WASHINGTON — In another victory for advocates of a constitutional right to die, the U.S. appeals court in New York on Tuesday struck down that state's law barring doctors from helping terminally ill persons end their lives.
In a 3-0 ruling, the appeals court said it made no sense to allow doctors to end the lives of those who are hooked up to respirators, while requiring them to preserve the lives of other terminally ill patients who are not on life-support systems.
This discrimination by law violates the Constitution's equal protection guarantee, the appeals court said, because it "is not rationally related to any legitimate state purpose."
"Physicians do not fulfill the role of 'killer' by prescribing drugs to hasten death any more than they do by disconnecting life-support systems," wrote Judge Roger J. Miner of Albany, N.Y.
Three doctors and three dying patients--one with cancer and two with AIDS--brought the lawsuit challenging New York's ban on assisted suicide as unconstitutional.
The 36-page opinion in their favor strengthens the fast-evolving constitutional right to die in two ways.
First, the opinion adopts a second reason--discrimination--for striking down state laws that bar all doctor-assisted suicides. This approach is grounded in a long line of Supreme Court decisions forbidding different treatment for people in similar situations.
By contrast, the U.S. 9th Circuit Court of Appeals for nine Western states, including California, relied on previous abortion rulings last month when it decided Americans have a right to personal liberty and privacy that gives them--rather than the government--the right to decide to end their suffering when they are terminally ill.
Judge Stephen Reinhardt of Los Angeles, writing for the 8-3 majority, quoted from Supreme Court rulings upholding the privacy right.
Harvard law professor Laurence H. Tribe said that the equal-protection argument may stand up better in the Supreme Court.
"While I find much to admire in Judge Reinhardt's opinion, this [equal protection] provides a more modest and narrow path for getting there. There is something utterly arbitrary and unintentionally cruel in condemning some competent terminally ill patients to continue their suffering because they have not been put on respirators," said Tribe, who supports the "right to die."
Secondly, Tuesday's opinion emerged from a more conservative appeals court and was written by an appointee of former President Reagan, meaning that now both conservative and liberal judges have upheld a right to die.
Miner, 61, was appointed as district judge by Reagan in 1981 and elevated to the appeals court in 1985. He was joined in the ruling by former Yale Law School Dean Guido Calabresi, an appointee of President Clinton, and senior U.S. District Judge Milton Pollack, who was appointed by former President Johnson.
"We are elated at this second sweeping civil rights victory for terminally ill patients who wish to have . . . assistance in hastening death . . . to end their suffering," said Ralph Mero, executive director of Compassion in Dying, a Seattle-based group that sponsored the legal challenges in New York and Washington state.
But others remain opposed to the idea of a right to die. Opponents include the Catholic Church and the American Medical Assn. Leaders of both groups questioned the authority of judges to nullify long-standing laws that forbid assisted suicide.
Dr. Nancy Dickey, AMA president, said doctors draw a sharp distinction between using technology to keep alive a dying person and actively using drugs to end a patient's life.
"Stepping over that line [to assist a suicide] is not in the best interest of patients or society," she said.
Tuesday's ruling almost assures that the Supreme Court will take up the issue within the next year.
The 9th Circuit Court ruling declares that a constitutional right to die exists in the nine Western states, including California. Attorneys for Washington state said they would appeal to the Supreme Court by June.
The 2nd Circuit ruling extends the right to die to include New York, Connecticut and Vermont.
"It's the population of about half the country between these two decisions," said Kathryn Tucker, an attorney for the right-to-die advocates.
The lead plaintiff in the New York case, Dr. Timothy E. Quill, was investigated by a grand jury after he published an article in 1991 in the New England Journal of Medicine in which he described giving barbiturates to a dying cancer patient. The three patients included George Kingsley, a 49-year-old publishing executive with AIDS; William A. Barth, a 28-year-old fashion editor, also with AIDS; and a 76-year-old cancer patient known as Jane Doe. All have since died.
On the other side, the Michigan Supreme Court has said that no right to die exists in American law. It has upheld that state's move to prosecute retired pathologist Jack Kevorkian for aiding terminally ill patients in ending their lives.