Washington v. Glucksberg and Vacco v. Quill

Washington v. Glucksberg and Vacco v. Quill, 521 U.S. 702 (1997) and Vacco v. Quill, 521 U.S. 793 (1997), argued 8 Jan. 1997, decided 26 June 1997 by vote of 9 to 0; Rehnquist for the Court, O'Connor concurring, joined in part by Ginsburg and Breyer; Stevens, Souter, Ginsburg and Breyer filed opinions concurring in the judgment.

As the American population has grown older and medical technology more sophisticated, the question of how and when life can be ended has become increasingly controversial. Dr. Jack Kevorkian of Michigan, for example, presided over several widely publicized incidents in which he helped people suffering from serious illnesses to kill themselves. Critics of Kevorkian argued that should the practice become widespread, it would cheapen life and fall disproportionately on those most vulnerable. At the same time, several groups eager to make the practice legal pressed lawsuits insisting that state laws banning persons from assisting in suicides were unconstitutional. Both New York and Washington state, for example, made it a felony for one person to assist another in committing suicide, although both states permitted competent persons to refuse or have withdrawn life‐sustaining treatment. The Supreme Court, moreover, in Cruzan v. Director, Missouri Department of Health (1990), with Chief Justice William H. Rehnquist writing for the majority, found that persons can refuse medical treatment or stop medical care that is intrusive, even if the outcome of that decision is expected to be life ending.

Physicians in both New York and Washington, along with several of their terminally ill patients, filed suits challenging the constitutionality of the law prohibiting assisted suicide. In New York, Dr. Timothy Quill, on behalf of two AIDS patients, claimed that there was no essential legal difference between ending a life by terminating medical treatment, as permitted by Cruzan, and a doctor proactively administering life‐ending drugs. The United States Court of Appeals for the Second Circuit ruled, in what came to be the case of Vacco v. Quill, in favor of the plaintiffs on the grounds that the state's assisted‐suicide ban violated the Equal Protection Clause of the Fourteenth Amendment. The court reasoned that while New York law permitted competent terminally ill persons to hasten their own deaths by ordering the withdrawal of life‐sustaining treatment, these same persons were unconstitutionally prohibited from engaging the services of a physician to administer a lethal drug overdose.

The suit from Washington state, Glucksburg v. Washington, took a different tack. The plaintiffs there argued that the state's ban on assisted suicide violated the Due Process Clause of the Fourteenth Amendment. The United States Court of Appeals for the Ninth Circuit sustained this argument and overturned the Washington statute banning assisted suicide. The federal circuit court found that every person had a fundamental liberty interest in controlling the time and manner of their death, an interest protected by the Due Process Clause.

The high court issued two separate opinions in these cases, but it acted in essentially the same manner in dealing with both of them. Chief Justice Rehnquist spoke for the Court in both opinions, although in each case the seeming unanimity of the Court was broken by the realization that only five of the nine justices agreed that an absolute ban on assisted suicide was acceptable. Rehnquist drew a sharp distinction between ending life by refusing treatment and ending life by assisted suicide. Thus, in Vacco, the chief justice concluded that as a matter of history and professional medical practice the law had correctly treated these two practices as different. Rehnquist also found that such differences were entirely rational and therefore supportable as a matter of state legislative prerogative. The government, Rehnquist observed, had a legitimate interest in banning assisted suicide, since failing to do so would undermine the role of the physician as healer, expose the vulnerable to abuse, and initiate a steady slide toward euthanasia.

Rehnquist was even more forceful in dealing with Glucksburg v. Washington. He rejected the claim that an abstract concept of personal autonomy, akin to that described in the abortion decision Roe v. Wade (1973), provided a sufficient basis to assert a due process right to commit suicide or to have someone assist in a suicide. There was not, Rehnquist made clear, a fundamental right to assisted suicide because it was not deeply rooted in the nation's history and traditions. The Washington ban on assisted suicide was acceptable because it was related to a number of important governmental interests, including protecting the integrity and ethics of the medical profession, protecting the vulnerable from mistakes, and reaffirming the value of life.

Various justices weighed in with concurring opinions, all of which suggested that the issue of assisted suicide was not entirely foreclosed from further discussion by the Court. Justice Sandra Day O'Connor, for example, speculated that a mentally competent person experiencing great suffering might be able to secure help in shaping the circumstances of his or her imminent death. Even Chief Justice Rehnquist noted that the decisions in both cases left open the possibility for further debate on the issue. Yet both decisions made a constitutional challenge unlikely to succeed without a state first enacting legislation that would permit assisted suicide. As in many other areas of the law, the Rehnquist Court decided to return the issue to the states and their legislative processes rather than imposing a federally mandated judicial solution.

Kermit L. Hall