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Physician Assisted Suicide
Annotated Bibliography


Kelly A. Long
The University of Dayton School of Law
Spring 2000

Introduction

This annotated bibliography attempts to explore the many issues involved in the debate over Physician Assisted Suicide. The United States Supreme Court has closed the door to only a few of the many arguments on each side of the issue. And some insist, that door was not really shut, they believe there is still room under the Constitution for a protection of the right to physician assisted suicide. The legal path that has been followed has taken many turns and depends on which state you look to, on which way that path has gone.

Currently, Oregon is the only state that has some form of legalized physician assisted suicide. The first step in understanding the issue of physician assisted suicide is to look at the development of the debate through the case history. It is very important to understand what the many courts have said regarding this debate. There are many different types of arguments that surround this debate. First, there are the legal arguments. Did the Supreme Court leave enough room open for a different constitutional challenge? Is there room under state constitutional law for the protection of those that desire physician assisted suicide? Should state legislature's take up this issue and legalize physician assisted suicide? Second, there are the moral and social arguments. Should someone really have the right to assistance in terminating their own life? If the door is open to physician assisted suicide then what about voluntary euthanasia? What protections are there that we will not go down the slippery-slope and legalize nonvoluntary euthanasia? What if any protections will there be to protect those groups that are more vulnerable to the desire to commit suicide? These are only a few of the many questions surrounding this debate, this paper attempts to address many of the questions.

One of the constitutional challenges that the United States Supreme Court has addressed is the challenge that laws that make physician assisted suicide illegal violate the Fourteenth Amendment and the Equal Protection Clause of the Fourteenth Amendment. The Court unanimously decided that neither of the challenges presented violated the Constitution. This would seem to be the end of the debate. How very wrong. The decisions by the Supreme Court only closed two avenues to the proponents of physician assisted suicide. The first few articles offers a look at the history of how the debate reached the highest court and also what the arguments are on each side of the issue. There does not appear to be any constitutional argument offered that would be successful. Therefore proponents must look elsewhere.

Proponents must look to the states and fight for the "right" to physician assisted suicide in each individual state. An article is included which discusses the possible success of legalization in the states. Many are looking to Oregon to see what the results will be there. It is entirely to early to determine what the effects of legalization will be in Oregon. It appears that a situation similar to abortion will emerge in the states. Each state will tolerate a different level of assisted suicide, leading to people crossing state lines to a more "favorable" state. The debate over physician assisted suicide parallels the debate over abortion in many ways. In fact the courts looked at the cases involved in the abortion debate for guidance. Many distinguish the two debates as entirely different. They both deal with the ending of life, and the legal debates are similar. However, there is a big difference, an abortion is ending a life yet to be lived. And there is still debate over exactly when that life begins. Assisted suicide is ending a life, and there is not debate that it is a life, that has already been lived to some extent. This brings up the social debates surrounding physician assisted suicide.

One article exposes alarming statistics from just one group of people that is considered at risk Women, minorities and the disabled are especially vulnerable to the desire to commit suicide. It is noted that depression plays a large role in the desire for physician assisted suicide. There are many socio-economic factors that make women vulnerable. As the result of divorce, widowhood and the fact that women are still paid less for the same work as men, they are more likely to feel the strain of economic factors. If you don't have the money to pay for the needed treatment then it is likely that you begin seeking other alternatives such as physician assisted suicide. Perhaps, instead of legalizing physician assisted suicide a better understanding of the depression that effects these at risk groups is what is really needed.



The following articles are annotated in this bibliography:

Too Many Physicians: Physician Assisted Suicide After Glucksberg/Quill.

Women and Assisted Suicide: Exposing the Gender vulnerability to Acquiescent Death.

Give me Liberty and Give Me Death: Assisted Suicide as a Fundamental Liberty Interest.

The Constitutional Right to Suicide, the Quality of Life, and the "Slippery-Slope": An Explicit Reply to Lingering Concerns.

Does Pro-Choice Mean Pro-Kevorkian? An Essay on Roe, Casey and the Right to Die.

A State Based Right to Physician Assisted Suicide.

Krischer v. McIver: Avoiding the Dangers of Assisted Suicide.

Physician-Assisted suicide: Does "The End" Justify the Means?

The "Right to Die" in America: The Ninth Circuit's Decision in compassion in Dying v. The State of Washington.

Annotations

Eryn R. Ace, Note: Krischer v. Mciver: Avoiding the Dangers of Assisted Suicide, 32 Akron Law Review 723 (1999).

The author examines how one state, Florida, has dealt with the issue of Physician Assisted Suicide after the United States Supreme Court held that the prohibition of assisted suicide did not violate the Fourteenth Amendment or the Equal Protection clause of the Fourteenth Amendment.(1) The issue was decided by the Florida Supreme Court in the case Krischer v. Mciver(2). The author first begins with the background of how the issue came before the Florida Supreme Court. Since the federal Questions of constitutionality had already been decided by the United States Supreme Court the Florida court only had to deal with the Florida Privacy Amendment. The Florida Supreme court relied on the following policy reasons in making its decision (1) the preservation of life, (2) the prevention of suicide, (3) the protection of innocent third parties, and (4) the maintenance of the ethical integrity of the medical profession.(3)

Although the author does a good job at outlining the decision of the Florida court and the progression of the issue in Florida, there is very little critique of any of the decisions rendered by the courts involved. This article offers a good starting point for someone who wishes to explore the progression of the issue in the Untied States.

 


Christopher Kelly, The "Right to Die" in America: The Ninth Circuit's Decision in Compassion in Dying v. The State of Washington, Vol 29, No. 4 American Health Lawyers Association, Journal of health Law 246 (July 1996/August 1996).

The author tracks the development of the legal issues as the courts of the United States have tried to deal with the issue of Physician Assisted Suicide. "Throughout their professional careers, many physicians are forced to deal with terminally ill patients who want to end their suffering. The legal issue that has developed from these types of patient requests is whether a terminally ill, competent patient possess a right to die"(4)

The author first begins with a look at the historical foundations of the "right to die". The United States first began consideration of this issue with the case of Karen Quinlan in 1976.(5) The Quinlan case dealt with whether Karen Quinlan's right to privacy granted to her the ability to decline medical treatment. The New Jersey court relied on the right to privacy because the "right to die" is not expressly granted.(6) The first watershed case for the United States Supreme Court to decide was the Cruzan case.(7) The court stated that, while a liberty interest to refuse treatment does exist, a constitutional violation can be found only "by balancing the individual's liberty interests against the relevant state interests."(8) The author then looks at the decisions of the trial court as well as all the subsequent appeals in Compassion in Dying v. The State of Washington.(9) "The court sought guidance from the abortion decisions, because the court determined that each issue involved 'the most intimate and personal choices a person may make in a lifetime, choices central to personal dignity and autonomy, are central to the liberty interest protected by the Fourteenth Amendment."(10)

The author does a good job of defining the issues that the many courts have articulated in decisions already issued. He takes a methodical approach to looking at each decision that has lead to the current legal status of Physician Assisted Suicide. He offers no opinion as to any of the arguments addressed by the various courts but simply offers the decisions with no additional comments. This offers the reader an opportunity to merely look at the progression of the issue without the tainted views of the author. It was difficult for this reader to determine on what side of the issue the author falls on. This article offers a good starting point for anybody who may wish to journey into this very heated discussion with so many differing opinions. 


Dr. G. Steven Neeley, The Constitutional Right to Suicide, The Quality of Life, and the "Slippery-Slope": An Explicit Reply to Lingering Concerns, 28 Akron Law Review 53 (Summer 1994).

Many courts and scholars appear to be motivated by an implicit concern with the so called "quality of life" argument.(11) Dr. G. Steven Neeley contends that this argument is simply an extension of the slippery slope arguments which he contends are logically misleading and, at best, are swayed only by emotional appeal.(12) He first examines the problems with the slippery-slope argument. There are several different comparisons that are drawn when using the slippery-slope arguments. Some have linked voluntary euthanasia with the Nazi Genocide. Still others argue that if voluntary euthanasia were legalized there is reason to believe that compulsory euthanasia would then be legalized at a later date.(13) He criticizes these arguments by drawing a line of demarcation because of the voluntariness of the act of Physician assisted suicide.(14) He continues to argue that society will not lose respect for human life once it accepts the sanctity of individual choice.(15)

The second argument he attacks is that of a "falling dominoes" scenario. Although he considers this more plausible than the first set of arguments, he finds fault with it as well.(16) This argument proceeds as follows: once legislature legalizes voluntary euthanasia then inevitably political pressures will mount for legalization of nonvoluntary euthanasia, which will then be legalized. This will then lead to pressure for legalization of involuntary euthanasia and so on.(17) His problem with this theory is mainly that it depends on how these dominoes are in place, and that can not be determined by any certainty.(18) He goes on to argue that there are many circumstances in which society views killing as acceptable; war, capital punishment, and self-defense, yet these exceptions have not led to the devaluation of human life.(19) There does seem to be some fault in the logic of the authors argument. A simple look at the society in which we live in, is increasingly showing signs of a devaluation of human life. Although the "falling dominoes" scenario does not seem logically possible, his argument against it does seem to ignore the fact of our increasingly violent society.

Another criticizism of Physician Assisted Suicide involves the doctrine of substituted judgment. This doctrine would under some circumstances allow a guardian ad litem to assert the "right" to physician assisted suicide on behalf of an incompetent patient.(20) The author argues that because the court endeavors to follow what the incompetent patient would have chosen that euthanasia under this doctrine would actually fall under voluntary euthanasia.(21)

The author offers as an argument in support of physician assisted suicide that "the absolute interdiction of suicide and euthanasia involves the impossible assertion that every life, no matter what its quality or circumstances, is worth living and obligatory to be lived.(22) He continues by asserting that the right to suicide stems from the constitution's commitment to personal autonomy and that this does not harm others.(23)

The author does a good job at pointing out the weakness in the arguments of those that oppose Physician Assisted Suicide. This paper offers the reader a good look at the many views regarding this issue. He attempts to argue that those that oppose Physician Assisted Suicide have terrible weaknesses inherent in their arguments. The one major weakness of the article is that the author ignores the weaknesses in his argument instead of trying to deal with them.

 


David A. Pratt,  Too Many Physicians: Physician-Assisted Suicide after Glucksberg/Quill 9 Albany Law Journal of Science and Technology 161 (1999).

The author begins with a look at the decisions of the United States Supreme Court in Washington v. Glucksberg and Vacco v. Quill.(24) He does a quick overview of the different arguments that were presented on both sides of the debate to the Supreme Court. The author first starts with the decision in the Glucksberg case. The legal issue presented to the court in this case as articulated by the Chief Justice was whether "the 'liberty" specially protected by the Due Process Clause includes a right to commit suicide which itself includes a right to assistance in doing so."(25) The Chief Justice's opinion concludes that there is no fundamental right to Physician Assisted Suicide and offers little hope to proponents that any future due process claim would be successful.(26)

The author then moves on to the decision of the Supreme Court in Vacco v. Quill. The Quill case involved the issue of whether the Equal Protection Clause could offer any protection of the 'right" to Physician Assisted Suicide.(27) The proponents of Physician Assisted Suicide did not fare any better in this decision than they did in the Glucksberg case which was decided by the court at the same time. Proponents of Physician Assisted Suicide have made the assertion that there is little difference between the right for a competent adult to refuse medical treatment that would prolong life and the right to Physician Assisted Suicide. The court drew a very important distinction between the two. When someone refuses treatment they die from the underlying condition; but when someone ingests drugs that are prescribed by a physician in order to facilitate the suicide, the person is dying from the medication.(28) The court also distinguishes between the intent of the parties involved in the two different circumstances.(29) The author points out that someone who refuses treatment does not always do it out of a desire to die, there are often religious reasons or merely because the treatment is painful.

The author then moves into the policy debate surrounding the issue. The briefly reviews the different physicians that have been caught up in the debate and the actions of the courts in those states in which these physicians have conducted the activity. Some courts have indicated that merely prescribing drugs to a terminally ill patient would not constitute a violation of the laws prohibiting Physician Assisted Suicide.(30) Proponents then argue what difference is there between prescribing pain medication that a physician suspects the patient will use to commit suicide, and a physician taking a more active role such as Dr. Kevorkian's "suicide machine".(31) The author asserts that to allow the second would be to ignore the "disastrous side effects of this radical change."(32)

The author then takes a look at the only state that has made Physician Assisted Suicide legal, which is Oregon. The Oregon law is still fairly new and therefore it is difficult to get an accurate picture of whether there are abuses. The author critiques a report that was issued by the Oregon Health Division after the first year under the new law. He notes that the report relies heavily on physician self-reporting, which in turn tends to show that the law is operating well and it is being regularly being followed.(33)

The author suggest that we need to ascertain the risks of mistake and abuse as well as the real need for Physician Assisted Suicide before relaxing any of the prohibitions.(34) He argues that we must proceed with great care and that the issue must be addressed by the state legislatures and not simply ignored.(35) If it is ignored then he asserts the Court would be forced to entertain a constitutional challenge not to a state's assisted suicide laws, but to other laws which deny dying patients adequate palliative care.(36)

The authors critique of proponents of Physician Assisted Suicide argument is through and points out the many weaknesses that are inherent in their argument. The author does not just stand on the Supreme Courts decisions that there is no constitutionally protected right to Physician Assisted Suicide. He goes further and discusses fully the "holes" in not only the legal arguments but the social arguments as well. It is a well rounded argument, not just concentrating on the weakness of the proponents argument but discusses the oppositions arguments fully as well.

 


Seth F. Kreimer, Does Pro-Choice Mean Pro-Kevorkian? An Essay on Roe, Casey, And the Right To Die, 44 The American University Law Review 803 (1995).

The author first begins with a discussion of how the issue of Physician Assisted Suicide is linked to the issue of the right of a woman to an abortion as outlined by the Court. He asserts that "each of the judges who has voted to permit assisted suicide has based his or her decision in part on an inference from the abortion cases."(37)

It has been argued that if a woman has a right to control her own body and avoid a pregnancy then a patient suffering in pain should have a similar right to end the condition which causes him/her such pain.(38) The author asserts that this connection should not be made.(39) The author draws a clear line between the two issues stating that "unlike abortion, where the status of the fetus is a matter of intense moral debate, in the area of assisted suicide, the State must choose between preventing deliverance from suffering and acquiescing in the risk of what all would concede is murder.(40) He also notes the similarities between the two decisions. This article was penned before the United States Supreme Court issued its decisions in the Glucksberg and Quill cases and therefore the author makes arguments as to why there should not be any constitutionally guaranteed right to Physician Assisted Suicide.

There is still considerable debate about whether a fetus is a life and if it is when does it become a life. In contrast, there is no debate that those that request Physician Assisted Suicide are indeed lives and therefore should be protected.

The author does not just discuss the legal implications of legalizing Physician Assisted Suicide. He also goes into great detail about the social and moral issues that must be faced if Physician Assisted Suicide was to be legalized. One argument that has been advanced is that as long as guns, plastic bags, and tall buildings are freely available, most people have the capacity to commit suicide. The author does point out the weakness in this argument, in that it ignores the fact that many who desire Physician Assisted Suicide do so because they do not have the physical means to use any of the above mentioned "means" to commit suicide.(41)

The author also discusses the observational error that is believed to be so prevalent in the medical field. Medical literature suggests that doctors often estimate the quality of life to be lower than the patient themselves.(42) The possibility of a lethal mistake he argues is a reason not to lift the ban.(43) An argument is made that if the ban is lifted that doctors will not be able to resist the financial considerations and other pressures, and that euthanasia will result.(44) This argument seems to me to be close to absurd. It is not doubtful that a physician may consider all the implications, but to lift the ban on Physician Assisted Suicide does not effect the illegality of euthanasia. The author spends little time with the argument which leads one to believe that it is not in fact a strong argument.

An additional argument made by the author is in which he asserts that current medical practice radically undertreats pain, which in turn makes suicide an attractive option to those that are suffering.(45) If the medical profession took a more aggressive role in pain management perhaps the need for Physician Assisted Suicide would decrease greatly. It has also been expressed the medical profession has difficulty diagnosing and treating depression.(46) If this were to change the need for Physician Assisted Suicide would seem to decrease as well.

The author acknowledges that the prohibition of assisted suicide forces the State to choose to protect the welfare of others at the cost of the patients control over her own body, which raises moral difficulties.(47) The author asserts that "to prohibit assistance enshrines the State's responsibility to protect the vulnerable and to affirm their connection to society."(48)

This article though written before the decisions by the United States Supreme Court that there was not Constitutionally protected right to Physician Assisted Suicide, does an amazingly good job of anticipating what the Court would rest its' decision on. The author discusses the many legal, social and moral issues involved in this debate. He acknowledges the seemingly unfair result of "forcing" those that desire not to, to continue living. The arguments presented are for the most part well thought out and articulated very well. He also offers alternatives to lifting the ban on Physician Assisted Suicide such as better pain management.

 


Robert L. Kline, Commentary: Give Me Liberty and Give Me Death: Assisted Suicide as a Fundamental Liberty Interest,6 The Boston Public Interest Law Journal 527 (Winter 1997).

This article was written prior to the Supreme Court's decisions in the Glucksberg and Quill cases but the author does a very good job of outlining the arguments that were asserted in front of the Second and Ninth circuit Courts of Appeals. The author first discusses the Glucksberg case. There were two steps to the Ninth Circuit's decision, the first being to decide whether there was a liberty interest in hastening death. Secondly, provided that an interest exists, whether the state may restrict exercise of that interest by banning medically assisted suicide.(49) The court held that the state's absolute prohibition on assisted suicide for mentally competent, terminally ill adults unconstitutionally limited such person's liberty interest.(50) The Ninth Circuit analogized the liberty interest in assisted suicide to the liberty interest of a woman to terminate her pregnancy.(51)

The author also discusses the Second Circuit Court of Appeals decision in Vacco v. Quill.(52) The court in this case found no liberty interest in the right to physician assisted suicide.(53) The court did find a violation of the Equal Protection clause of the Fourteenth Amendment.(54) The court reasoned that if individuals on life support were permitted to refuse or terminate life support systems, then mentally competent, terminally ill individuals should be permitted to make similar decisions.(55) It was argued that physicians do not fulfill the role of a killer by prescribing medication than they do by disconnecting life support.(56)

The author noted that Justice O'Connor was going to be a key on how the "right" to assisted suicide cases were to be decided. The author discusses in detail the opinions of Justice O'Connor on the issue of liberty. In an opinion by O'Connor in the Cruzan case she discussed two themes, first the government should be prevented from violating an individual's bodily integrity.(57) Second, individual decisional privacy where the government burdens an individual's choice on intimate and personal matters relating to an established constitutional right or liberty interest should be preserved.(58) The author states that Justice O'Connor's opinion that the government should not violate an individual's bodily integrity applies to assisted suicide as well.(59)

The author thought that the court would find a constitutionally protected liberty interest in physician assisted suicide.(60) This is an excellent overview of the different arguments that were presented to the Supreme Court. Of course, now we know that these arguments were rejected by the court. However, it is important to know these arguments because it is likely that the court will hear arguments on this subject again. Once the "experimentation" in the states begins in earnest the court most likely find many challenges to the states interpretation. In order to know what arguments would succeed it is important to know what failed. Also with the likelihood that the makeup of the court will change over the course of the near future it is important to note the balance of the court in these decisions.

 


Paul Moore,  Physician-Assisted Suicide: Does "The End" Justify the Means? 40 Arizona Law Review 1471, (Winter 1998).

Like so many others this article begins with the overview of the decisions by the Supreme Court in the Glucksberg and Quill cases. There is nothing unique in this overview of the cases and therefore I will not go into detail about them. The author expands from just a general overview of the cases. He notes that the separate concurring opinions filed in Glucksberg of Justices Souter, O'Connor, Stevens, and Breyer all point out the narrowness of the decisions.(61) Justice O'Connor indicated that the court need not reach the question of whether a mentally competent person who is experiencing great suffering has a constitutional interest in controlling the circumstances of his or her imminent death.(62) Justice Stevens noted that "the constitutionality of the general statutory ban on assisted-suicide does not validate every application of that ban."(63)

This leaves the issue of assisted-suicide in the hands of the states. The author then looks at the physicians ethical and traditional role in assisted-suicide. A majority of the medical profession continues to be opposed to physician-assisted suicide.(64) In legalizing physician assisted suicide the relationship between physician and patient will be changed. Both sides of the discussion agree to that. What they do not agree on is in what way the relationship will change.(65) Given the current diminishing regard for the health care profession, and the highly publicized desire to cut costs, it is easy to believe that patients will suspect the advice of a physician prescribing death.(66)

The author next discusses the difficulty in defining what condition would qualify for assisted suicide. He notes the difficulty in being able to determine how long an individual has to live.(67) If pain and suffering is included in the definition of who qualifies then how exactly do you determine what is pain and suffering.(68) It is also difficult to determine who has a terminal illness from those that are in the last stage of a terminal illness and this distinction should be very important.(69) He also points out that the opponents of physician assisted suicide have argued that the medical community should take a more aggressive role in alleviating the physical and emotional suffering of patients, and by doing this the need for physician assisted suicide would decrease greatly.(70) This argument may in fact not be accurate because there is strong evidence that pain has very little to do with a request for suicide.(71)

Depression is the primary indicator for a request for assisted suicide.(72) If this is indeed correct then the author argues that legalization of physician assisted-suicide is not the answer but better treatment of depression would be.(73) There is a legitimate concern that the "insurance-poor" and other groups that lack adequate health care coverage as well as minorities, disabled and the elderly will receive unequal guidance regarding assisted suicide.(74)

This is an excellent review of not just the legal arguments but some of the social arguments as well. The author believes that perhaps the best thing to do is to leave the situation as it is and to increase the effectiveness of treating depression in order to decrease the requests for assisted suicide.

 


John A. Brennan, Note: A State Based Right To Physician Assisted Suicide, 79 Boston University law Review 231 (February, 1999).

The United States Supreme Court has issued rulings in which the right to physician assisted suicide is not protected by the constitution. It does not appear that this is the end of the debate. The author of this article believes that the right to physician assisted suicide may indeed be protected in the individual constitutions of each state.(75) There are two avenues suggested by the author, the first is through legislative measures and the second is through the constitutions of each state.(76) Most states have reacted by enacting laws that explicitly bar assisted suicide.(77) This avenue does not seem to be one in which proponents would be successful.

The second avenue is through the courts interpretation of each state's constitution. In the past state constitutions have played a vital role in the protection of individual rights.(78) There have been many instances in which the states have gone in a different direction in interpreting the state constitution than the Supreme Court has gone in interpreting the constitution.(79) The author does a quick overview of a few of these instances. The instances the author discusses are Consensual Homosexual Sex, Paternity Rights, and Abortion Rights.(80)

The author then applies this reasoning to the instance of Physician Assisted Suicide. "The analysis demonstrates how claims involving intimate and personal decisions relating to sexuality, paternity and abortion, which were lift unprotected by the United States Supreme Court under the Fourteenth Amendment, were later embraced by state courts through their own constitutions."(81) The author turns first to how Florida and California have dealt with the issue. Both of these states have rejected the idea of a right to assisted suicide under their constitutions.(82) Both of these states interpret their constitutions similar to how the Supreme Court interprets the Constitution.(83) He then moves on to Kentucky which has a tradition of protecting individuals from "majoritarian moralistic views even when the United States Supreme court has been reluctant to do so."(84) "The notion of protecting a mentally competent, terminally ill person from state interference in matters of end-of-life decision making fits well with Kentucky's natural law tradition of respecting individual autonomy."(85)

The author believes that the only protection that physician assisted suicide will find is within the confines of the state constitutions. This seems to be the most likely course of action for the debate. This is a good look at what may be the only successful course of action. He does not rely on emotional or social arguments but merely observes what is most likely to be successful.

 


Lynne Marie Kohm and Britney N. Brigner,  Women and Assisted Suicide: Exposing the Gender Vulnerability to Acquiescent Death, 4 Cardozo Women's Law Journal 241 (1998).

It is argued that there are certain portions of the population that are at an increased risk of seeking physician assisted suicide. "Legalized physician-assisted suicide could effectively bring about a haste toward death among women that would recreate the 'gender gap' as never before."(86)

The authors first begin with a discussion of some of the issues that makes women particularly vulnerable. The first issue is the many financial factors. In the situation of a divorce often the women have a stark reduction in available income.(87) This is often true as well in cases where a women's spouse dies.(88) It is also well known that women often earn less for the same work that a man performs, which in turn also creates a financial hardship.(89) Women also have a greater need for health care both in their reproductive years and as they get older.(90) Many women are forced to rely on public resources because of the lack of adequate financial, family , social and emotional support.(91)

There are other factors as well, such as emotional and biological factors. "Women are twice as likely as men to suffer from major depression, for reasons more often cultural than biological..."(92) It is argued that women often take on the roll of nurturer, that they are used to sacrificing and are uncomfortable with a roll of being the recipient of sacrifice.(93)

Next the authors begin to look at the women that Dr. Kevorkian has assisted in their desire to commit suicide. This is an alarming list. At the time the authors wrote this 71% of his reported cases of assisted suicide had been women.(94) The authors list each woman that Dr. Kevorkian had assisted and what their reported diseases were and a little biographical information. The list is very effective helping the reader to understand the dynamics involved in each case. The list contains information on fifty-eight(58) women.(95) Many of the women suffered not only from physical ailments or mental conditions but also suffered from one of the previous mentioned factors.(96) Emotional factors were present in the majority.(97) "The brief portraits of the women assisted in their suicide by Jack Kevorkian are ominous, and provide compelling evidence for the gender vulnerability to acquiescent death."(98) There is a stark difference between the women Kevorkian assisted and the men that he assisted. Most of the men were declared terminally ill by their own doctors, were in constant, severe pain and were often physically incapacitated.(99) One the other hand many of the women had ambiguous complaints, and were not diagnosed terminal and had not been complaining of severe or constant pain.(100)

This article makes it clear why there is such opposition to physician assisted suicide. It does it in a way that is most effective. It is difficult to read the stories of the many women assisted by Dr. Kevorkian and not believe that perhaps these women really do need the protection of the state. When you look at the way many other factors make women more vulnerable you can see the need to really look into whether assisted suicide is the appropriate measure for the women. 

1. Washington v. Glucksberg, 117 S. Ct. 2258 (1997) and Vacco v. Quill, 117 S. Ct. 2293 (1997).

2. 697 So. 2d 97 (Fla. 1997)

3. Eryn R. Ace, Note: Krischer v. Mciver: Avoiding the Dangers of Assisted Suicide, 32 Akron Law Review 723, 732 (1999).

4. Christopher Kelly, The "Right to Die" in America: The Ninth Circuit's Decision in Compassion in Dying v. The State of Washington, Vol 29, No.4 American Health Lawyers Association, Journal of Health Law 246 (July 1996/August 1996).

5. See In re Quinlan, 355 A.2d 647 (N.J. 1976).

6. Kelly, supra note 4

7. See Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990).

8. Id at 279.

9. See Compassion in Dying v. State of Washington 850 F. Supp. 1454 (1994, rev'd, 49 F.3d 58 (9th Cir. 1995) and Compassion in Dying v The State of Washington 1996 WL 94848 (Wash. 1996).

10. Kelly, supra note 4.

11. Dr. G. Steven Neeley, The Constitutional Right to Suicide, The Quality of Life, and the "Slippery-Slope": An Explicit Reply to Lingering Concerns, 28 Akron Law Review 53 (Summer 1994).

12. Id.

13. Id at 58.

14. Id at 59.

15. Id.

16. Id at 60

17. Id.

18. Id.

19. Id.

20. Id at 63.

21. Id.

22. Id at 65

23. Id at 66

24. See supra note 1.

25. See Washington v. Glucksberg, 117 S. Ct. 2258, 2269 (1997).

26. David A. Pratt, Article: Too many physicians: Physician-Assisted Suicide after Glucksberg/Quill 9 Albany Law Journal of Science and Technology 161 (1999).

27. See Vacco v. Quill, 117 S. Ct. 2293 (1997).

28. See Id at 2298.

29. Id.

30. Supra note 26.

31. Id.

32. Id.

33. Id.

34. Id.

35. Id.

36. Id.

37. Seth F. Kreimer, Essay: Does Pro-Choice Mean Pro-Kevorkian? An Essay on Roe, Casey, And the Right To Die, 44 The American University Law Review 803,806 (1995).

38. Id.

39. Id.

40. Id at 807

41. Id at 817 and 851.

42. Id at 821.

43. Id.

44. Id at 822.

45. Id at 827.

46. Id at 827-828.

47. Id at 841.

48. Id at 853.

49. See Compassion in Dying v. Washington, 79 F.3d 790 (9th Cir. 1996).

50. Id at 816.

51. Id at 800.

52. See Vacco v. Quill, 80 F3d. 716 (2d Cir. 1996).

53. See Id at 727-28.

54. See Id.

55. See Id. at 729.

56. Robert L. Kline, Commentary: Give Me Liberty and Give Me Death: Assisted Suicide as a Fundamental Liberty Interest,6 The Boston Public Interest Law Journal 527, 545 (Winter 1997).

57. See Cruzan v. Director, Missouri Dep't of Health, 497 U.S. 261, 287-99 (1990).

58. Id.

59. Supra note 56.

60. Id at 550.

61. Paul Moore, Note: Physician-Assisted Suicide: Does "The End" Justify the Means? 40 Arizona Law Review 1471, 1478 (Winter 1998).

62. See Washington v. Glucksberg, 117 S. Ct. 2302, 2303 (1997).

63. Id at 2304.

64. Supra note 61 at 1480.

65. Id at 1482-83.

66. Id.

67. Id at 1484.

68. Id.

69. Id.

70. Id at 1486.

71. Id.

72. Id.

73. Id at 1487.

74. Id.

75. John A. Brennan, Note: A State Based Right To Physician Assisted Suicide, 79 Boston University law Review 231, 241 (February, 1999).

76. Id at 241

77. Id.

78. Id.

79. Id. at 243

80. Id at 243-48.

81. Id. at 248.

82. See Donaldson v. Van De Kamp 4 Cal Rptr. 2d 59 and Krischer v. McIver 697 So. 2d 97.

83. Supra note 75 at 252

84. Id. at 251.

85. Id. at 254

86. Lynne Marie Kohm and Britney N. Brigner, Article: Women and Assisted Suicide: Exposing the Gender Vulnerability to Acquiescent Death, 4 Cardozo Women's Law Journal 241, 250 (1998).

87. Id at 251-52.

88. Id at 256.

89. Id at 258.

90. Id at 259.

91. Id.

92. Id.

93. Id at 260.

94. Id at 266.

95. Id at 270-304.

96. Id at 304.

97. Id at 306.

98. Id at 315.

99. Id at 316.

100. Id.

 


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The University of Dayton School of Law
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