Critical Analysis of The Right-to-Die Movement

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The right-to-die movement is based on the belief that people should be allowed to commit suicide undertake voluntary euthanasia, most commonly in cases in which the patient suffers from a terminal illness and wishes to decline treatment or commit suicide which this sample essay discusses.

Is there a right to die?

Proponents of the movement assert that one should be able to be in charge of their own fate. Conversely, others believe that the belief that someone of sound mind should be able to make that decision because they think wanting to end your own life indicates that one is not of sound mind. While some religions accept the right to die for patients who suffer from terminal illnesses, others condemn suicide as a terrible sin. The argument over the right to die has been present in American society as far back as our country’s history reaches and continues to be an important issue today. 

The Right-to-Die movement in America

In 1868, supporters for the right-to-die movement argue that the Fourteenth Amendment supports their belief that people are responsible for whether they live or die and should be able to choose to end their lives. The amendment states,

“No State shall… deprive any person of life, liberty, or property, without due process of law…” (U.S. Const. amend. XIV).

‘Due process’ suggests that people are responsible for their own lives and should be able to end them if they so desire to. Though advocates of the movement felt this way, physician-assisted suicide was nowhere to be found in public policy of the time (Head). There was nothing in the law at all regarding a person’s right to end their life if they so choose.

In 1969, the living will was proposed by an attorney but the name of Luis Kutner. Luis wrote that when a patient is unconscious or is otherwise unable to speak for themselves or give consent for treatment, it is assumed that they would agree to anything that would allow them to live and doctors do everything they can in order to do so. The living will gives people another option.

They can sign a legal document stating that if their condition were to reach a point in which their condition became incurable without possibility of recovery, physicians do not have permission to conduct surgery, administer drugs or radiation, or perform any form of resuscitation; instead, the patient is permitted to die (Head).

This allowed a patient die if that is what they chose ahead of time. However, not every patient has the opportunity to have signed such a document ahead of time. Just like a document is needed in order to not take life-saving action, it is also necessary or obtain permission to perform surgery or similar forms of treatment without permission. While the patient is completely in control of their faculties and retains the ability to express themselves, they are able to indicate their consent, or lack thereof, to treatment –their living will. 

The Hemlock Society and the right to die

In 1975, a man named Derek Humphry assisted his wife in taking her own life when she was dying from breast cancer. Five years later, he founded the Hemlock Society, the United States’ first right-to-die organization in his garage in California with a mission of helping terminally ill patients die peacefully (Childress 2012). The first right-to-die case to make it to court took place in 1976 and it was also the first time that American society started discussing whether or not people had the right to choose when they die.

Karen Ann Quinlan has always been a healthy girl until she was twenty one years old and, after a night of drinking and taking Valium, she was found not breathing. An ambulance rushed her to the hospital and EMTs performed mouth-to-mouth, gave Karen Ann oxygen, and put her on a ventilator. Her pupils did not react, she was unresponsive to deep pain, and was incapable of breathing on her own (Morrow). Doctors determined that Karen Ann was in a coma and was incapable of ever recovering from her condition, a persistent vegetative state.

Her family determined that she would not want to live in such a state and that they would turn off her ventilator and be allowed to resume her ‘natural state’. Though the hospital originally agreed, they later changed their mind and denied the family’s request, spurring a legal battle. During the case, a court-appointed guardian argued that Karen Ann’s parents had no right to end her life by removing her ventilator (Morrow). The Quinlans lost their case but brought it to the New Jersey Supreme Court, which ended up ruling in the family’s favor.

Karen Ann was removed from her respirator was continued to receive artificial nutrition and hydration in the nursing home in which she lived until she died nine years later from pneumonia (Morrow). This case was instrumental in establishing patients’ rights to refuse medical care and control their own medical treatment. 

1980 saw the creation of The Hemlock Society, an organization aiming to support, educate, and advocate end-of-life choices. As stated previously, it was created by Derek Humphry who founded the organization to help legalize the use of physician-assisted suicide for mentally sound and terminally ill patients (Morrow 2012). The organization has been instrumental in legalizing physician-assisted euthanasia in Oregon, and Washington; in all three states, a lethal dose of medication is prescribed and administered by a physician to the terminally ill patient. Compassion & Choices also advocates for quality palliative care and symptom management (Morrow 2012). Their focus is on relieving patients of their pain.

Terri Schiavo 

In February of 1990, a woman named Terri Schiavo suffered cardiac arrest that deprived her brain of oxygen. After her accident, she was kept alive by a feeding tube and declared to be in a persistent vegetative state (Sanburn 2015). Her husband Michael attempted to remove her feeding tube and claimed she would not want to continue to live in that state of being. However, her parents felt that their daughter would have wanted to live and the case dragged on in court for years.

When the courts ruled to remove her feeding tube, the governor of Florida signed a bill to have it reinserted. When her case was heard in federal court, it was agreed again that the feeding tube would be removed; Terri died on the last day of March in 2005 and United States Congress all but stopped trying to pass laws that would ban aid in dying (Sanburn 2015). The months following her death saw a sharp increase in national interest in written advance directives as many Americans were thinking of their own end-of-life desires for the first time.

Also in 1990, United States Congress passed the Patient Self-Determination Act, which effectively expanded the reach of do-not-resuscitate orders. Do-not-resuscitate orders are signed by physicians and allow patients to deny CPR should their heart stop or they stop breathing.

The Patient Self-Determination Act requires that health care institutions (though not individual doctors) do four things:

1. They must provide the patient with a written summary of their health care decision-making rights and the facility’s protocol for recognizing advance instructions and wishes;
2. They must ask you if you have any advance directives and they must document your answer in your medical record;
3. They must alert their staff and community to the advance directives you may have;
4. They must never discriminate against patients based on whether or not they have any advance directives (it is also illegal for them to require that you either have one or do not have one) (“Law for Older Americans”).

This law provided further protection for patients that choose to exercise their right to die.

Dr. Jack Kevorkian AKA “Dr. Death”

That same year, the first of Dr. Jack Kevorkian’s died. Nicknamed “Dr. Death”, Kevorkian was present for the death of Janet Adkins, a patient with Alzheimer’s disease who expressed her wish to die before her mind deteriorated. Adams died in Kevorkian’s Volkswagen van by his ‘suicide machine, which he built in his apartment from thirty dollars’ worth of scrap parts (Childress 2012).

Kevorkian would be credited with assisting in one hundred and thirty people taking their own lives over a span of eight years. Two years later, in California, Kevorkian is also credited with turning the public off to ‘death with dignity’ when voters shot down a measure that would have legalized physician-assisted suicide. Humphry said in a statement,

“The Hemlock Society was founded ten year before Kevorkian came on the scene. And he did a great job in publicizing the right to choose to die… [But] our tactics were different. I wanted to change the law, to permit physician-assisted suicide for the terminally ill. He wanted to shock the medical profession by his antics and his show-offs on television and his costumes and all the rest of it. But that’s not how things work. Doctors will not step outside the law if the can possible help it.” (Childess 2012).

Kevorkian’s actions also sparked a response from Michigan governor John Engler, inspiring him to sign into a law a bill banning assisted suicide. The American Civil Liberties Union challenged the legislature and the law is found by the Michigan appeals court to be unconstitutional. Eventually, two years later, the Michigan Supreme Court upholds the ban and ruled the act illegal.

However, the same year that this was decided, Oregon became the first state to allow terminally ill adults of a competent mental state who are likely to die in six months obtain a prescription for lethal medication (Childess 2012). The appeals to the decision began immediately.

Later that decade, Texas passed the Futile Care Law, which allowed physicians to discontinue medical treatment in situations where they deemed it would serve no purpose or make no difference. The physicians are required to provide notice to the patient’s family and the family is able to appeal the decisions (Morrow). Interestingly, though, Texas does not allow physician-assisted suicide. 

No other states endorsed physician-assisted suicide again until 2008 when Washington voted to legalize the act in a law modeled on that of Oregon. In December of 2009, though, the Montana Supreme Court ruled that doctors were unable to be prosecuted for helping to hasten the death of terminally ill patients. Still, the court stopped short before saying that the right to die is protected under the U.S. Constitution.

In 2014, the United States has seen a renewed interest in the subject of end-of-life choices. A twenty nine year old woman named Brittany Maynard was diagnosed with terminal brain cancer in January of that year. Though she underwent a partial craniotomy and a partial resection of her temporal lobe, the cancer returned in April of 2014 and Maynard was given six months to live. Maynard, a newlywed, lived in California at the time of her diagnosis and moved to Oregon, where physician-assisted suicide is legal.

On November 19 of 2014, Maynard ingested barbiturates given to her by her doctor and passed away (Sanburn 2015). This inspired more than half of all states in the United States to introduce, or signal that they intend to introduce, legislation regarding end-of-life decisions.

Public opinion on end-of-life choices

After Terri Schiavo’s case, the majority of Americans found themselves thinking about their feelings towards such subjects, many for the first time ever. It would found in a Time magazine poll in 2005 that 70% of participants disapproved in the fact that the president had played a role in the issue and 54% of participants said that they were more likely to vote against their Congressional representative if they sided with the president’s actions (Sanburn 2015).

It seemed Americans felt that decisions made between physicians and patients should be kept free from government control.  Peg Sandeen, director of the Death With Dignity National Center, stated,

“The will of the people was not for the government to intervene in end-of-life decisions. When [congressmen] are on the floor diagnosing her, not having ever looked at her as a patient, I think America said, ‘Enough is enough.’” (Sanburn 2015).

A decade later, surveys suggest that American still feel the same way; according to Time, currently seven out of ten Americans support the belief that state and federal governments have no right to interfere in people’s end-of-life decisions for themselves (Sanburn 2015). Brittany Maynard’s case turned a lot of Americans on to the idea that terminally ill patients should be able to make the decision to be kept alive by machines or to die with dignity.

After her death, 74% of Americans now believe that patients that suffer terminal illness and are in pain should have the right to end their lives if they choose, an increase from 70% in 2011 (Thompson 2014).  It seems as though more and more Americans agree that these decisions should be left to the patient alone.

Conclusion

Ever since our country’s beginning, Americans have sought out their right to die in circumstances of terminal illness and terrible pain. Through countless cases, some have fought for citizens’ rights to die with dignity while others believe that people should live as long as they possibly can. Does a person really end their lives through physician-assisted suicide?

Congress has sought to answer this question for decades, but the majority of Americans seems to agree that these decisions are best left up to the individual. From Dr. Kevorkian to Terri Schiavo to Brittany Maynard, the public’s opinion of a person’s end-of-life choices have developed over time until most agree that the government has no place in making those decisions. Research suggests that the number of those who agree will only continue to grow.

References

Head, Tom. "History of the Right to Die Movement (Timeline)." About News. About.com, n.d. Web. 20 Sept. 2015.

"Law for Older Americans." American Bar Association: Division for Public Education. American Bar Association, n.d. Web. 02 Oct. 2015.

Morrow, Angela. "Karen Ann Quinlan - Right-To-Die Activist." About Health. About.com, n.d. Web. 21 Sept. 2015.

Morrow, Angela. "Compassion and Choices." About Health. About.com, 6 Nov. 2012. Web. 2 Oct. 2015.

Sanburn, Josh. "How Terri Schiavo Shaped the Right-to-Die Movement." Time. Time, 31 Mar. 2015. Web. 04 Oct. 2015.

U.S. Constitution. Amend. XIV

Thompson, Dennis. “Most Americans Agree with Right-to-Die Movement”. Health Day. HealthDay, 05 Dec. 2015. Web. 04 Oct. 2015.