By Alex Schadenberg, Executive Director, Euthanasia Prevention Coalition
The Supreme Judicial Court of Massachusetts decided on December 19 to reject a challenge to Massachusetts prohibition of assisted suicide, finding that there is no right to assisted suicide in the Massachusetts Constitution.
EPC-USA is incredibly pleased by this decision. EPC-USA was the only group to submit a friend-of-the-court brief and also provide an oral argument before the Massachusetts Supreme Judicial Court.
The case known as Kligler v. Healy concerns Dr Roger Kligler. He is living with prostate cancer and seeking death by assisted suicide, and Dr Alan Steinbach who is willing to prescribe a lethal drug cocktail for Kligler to die by assisted suicide. Kligler who claimed to be terminally ill when the case began in 2016 is very much alive today.
Kligler and Steinbach argued that doctors cannot be prosecuted for prescribing lethal drug cocktails for assisted suicide to competent terminally ill persons because there was a right to assisted suicide under the Massachusetts state constitution.
The Supreme Judicial Court of Massachusetts decided that:
Although we recognize the paramount importance and profound significance of all end-of-life decisions, after careful consideration, we conclude that the Massachusetts Declaration of Rights does not reach so far as to protect physician-assisted suicide. We conclude as well that the law of manslaughter may prohibit physician-assisted suicide, and does so, without offending constitutional protections.
As to the question of whether assisting a suicide can result in a charge of manslaughter the Supreme Judicial Court of Massachusetts decided that:
As the motion judge concluded, physician-assisted suicide could constitute wanton or reckless conduct. Our case law demonstrates that knowingly providing someone who has expressed an interest in ending his or her life with the means to do so may be considered wanton or reckless behavior. … That a doctor’s intent in providing the lethal medication was to alleviate a patient’s suffering is irrelevant, as conduct may be wanton or reckless even where the actor “meant no harm to the victim.” … (motive is irrelevant to crime of manslaughter).
Dr Steinbach argued that prescribing lethal drugs for assisted suicide is not proximate to the death and therefore cannot result in a charge of manslaughter. The Supreme Judicial Court of Massachusetts referred to the February 2019 decision upholding the voluntary manslaughter conviction of Michelle Carter for assisting the suicide of Conrad Roy who was 18 at the time of his death. Carter, who was 17 at the time of the death, pressured Roy to die by suicide by urging him during the act while on her cell phone. She was sentenced to 15 months in prison.
The Supreme Court of Massachusetts settles the argument that assisted suicide is not proximate to the death:
Steinbach argues that, regardless, doctors who provide physician-assisted suicide cannot be the proximate cause of a patient’s death because the patient’s decision to ingest the medication is a superseding event that extinguishes proximate cause. We do not agree. It is entirely foreseeable that a terminally ill patient who requests medication intended to bring about death may use the medication for such a purpose.
…In sum, under our existing law, doctors who engage in physician-assisted suicide may risk liability for involuntary manslaughter.
The question as to whether the Massachusetts Constitution could be interpreted to include a right to assisted suicide the Supreme Court of Massachusetts stated:
In sum, the history of suicide in general, and physician assisted suicide in particular, provides no support for the conclusion that physician-assisted suicide is an individual right protected by the Massachusetts Declaration of Rights.
Steinbach argued that the right to assisted suicide is a natural outgrowth to the right to refuse medical treatment. The Supreme Court of Massachusetts said
We do not agree, but, rather, recognize an important distinction between the refusal of medical treatment and physician-assisted suicide, which lies in fundamental legal principles of cause and effect; whereas withdrawing or withholding medical care is not the primary cause of a patient’s death, physician-assisted suicide is.
The Supreme Court of Massachusetts further analyses the question of the right to refuse treatment and states:
In medical ethics, “the right of competent, informed patients to refuse life-prolonging interventions . . . is firmly established,” whereas the right to physician-assisted suicide is a matter of “ethical . . . controversy.”
The American Medical Association has opined, for example, that although physicians should “honor patients’ informed decisions to refuse life-sustaining treatment,” physicianassisted suicide “is fundamentally incompatible with the physician’s role as healer.”
In their conclusion, the Supreme Judicial Court of Massachusetts states:
In sum, given our long-standing opposition to suicide in all its forms, and the absence of modern precedent supporting an affirmative right to medical intervention that causes death, we cannot conclude that physician-assisted suicide ranks among those fundamental rights protected by the Massachusetts Declaration of Rights. Thus, application of the law of manslaughter to physician-assisted suicide would not impinge on an individual’s right to substantive due process.
The Supreme Judicial Court of Massachusetts then states:
Application of the law of manslaughter to physician assisted suicide passes constitutional muster because the law is reasonably related to the State’s legitimate interests in preserving life; preventing suicide; protecting the integrity of the medical profession; ensuring that all end-of-life decisions are informed, voluntary, and rational; and “protecting vulnerable people from indifference, prejudice, and psychological and financial pressure to end their lives.”
As much as the Supreme Court of Massachusetts reject a right to assisted suicide they do keep the issue open to a legislative change by stating:
These questions are best left to the democratic process, where their resolution can be informed by robust public debate and thoughtful research by experts in the field.
The Euthanasia Prevention Coalition and EPC-USA would like to thank Christopher P. Schandevel from Alliance Defending Freedom (ADF) for representing us before the Supreme Judicial Court of Massachusetts.
Editor’s note. This appeared on Mr. Schadenberg’s blog and is reposted with permission.