted suicide laws on the books:

• Oregon — Voters passed the Oregon Death with Dignity Act in 1997. The Act requires two oral and one written doctor's request.
• Montana — In 2009, the Montana Supreme Court expanded the state's existing Rights of the Terminally Ill Act. The expansion includes physician-assisted suicide. Montana still lacks a regulatory framework for the Act.​
• Vermont — Vermont passed the Patient Choice and Control at End of Life Act in 2013. The Act is like right-to-die laws in other states.

Need Help with End-of-Life Matters? An Attorney Can Help

As the saying goes, death and taxes are the only sure things in life. If a loved one has a terminal illness with no chance for recovery, you may want to help them explore ways to end their life on their own terms. While the right to die is not the law in most states, a few options may be available to accomplish one's end-of-life wishes. Get help with your end-of-life concerns by consulting with a healthcare attorney near you.