The Ninth Circuit Court's treatment of the history of suicide by Ancient Jews and Christians in Compassion in Dying v. State of Washington: historical naivete or special pleading?

In this article, Prof. Darrel Amundsen critiques Judge Reinhardt's comments regarding "Historical Attitudes Toward Suicide" in his Compassion in Dying opinion. Amundsen demonstrates that the court's characterization of ancient Jewish and Christian practices is inaccurate and misleading because it fails to acknowledge the complexities of the moral issue of suicide. Amundsen discusses martyrdom, suicide in general, suicide by the ill, and euthanasia in ancient Judaism. In contrast to the court's commentary, Amundsen demonstrates that regard for human life is a central feature of Jewish ethical monotheism. Furthermore, the author challenges the court's conclusions about early Christianity, and explains why its treatment of the issue of suicide in early Christianity is misleading and inaccurate. Amundsen's discussion of early Christianity includes suicide, martyrdom, and especially the Augustinian teaching on suicide. He concludes that the court's treatment of the issue of suicide in early Christianity is so historically and conceptually muddled as to be fundamentally inaccurate.

Medical ethics in the courtroom: a reappraisal

Following up on a 1989 paper on the subject, this essay revisits the question of ethical expertise in the court room. Informed by recent developments in the use of ethics experts, the authors argue 1) that the adversarial nature of court proceedings challenges the integrity of the ethicist's pedagogical role; 2) that the use of ethics experts as normative authorities remains dubious; 3) that clarification of the State's interest in "protecting the ethical integrity of the medical profession" is urgently required; and 4) that the expertise of the ethicist may be more appropriately used in advising the legislature that in influencing the court.

Does it make clinical sense to equate terminally ill patients who require life-sustaining interventions with those who do not?

Two US courts of appeals have ruled that competent, terminally ill patients have a constitutional right to physician-assisted suicide. The cases are now before the US Supreme Court, which is expected to issue a ruling later this year. This article analyzes the keystone of the courts' ruling: their assertion that competent, terminally ill patients who are being kept alive on life support are equivalent to competent, terminally ill patients who do not require such support. Because the former are permitted to end their lives by refusing treatment, the courts found that the latter also have a right to determine the time and manner of their death, through prescriptions for lethal doses of medication. This article analyzes whether the courts' thinking is premised on a clinically plausible view of the care of terminally ill patients. Based on a discussion of common situations involving terminal illness, we argue that the courts' reasoning is deeply flawed. The article also analyzes how the implications of the courts' reasoning might undermine the care of terminally ill patients.

Assisted suicide and equal protection: in defense of the distinction between killing and letting die

The author argues that the distinction between intentionally killing oneself and intentionally letting oneself die is both coherent "as a matter of principle" and morally relevant. This principled distinction then provides a benchmark for courts considering equal protection arguments to distinguish one patient seeking to commit suicide from another wishing to free herself of unwanted life-sustaining medical treatment, and to conclude that these two individuals are not similarly situated for purposes of the Equal Protection Clause. These two situations are morally distinct--the deaths are caused by different means and those involved have different intentions. The intention of the doctor and patient to hasten the patient's death is material, and the intention relates to understanding what it means to treat people equally. Doctors who participate in assisted suicide intend their patients to die by their own acts, i.e., intentional killing. The author concludes that those who ask their doctors to commit assisted suicide and those who forego treatment are not similarly situated for purposes of the Equal Protection Clause. The afterward comments on the Supreme Court's recent assisted suicide decision. It affirms the author's analysis.

Lethal aid--physician or lawyer-assisted suicide?

This article will provide information about the current legal status of the right of a person to request physician-assisted suicide. It will provide a background on two appellate court cases which dealt with this issue and the significance of the U.S. Supreme Court's intervention.