In 1994, a group of plaintiffs sought a federal court declaration that the State of Washington’s prohibition on assisted suicide was unconstitutional. Plaintiffs included four physicians who treat terminally ill patients, three gravely ill individuals, and a nonprofit organization that counsels people considering assisted suicide. Under Washington law, aiding a suicide attempt is a felony punishable by up to five years in prison and a $10,000 fine. The plaintiffs asserted ‘‘the existence of a liberty interest protected by the Fourteenth Amendment which extends to a personal choice by a mentally competent, terminally ill adult to commit physician-assisted suicide.’’ The district court held that the Washington law violated the substantive component of the due process clause and the equal protection clause of the Fourteenth Amendment. Ultimately, the Ninth Circuit Court of Appeals affirmed on substantive due process grounds. The State appealed to the U.S. Supreme Court.
In a unanimous judgment, the Court reversed, holding that Washington’s prohibition does not violate the due process clause. Writing for the Court, Chief Justice William Rehnquist noted that the fundamental liberty interests protected by the due process clause—marriage, procreation, and child rearing, for example—have been firmly rooted in American history and tradition. Within that tradition, however, assisted suicide has been consistently criminalized or otherwise discouraged for more than 700 years. As a result, ‘‘the asserted ‘right’ to assistance in committing suicide is not a fundamental liberty interest protected by the Due Process Clause.’’ Rehnquist also distinguished the Court’s holding in Cruzan v. Missouri Department of Health (1990), which presumed the right of a mentally competent individual to refuse life-sustaining medical treatment. He observed that the right to refuse treatment developed not from ‘‘abstract concepts of personal autonomy,’’ but from the common-law rule that forced medication constitutes an unlawful battery. Thus, while the ‘‘decision to commit suicide with the assistance of another may be just as personal and profound as the decision to refuse unwanted medical treatment, ... it has never enjoyed similar legal protection.’’ Applying traditional rational basis review, the Court noted the State’s legitimate interests in the preservation of human life, in protecting the integrity and ethics of the medical profession, and in guarding against the possibility of voluntary and involuntary euthanasia.
Five justices filed concurring opinions, each suggesting that further information—about the practice of assisted suicide in other countries, the availability of palliative care for terminally ill patients, or application of the prohibition in different circumstances— could shift the balance between a patient’s interests and the State’s, possibly rendering the statute ‘‘an intolerable intrusion on [a] patient’s freedom.’’ All of the opinions, including the Court’s, emphasized the need for further study and debate regarding the ‘‘morality, legality, and practicality, of physician-assisted suicide.’’ In a companion case, Vacco v. Quill (1997), the Court also reversed a decision of the Second Circuit Court of Appeals, which had invalidated New York’s prohibition on assisted suicide on equal protection grounds.
Cases and Statutes Cited
See also Cruzan v. Missouri, 497 U.S. 261 (1990); Equal Protection of Law (XIV); Privacy