Watching a loved one suffer through an agonizing illness or medical condition can be very difficult, especially when it's terminal. But when all hope is lost and the patient no longer has the will to live, does she have the right to end her life? It depends. Federal law doesn't specifically protect the act of mercy killing or euthanasia, nor does it prohibit the practice altogether. Instead, the right to assisted suicide (also sometimes known as 'death with dignity') is established by state law.
The vast majority of states do not allow patients to end their lives, either on their own or through the aid of a doctor. However, in 1990 the U.S. Supreme Court did rule that patients or their designated health care agents may refuse life-preserving medical treatment, including feeding tubes. A health care agent is an individual named by the patient to make health care decisions on their behalf, usually through a durable power of attorney. Health care agents typically follow a patient's wishes laid out in a living will or "do not resuscitate" form.
So while all states allow patients to withhold treatment, only a few states allow doctors to take an active role in assisting a patient's death. Most of these laws require the patient to:
If a patient is unable to make this request orally, they may do so through their health care agent.
The following is a breakdown of the states that allow assisted suicide or 'death with dignity':
Gov. Jerry Brown signed the End of Life Option Act into law in 2015, allowing physicians to prescribe lethal drugs to certain terminally ill patients. The law is modeled after similar laws in Oregon, Washington, and Vermont. Patients who are expected to die within the next six months, provide informed consent, have a medically confirmed diagnosis, and who request assistance three times may obtain a prescription for lethal drugs.
The Montana Supreme Court issued a ruling in late 2009 that broadened the state's Rights of the Terminally Ill Act to include physician-assisted suicide. However, Montana statute does not provide a regulatory framework for doctor-assisted suicide. Instead, the ruling shields doctors from prosecution as long as they have the patient's request in writing. Several attempts to pass euthanasia-related bills, which would establish rules and procedures for assisted suicide, were made since the ruling, but none have passed.
Although New Mexico's statutes continue to list assisted suicide as a fourth-degree felony, the practice was made legal through the courts in early 2014. The 2nd District Court in Albuquerque ruled that New Mexico doctors may legally prescribe lethal drugs to assist terminally ill people with suicide. The state's attorney general declined to challenge the ruling, letting it stand. As with Montana, the ruling provides a defense for doctors who help eligible patients die but doesn't provide a regulatory framework.
Note: The New Mexico Court of Appeals ruled against the 2014 decision that legalized physician-assisted suicide in September of 2015. The practice is now illegal in the state, but a challenge in the New Mexico Supreme Court is likely.
Oregon voters passed the Death with Dignity Act in 1994 with 51 percent of the vote, which allows terminally ill patients to obtain a prescription for lethal drugs. A ballot measure attempting to repeal the law lost (with 60 percent of voters opposed) in 1997, and was upheld by the U.S. Supreme Court in 2006. To be eligible, patients must wait 15 days after making an oral request to a doctor, and then make another oral and written request, followed by a 48-hour waiting period before medications are made available.
Vermont lawmakers passed the Patient Choice and Control at End of Life Act in 2013. The law protects doctors who follow the steps outlined in the Act from liability. Doctors are then able to prescribe lethal drugs to terminally ill patients. The state also requires patients to make two separate oral requests -- plus one in writing -- separated by a 15-day waiting period before doctors are allowed to prescribe lethal drugs. The initial diagnosis must be certified by a consulting physician and the patient must be of sound mind.
Voters approved the Washington Death with Dignity Act in 2008 with 58 percent of the vote. The law permits eligible patients with a terminal illness to request lethal drugs to end their lives. Individual hospitals may prohibit participation in euthanasia, but must clearly state their policy. Washington law is very similar to assisted suicide laws in Oregon and Vermont. The statute requires a series of requests and waiting periods, while requiring the patient to be of sound mind and capable of clear communication.
This is an emerging area of the law and only a handful of states permit physician-assisted suicide. If you have additional legal questions about this issue, including euthanasia and advanced directives, contact a health care attorney in your state.