Montana's Assisted Suicide Ruling Falls short of Constitutional Guarantee
JANUARY 7, 2010 TAGS:
In a narrow ruling delivered on the last day of 2009, the Montana Supreme Court ruled that physician-assisted suicide is legal. The court’s 4-3 decision in Baxter v. Montana affirmed that there is a legal right established by statutory precedent in Montana for physician-assisted suicide. But, it stopped short of finding a right protected by the state’s constitution, which proponents argued existed.
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The ruling makes the Big Sky state the third in the nation to allow physician-assisted suicide. But unlike Oregon and Washington State, which brought the issue to state-wide referenda, Montana’s ruling stands to be overturned by legislative action over the next few years, as the Republican party of Montana, which opposes legalized euthanasia, has vowed to defeat the provision through legislation.
The Montana ruling is not a watershed moment for proponents of “death with dignity” or doctor aided suicide. Rather it’s an intellectual stopping point that pits the opposing ideologies of “right to die” and “right to life” in a legalistic microscope. Arguments on both sides employ the rubrics of individual liberty, compelling state interests, a doctor’s duty and the sanctity of life to further their arguments. But each side defines the categories differently.
The debate seems to prove that right to die issues, like the other political hot-button issues, abortion, hinge on the permeable boundary between life and death.
Compassion and Choices, the ACLU and other organizations that support physician assisted suicide had high hopes for the Baxter case. Montana’s constitution, written in 1972, has a definite sentence known as Section 4, which states, “The dignity of the human being is inviolable.” This lofty declaration, proponents argued, should have made Montana the first state to hold that physician assisted suicide is constitutionally guaranteed. Dignity, as a constitutional concept, ought to apply to death as well as life, the argument goes.
That logic isn’t perfect in the legal context, however, and the Court found recourse in previous legislation citing a 1985 law that addresses the withdrawal of treatment for the terminally-ill as precedent in public policy that allows for physician assisted suicide.
Withdrawing of treatment in terminal cases is one thing, but offering treatment that effectively hastens death is entirely different. Missoula, Montana litigator Mark Connell, who argued on behalf of Baxter, links a terminal patient’s inexorable march of death with the state’s interest in preserving life, in an attempt to bridge this gap.
In his oral arguments, delivered on September 2, 2009, Connell rebuts the statement that the sanctity of life for terminal patients is a compelling state interest:
“Is there a conceivable state interest to force a dying and suffering patient to remain alive against his will, simply so he can suffer a little longer?”
Connell concludes that the state’s compelling interest in preserving life wanes as a terminal patient approaches death. The death, to Connell, is already “in progress,” and there is nothing the law, medicine or any institution of man can do to prevent it. That immutable fact changes a job a physician from saving a life to alieviating suffering. That is the practical reality of terminal illness.
But the State of Montana, in their argument, denied that death starts at any point before the heart stops and focused on a different set of practical realities: ever-eager heirs, new “best friends” and other people vested in hastening the demise of a patient. The state sought to protect the patient in perhaps the most vulnerable point in his or her life.
Ultimately, the question was decided on narrow grounds, so no great jurisprudential pronouncement came from Baxter v. Montana. The fight over aid in dying will surely continue. But the question, “When does death start,” lingers. Surely Connell used “a death in progress” for rhetorical flourish; he did not seek a new definition of death.
Some have. Dr. Sanjay Gupta, chief Medical correspondent for CNN, claims in his book, Cheating Death, that dying is a process we know very little about. Those who are considered dead, he argues, can be revived with the correct intervention. Gupta focuses on accidental deaths, not terminal illness, so his inquiry is somewhat off point. But that permeable boundary between the living and the dead, like the journey across the river Styx, seems to be of unknowable width. Or, as medicine advances, that river grows wider.
The ruling makes the Big Sky state the third in the nation to allow physician-assisted suicide. But unlike Oregon and Washington State, which brought the issue to state-wide referenda, Montana’s ruling stands to be overturned by legislative action over the next few years, as the Republican party of Montana, which opposes legalized euthanasia, has vowed to defeat the provision through legislation.The Montana ruling is not a watershed moment for proponents of “death with dignity” or doctor aided suicide. Rather it’s an intellectual stopping point that pits the opposing ideologies of “right to die” and “right to life” in a legalistic microscope. Arguments on both sides employ the rubrics of individual liberty, compelling state interests, a doctor’s duty and the sanctity of life to further their arguments. But each side defines the categories differently.
The debate seems to prove that right to die issues, like the other political hot-button issues, abortion, hinge on the permeable boundary between life and death.
Compassion and Choices, the ACLU and other organizations that support physician assisted suicide had high hopes for the Baxter case. Montana’s constitution, written in 1972, has a definite sentence known as Section 4, which states, “The dignity of the human being is inviolable.” This lofty declaration, proponents argued, should have made Montana the first state to hold that physician assisted suicide is constitutionally guaranteed. Dignity, as a constitutional concept, ought to apply to death as well as life, the argument goes.
That logic isn’t perfect in the legal context, however, and the Court found recourse in previous legislation citing a 1985 law that addresses the withdrawal of treatment for the terminally-ill as precedent in public policy that allows for physician assisted suicide.
Withdrawing of treatment in terminal cases is one thing, but offering treatment that effectively hastens death is entirely different. Missoula, Montana litigator Mark Connell, who argued on behalf of Baxter, links a terminal patient’s inexorable march of death with the state’s interest in preserving life, in an attempt to bridge this gap.
In his oral arguments, delivered on September 2, 2009, Connell rebuts the statement that the sanctity of life for terminal patients is a compelling state interest:
“Is there a conceivable state interest to force a dying and suffering patient to remain alive against his will, simply so he can suffer a little longer?”
Connell concludes that the state’s compelling interest in preserving life wanes as a terminal patient approaches death. The death, to Connell, is already “in progress,” and there is nothing the law, medicine or any institution of man can do to prevent it. That immutable fact changes a job a physician from saving a life to alieviating suffering. That is the practical reality of terminal illness.
But the State of Montana, in their argument, denied that death starts at any point before the heart stops and focused on a different set of practical realities: ever-eager heirs, new “best friends” and other people vested in hastening the demise of a patient. The state sought to protect the patient in perhaps the most vulnerable point in his or her life.
Ultimately, the question was decided on narrow grounds, so no great jurisprudential pronouncement came from Baxter v. Montana. The fight over aid in dying will surely continue. But the question, “When does death start,” lingers. Surely Connell used “a death in progress” for rhetorical flourish; he did not seek a new definition of death.
Some have. Dr. Sanjay Gupta, chief Medical correspondent for CNN, claims in his book, Cheating Death, that dying is a process we know very little about. Those who are considered dead, he argues, can be revived with the correct intervention. Gupta focuses on accidental deaths, not terminal illness, so his inquiry is somewhat off point. But that permeable boundary between the living and the dead, like the journey across the river Styx, seems to be of unknowable width. Or, as medicine advances, that river grows wider.
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