Montana addresses physician-assisted suicide
It started with a court case brought by Robert Baxter when he was terminally ill with lymphocytic leukemia. His symptoms included infections, chronic fatigue, anemia, night sweats, nausea, massively swollen glands, digestive problems and generalized pain.
“I have lived a good and a long life, and have no wish to leave this world prematurely,” Baxter told the trial court back in 2008. “As death approaches from my disease, however, if my suffering becomes unbearable I want the legal option of being able to die in a peaceful and dignified manner by consuming medication prescribed by my doctor for that purpose.” Without court permission, Baxter’s doctor could not prescribe such a lethal dose without exposing himself to a charge of homicide.
The trial court granted Baxter’s petition—but tragically, not until the day he died.
The case was nevertheless appealed to the Supreme Court of Montana, to obtain guidance for similar situations in the future. The court recently ruled that a doctor on trial for abetting a patient’s suicide can defend himself by offering evidence that the patient consented to his own death. Before this ruling, it was not clear whether the state’s “public policy” would permit such a defense.
So the Baxter case represents a step forward for Montana, whose doctors can now assist their patients’ suicides with a decent chance for acquittal on homicide charges. But there’s obviously a big difference between having to stand trial on homicide charges and not having to enter a courtroom at all. In this sense, Montana law falls far short of the reform standard established by Oregon and Washington. In those states, the legislature has immunized doctors from having to stand trial at all—so long as they comply in good faith with a set of rigorous procedures.
In Oregon, for example, doctors are permitted to prescribe a lethal dose of drugs to a mentally competent, terminally ill patient who makes written and oral requests, consults two physicians, and endures a mandatory waiting period. Specific written forms are provided for recording each step of the process. The patient’s free choice is paramount throughout. Neither relatives nor doctors can apply on the patient’s behalf, and the patient himself administers the lethal dose. There’s no room for a power-hungry district attorney to bring charges against a doctor who has conscientiously complied with the procedures.
The Oregon and Washington statutes are designed to ensure that objective evidence of voluntariness will survive the patient’s death. That’s a proper means of protecting the individual’s right to end his own life, with a physician’s assistance. As I have written elsewhere,
The right to life includes and implies the right to commit suicide. To hold otherwise—to declare that society must give you permission to kill yourself—is to contradict the right to life at its root. If you have a duty to go on living, despite your better judgment, then your life does not belong to you, and you exist by permission, not by right.
For these reasons, each individual has the right to decide the hour of his death and to implement that solemn decision as best he can. The choice is his because the life is his. And if a doctor is willing (not forced) to assist in the suicide, based on an objective assessment of his patient’s mental and physical state, the law should not stand in his way.
The Montana Supreme Court’s decision highlights the need for legislative reform to define procedures by which physicians can avoid all legal liability for assisting a mentally competent adult patient’s suicide. Montana’s legislature would do well to look westward to its sister states, Oregon and Washington, in crafting such legislation.
To access the full text of the Montana Supreme Court’s decision, go to this link, then click on “Supreme Court Case Number” and enter DA 09-0051.
Image: Wikimedia Commons