Medical Jurisprudence Commons^™

An In-Depth Review Of Euthanasia-Related Practices, Arguments For/Against Them, And Proposed Solutions For Their Most Glaring Legal/Ethical Problems, Macon Plecha

Williams Honors College, Honors Research Projects

This paper’s goal is to cover the topic of euthanasia-related practices at great length. Terminology, history, and current programs around the world are discussed first, with the last point covering a wide geographical range: Colombia, Japan, Israel, and Africa, to name a few outside of the Western world standard. Arguments for and against euthanasia-related practices are explored. Within these arguments, several pressing legal and ethical issues arise, and the most severe of these are expanded on through the offering of potential solutions: how to handle stand-alone psychiatric cases, how to improve advanced directives and poor reporting rates, and how to …

Maine's Living Will Act And The Termination Of Life-Sustaining Medical Procedures, Eric R. Herlan

Maine Law Review

The Maine Legislature recently enacted a law authorizing the execution and use of living wills. The execution of a living will, essentially a document of "informed consent," allows a person to preserve in a legally recognized form his desire that, once he has been diagnosed to have a terminal medical condition and is no longer competent to make treatment decisions, the doctor should discontinue all life-sustaining procedures. With the passage of this act, Maine has joined thirty-four other states and the District of Columbia in enacting living will provisions. In addition, the National Conference of Commissioners on Uniform State Laws …

Assistance In Dying: A Comparative Look At Legal Definitions, Jocelyn Downie, Mona Gupta, Stefano Cavalli, Samuel Blouin

Articles, Book Chapters, & Popular Press

Euthanasia, assisted suicide, medical assistance in dying, death with dignity: these and many other different terms are used around the world to capture various types of assistance in dying. This diversity in terminology can create confusion both in academic debates and in policy-making if it is unclear what type of action or inaction is intended to be captured, by whom, and under what circumstances. By defining and contrasting several terms and legal status of assistance in dying in jurisdictions authorizing it, this comparative glossary aims to lay a foundation that prevents linguistic and conceptual confusion.

Attitudes Toward Withholding Antibiotics From People With Dementia Lacking Decisional Capacity: Findings From A Survey Of Canadian Stakeholders, Gina Bravo, Lieve Van Den Block, Jocelyn Downie, Marcel Arcand, Lise Trottier

Articles, Book Chapters, & Popular Press

Background

Healthcare professionals and surrogate decision-makers often face the difficult decision of whether to initiate or withhold antibiotics from people with dementia who have developed a life-threatening infection after losing decisional capacity.

Methods

We conducted a vignette-based survey among 1050 Quebec stakeholders (senior citizens, family caregivers, nurses and physicians; response rate 49.4%) to (1) assess their attitudes toward withholding antibiotics from people with dementia lacking decisional capacity; (2) compare attitudes between dementia stages and stakeholder groups; and (3) investigate other correlates of attitudes, including support for continuous deep sedation (CDS) and medical assistance in dying (MAID). The vignettes feature a …

Social Determinants Of Health And Slippery Slopes In Assisted Dying Debates: Lessons From Canada, Jocelyn Downie, Udo Schuklenk

Articles, Book Chapters, & Popular Press

The question of whether problems with the social determinants of health that might impact decision-making justify denying eligibility for assisted dying has recently come to the fore in debates about the legalization of assisted dying. For example, it was central to critiques of the 2021 amendments made to Canada’s assisted dying law. The question of whether changes to a country’s assisted dying legislation lead to descents down slippery slopes has also come to the fore—as it does any time a jurisdiction changes its laws. We explore these two questions through the lens of Canada’s experience both to inform Canada’s ongoing …

Euthanasia Of The Coronavirus - Covid-19, Sheila P. Davis

Journal of Health Ethics

At the time of this editorial, COVID-19, aka the Novel Coronavirus, has wrecked havoc and left in its path of destruction, death, unemployment, the instability of nation’s economies, misery, uncertainty, despair, and a fear regarding what the new tomorrow will look like. And, perhaps more importantly, the question of who will be here tomorrow lingers. Now classified as a pandemic, this virus has resulted in over 1,381,014 cases worldwide with 78,269 deaths to date. Presently, Louisiana and Detroit are emerging as the next hot spots behind New York as the fastest rate of increase for COVID-19 cases in the world. …

Suicide And Euthanasia: The International Perspective On The Right To Die, Zachary A. Feldman

Cornell Law Review

Several countries across the globe have weighed their interests in preserving life, in preventing suicide, and in allowing terminally ill patients to end their lives at their own discretion with, or without, the help of a physician. This Note will highlight the inconsistencies in jurisdictions that treat suicidal ideations both criminally and medically, and ultimately argues for a uniform system of laws that govern mental illness internationally.

Interpreting Canada's Medical Assistance In Dying Legislation, Jocelyn Downie, Jennifer A. Chandler

Reports & Public Policy Documents

When the Canadian medical assistance in dying (MAiD) legislation came into force in June 2016, it was widely noted that the meaning of some of its key terms and phrases was unclear. For example, questions were immediately raised about the meaning of “incurable illness, disease, or disability,” “advanced state of irreversible decline in capability,” and “natural death has become reasonably foreseeable.” Interpretation challenges are not uncommon with new legislation. However, in the context of something as significant as access to MAiD and potential criminal liability for getting the meaning of the legislation wrong, these challenges must be confronted by those …

Permitting Voluntary Euthanasia And Assisted Suicide: Law Reform Pathways For Common Law Jurisdictions, Jocelyn Downie

Articles, Book Chapters, & Popular Press

End of life law and policy reform is the subject of much discussion around the world. This paper explores the pathways to permissive legal regimes that have been tried in various common law jurisdictions. These include legislation, prosecutorial charging guidelines, court challenges, jury nullification, the exercise of prosecutorial discretion in the absence of offence-specific charging guidelines, and the exercise of judicial discretion in sentencing. In this paper, I describe these pathways as taken (or attempted) in five common law jurisdictions (USA, UK, Australia, New Zealand, and Canada) and reflect briefly on lessons that can be drawn from the recent experiences …

Assisted Suicide: A Tough Pill To Swallow, Mary Margaret Penrose

Pepperdine Law Review

No abstract provided.

Death In Our Life, Joseph Raz

Faculty Scholarship

This is the text of the Annual Lecture of the Society for Applied Philosophy, delivered in Oxford on 22-5-12. I kept the talk style of the paper. It examines a central aspect of the relations between duration and quality of life by considering the moral right to voluntary euthanasia, and some aspects of the moral case for a legal right to euthanasia. Would widespread acceptance of a right to voluntary euthanasia lead to widespread changes in attitude to life and death? Many of its advocates deny that seeing it as a narrow right enabling people to avoid ending their life …

Pereira's Attack On Legalizing Euthanasia Or Assisted Suicide: Smoke And Mirrors, Jocelyn Downie, Kenneth Chambaere, Jan L. Bernheim

Articles, Book Chapters, & Popular Press

In a paper published in Current Oncology, University of Ottawa palliative care physician Jose Pereira states that the, “laws and safeguards [in countries in which euthanasia or assisted suicide have been legalized] are regularly ignored and transgressed in all the jurisdictions, and that transgressions are not prosecuted.” He purports to demonstrate that the safeguards and controls put in place in the permissive jurisdictions are an “illusion.”

In the present paper, we expose problems with the evidence base provided and relied upon by Pereira. It should be noted that we provide only examples of each of the categories of mistakes made …

Can Glucksberg Survive Lawrence? Another Look At The End Of Life And Personal Autonomy, Yale Kamisar

Articles

In Washington v. Glucksberg, the Court declined to find a right to physician-assisted suicide ("PAS") in the Constitution. Not a single Justice dissented. One would expect such a ruling to be quite secure. But Lawrence v. Texas, holding that a state cannot make consensual homosexual conduct a crime, is not easy to reconcile with Glucksberg. Lawrence certainly takes a much more expansive view of substantive due process than did Glucksberg. It is conceivable that the five Justices who made up the Lawrence majority-all of whom still sit on the Court-might overrule Glucksberg. For various reasons, …

How We Die: A New Prescription, Martin Bienstock

Journal of Law and Health

The dawn of the twenty-first century brought with it a profound change in the way we experience death. Until the last decades of the twentieth century, our bodies died all at once: when the heart kidneys, lungs, or brain failed, the body's other organs failed with them. Modern medicine now allows us to die in pieces, with failing organs supported or supplanted by technology. Modern death is different not only biologically, but also sociologically. Until the twentieth century, death was a private event that took place in the home with the family. It offered one final opportunity for family members …

The Case Against Assisted Suicide Reexamined, Ani B. Satz

Michigan Law Review

In Toni Morrison's acclaimed novel Beloved, Sethe, a runaway slave woman on the brink of capture, gruesomely murders one of her infant children and is halted seconds before killing the second. Cognizant of the approaching men, Sethe's actions are deliberate, swift, confident, and unflinching. Afterwards, she sits erect in the Sheriff's wagon. The reader is left to struggle, situating the horror of the event within the context of the reality of slavery. Was this an act of mercy tQ prevent the suffering Sethe's child would know as a slave? Is loss of autonomy, even rising to the condition of slavery, …

On The Meaning And Impact Of The Physician-Assisted Suicide Cases, Yale Kamisar

Book Chapters

I read every newspaper article I could find on the meaning and impact of the U.S. Supreme Court's June 1997 decisions in Washington v Glucksberg and Vacco v Quill. I came away with the impression that some proponents of physician-assisted suicide (PAS) were unable or unwilling publicly to recognize the magnitude of the setback they suffered when the Court handed down its rulings in the PAS cases.

Egregious Inaction: Five Years After 'Of Life And Death', Jocelyn Downie

Articles, Book Chapters, & Popular Press

In November 1999, the Standing Senate Committee on Social Affairs, Science and Technology was authorized to examine and report upon developments since the release of Of Life and Death, the final report of the Special Senate Committee on Euthanasia and Assisted Suicide. A subcommittee to update Of Life and Death was therefore established. On February 14, 2000, I participated in the first panel of witnesses before this subcommittee. In light of the subcommittee's mandate, I set myself the following two tasks: first, to update the legal status sections of Of Life and Death by reporting on any changes to the …

The Alleged Distinction Between Euthanasia And The Withdrawal Of Life-Sustaining Treatment: Conceptually Incoherent And Impossible To Maintain, David Orentlicher

Scholarly Works

Richard Epstein, in his book Mortal Peril, supports euthanasia and assisted suicide and rejects the distinction between them and withdrawal of treatment. In this essay, Professor Orentlicher argues that Epstein is correct in finding no meaningful moral distinction between euthanasia and treatment withdrawal, examines the reasons why the distinction has persisted in American jurisprudence, and explains why the distinction has eroded.

Epstein also concludes in his book that there is no constitutional right to euthanasia or assisted suicide. Professor Orentlicher's response is that constitutionality is not the appropriate inquiry; rather, the better question is whether to recognize a right to …

The Future Of Physician-Assisted Suicide, Yale Kamisar

Articles

I believe that when the Supreme Court handed down its decisions in 1997 in Washington v. Glucksberg and Vacca v. Quill, proponents of physician-assisted suicide (PAS) suffered a much greater setback than many of them are able or willing to admit.

Physician-Assisted Suicide: The Problems Presented By The Compelling, Heartwrenching Case, Yale Kamisar

Articles

Now that the U.S. Supreme Court has upheld New York and Washington state laws prohibiting the aiding of another to commit suicide,2 the spotlight will shift to the state courts, the state legislatures and state referenda. And once again proponents of physician-assisted suicide (PAS) will point to a heartwrenching case, perhaps the relatively rare case where a dying person is experiencing unavoidable pain (i.e., pain that not even the most skilled palliative care experts are able to mitigate), and ask: What would you want done to you if you were in this person's shoes?

On The Meaning And Impact Of The Physician-Assisted Suicide Cases. (Symposium: Physician-Assisted Suicide: Facing Death After Glucksberg And Quill), Yale Kamisar

Articles

I read every newspaper article I could find on the meaning and impact of the U.S. Supreme Court's June 1997 decisions in Washington v. Glucksberg' and Vacco v. Quill.2 I came away with the impression that some proponents of physician-assisted suicide (PAS) were unable or unwilling publicly to recognize the magnitude of the setback they suffered when the Court handed down its rulings in the PAS cases.

Pain Relief For The Dying: The Unwelcome Intervention Of The Criminal Law, Phebe Saunders Haugen

Faculty Scholarship

This Article addresses physician-assisted suicide and the medical treatment of pain and suffering. Part II discusses various medical misconceptions about the treatment of pain and how modern medicine fails to fulfill this aspect of its palliative care role. Part III reviews how the law currently circumscribes the patient and doctor's ability to make medical decisions when the patient is terminally ill. As will be shown, the law is clearer and more respectful of good medical practice than most medical practitioners currently believe. Moreover, this section will also establish that, while several competing philosophical positions surrounding physician-assisted suicide exist, these same …

The Supreme Court And Terminal Sedation: Rejecting Assisted Suicide, Embracing Euthanasia, David Orentlicher

Scholarly Works

No abstract provided.

Making Sausage: The Ninth Circuit's Opinion, Carl E. Schneider

Articles

As I write, the Supreme Court has just agreed to hear Compassion in Dying v. Washington and Quill v. Vacco, the two cases in which United States circuit courts of appeals held that a state may not constitutionally prohibit physicians from helping a terminally ill person who wishes to commit suicide to do so. These cases have already received lavish comment and criticism, and no doubt the Supreme Court's opinion will garner even more. Reasonably enough, most of this analysis addresses the merits of physician-assisted suicide as social policy. I, here, want to talk about how setting bioethical policy …

The Reasons So Many People Support Physician-Assisted Suicide - And Why These Reasons Are Not Convincing, Yale Kamisar

Articles

It would be hard to deny that there is a great deal of support in this country-and ever-growing support-for legalizing physician-assisted suicide (PAS). Why is this so? I believe there are a considerable number of reasons. In this article, I shall discuss five common reasons and explain why I do not find any of them convincing.

Physician Assisted Suicide: A Bad Idea, Yale Kamisar

Articles

It would be hard to deny that there is a great deal of support in this country - and ever-growing support - for legalizing physician-assisted suicide (PAS). Why is this so? I believe there are a considerable number of reasons. I shall discuss five common reasons - and explain why I do not find any of them convincing.

The 'Right To Die': On Drawing (And Erasing) Lines, Yale Kamisar

Articles

Until this year, no state or federal appellate court had ever held that there was a right to assisted suicide no matter how narrow the circumstances or stringent the conditions. In 1996, however, within the span of a single month, two federal courts of appeals so held; in an 8-3 majority of the Ninth Circuit (sitting en banc) in Compassion in Dying v. Washington and a three-judge panel of the Second Circuit in Quill v. Vacco. What heartened proponents of a right to physician-assisted suicide even more, and pleased those resistant to the idea even less, was that the two …

Physician Assisted Suicide: The Last Bridge To Active Voluntary Euthanasia, Yale Kamisar

Book Chapters

SOME 30 YEARS AGO an eminent constitutional law scholar, Charles L. Black, Jr, spoke of 'toiling uphill against that heaviest of all argumental weights- the weight of a slogan.' I am reminded of that observation when I confront the slogan the 'right to die.' Few rallying cries or slogans are more appealing and seductive than the 'right to die.' But few are more fuzzy, more misleading, or more misunderstood.

Against Assisted Suicide - Even A Very Limited Form (Symposium: Assisted Suicide, Health Care And Medical Treatment Choices), Yale Kamisar

Articles

Professor Robert Sedler is a leading constitutional law professor and a well-known civil liberties lawyer. I think he is right about many things. To cite but one example, I think he was right when he led the ACLU's successful legal attack on certain University of Michigan restrictions on "hate speech."' But I cannot agree with him about physician-assisted suicide, no matter how narrowly he frames the issue.2

The 'Right To Die': A Catchy But Confusing Slogan, Yale Kamisar

Articles

Some 30 years ago an eminent constitutional law scholar Charles L. Black, Jr., spoke of "toiling uphill against that heaviest of all argumental weights-the weight of a slogan. I am reminded of that observation when I confront the slogan the "right to die." Few rallying cries or slogans are more appealing and seductive than the "right to die." But few are more fuzzy, more misleading, and more misunderstood.