Legal Document

521 U.S. 793117 S.Ct. 2293138 L.Ed.2d 834 Dennis C. VACCO, Attorney General of New York, et al., Petitioners,v.Timothy E. QUILL al. No. 95-1858. Supreme Court the United States Argued Jan. 8, 1997. Decided June 26, Syllabus* In as in most States, it is a crime to aid another commit or attempt suicide, but patients may refuse even lifesaving medical treatment. Respondent York physicians assert that, although would be consistent with standards their practices prescribe lethal medication for mentally competent, terminally ill who are suffering great pain and desire doctor's help taking own lives, they deterred from doing so by York's assisted-suicide ban. They, three gravely have since died, sued State's General, claiming that ban violates Fourteenth Amendment's Equal Protection Clause. The Federal District disagreed, Second Circuit reversed, holding (1) accords different treatment those persons wish hasten deaths self-administering prescribed drugs than does do directing removal life-support systems, (2) this supposed unequal not rationally related any legitimate state interests. Held: prohibition on assisting suicide violate Pp. ____-____. (a) Clause embodies general rule must treat like cases alike unlike accordingly. E.g., Plyler v. Doe, 457 202, 216, 102 2382, 2394-2395, 72 786. statutes outlawing assisted neither infringe fundamental rights nor involve suspect classifications, e.g., Washington Glucksberg, --- ----, ---------, 117 2258, 2267-2271, therefore entitled strong presumption validity, Heller 509 312, 319, 113 2637, 2642, 125 257. On faces, law permitting treats anyone differently else draws distinctions between persons. Everyone, regardless physical condition, entitled, if unwanted treatment; no one permitted assist suicide. Generally, laws apply evenhandedly all unquestionably comply equal protection. City Transit Authority Beazer, 440 568, 587, 99 1355, 1366-1367, 59 587. This disagrees Circuit's submission ending refusing "is nothing more less suicide.'' distinction letting patient die making important, logical, rational, well established: It comports legal principles causation, see, People Kevorkian, 447 Mich. 436, 470-472, 527 N.W.2d 714, 728, cert. denied, 514 1083, 115 1795, 131 723, intent, Bailey, 444 394, 403-406, 100 624, 631-633, 62 575; has been recognized, at least implicitly, Cruzan Director, Mo. Dept. Health, 497 261, 278-280, 110 2841, 2851-2852, 111 224; id., 287-288, S.Ct., 2856-2857 (O' CONNOR, J., concurring); widely recognized endorsed profession, courts, overwhelming majority legislatures, which, York's, former while prohibiting latter. respondents' claim "arbitrary'' "irrational.'' line two acts always clear, certainty required, were possible. Logic contemporary practice support judgment different, therefore, Constitution, them differently. (b) reasons recognizing acting suicide-including intentional killing preserving life; preventing suicide; maintaining physicians' role patients' healers; protecting vulnerable people indifference, prejudice, psychological financial pressure end lives; avoiding possible slide towards euthanasia-are valid important public interests easily satisfy constitutional requirement legislative classification bear rational relation some end. See ante. P. __. 80 F.3d 716 (C.A.2 1996), reversed. REHNQUIST, C.J., delivered opinion Court, which O'CONNOR, SCALIA, KENNEDY, THOMAS, JJ., joined. O' filed concurring opinion, GINSBURG BREYER, joined part. STEVENS, SOUTER, GINSBURG, opinions judgment. Vacco, Brooklyn, NY, petitioners. Walter Dellinger, DC, amicus curiae. Laurence H. Tribe, Cambridge, MA, respondents. Chief Justice REHNQUIST Court. 1 suicide,1 treatment.2 question presented case whether Amendment. We hold not. 2 Petitioners various officials. Respondents Timothy Quill, Samuel Klagsbrun, Howard A. Grossman York. They "consistent [their] practice[s]'' "mentally patients'' App. 25-26.3 Respondents, died,4 urged because permits competent person life-sustaining treatment, refusal such "essentially same thing'' physician-assisted Quill Koppell, 870 F.Supp. 78, 84-85 (S.D.N.Y.1994). 3 disagreed: " [I]t hardly unreasonable irrational State recognize difference allowing nature take its course, severe situations, intentionally using an artificial death-producing device.'' Id., 84. court noted "obvious life, persons,'' concluded [u]nder Constitution federal system establishes, resolution issue left normal democratic processes within State.'' 84-85. 4 Appeals (1996). determined despite ban's apparent applicability, "New equally final stages fatal illness deaths,'' "those terminal systems allowed systems; similarly situated, except previous attachment equipment, death drugs.'' 727, 729. court's view, [t]he life [the withdrawal systems] '' 729 (emphasis added) (citation omitted). then examined was interests,5 "to extent [New statutes] prohibit physician prescribing medications self-administered terminally-ill his illness, interest.'' 731. granted certiorari, 518 36, 135 1127 (1996), now reverse. 5 commands shall "deny jurisdiction protection laws.'' provision creates substantive rights. San Antonio Independent School Dist. Rodriguez, 411 1, 33, 93 1278, 1296-1297, 36 16 (1973); 59, 1310 (Stewart, concurring). Instead, 2394, 786 (1982) (""[T]he require things fact treated though same''') (quoting Tigner Texas, 310 141, 147, 60 879, 882, 84 L.Ed. 1124 (1940)). If "neither burdens right targets class, we will uphold [it] long bears end.'' Romer Evans, 517 116 1620, 1627, 134 855 6 affect address matters profound significance Yorkers alike. classifications. 2267-2271; see F.3d, 726; Dist., U.S., 28, 1294 ("The alleged discrimination class defines none traditional indicia suspectness''); 33-35, 1296-1298 (courts look "importance'' asserted right, when deciding "fundamental''). These "strong validity.'' 257 (1993). 7 draw Generally speaking, "unquestionably comply'' 587 (1979); Personnel Administrator Mass. Feeney, 442 256, 271-273, 2282, 2292-2293, (1979) (" [M]any [laws] certain groups unevenly, itself other members described law''). 8 Appeals, however, people-those systems-are not, "hasten death'' latter through conclusion depends Ibid. Unlike think withdrawing profession6 our traditions, both logical; certainly rational. supra, 272, 2292 ("When basic based, uneven effects upon particular ordinarily concern''). 9 causation intent. First, refuses he dies underlying disease pathology; ingests physician, killed medication. See, 728 (1994), 723 (1995); Matter Conroy, 98 N.J. 321, 355, 486 A.2d 1209, 1226 (1985) (when feeding tube removed, "result[s] . patient's] condition''); re Colyer, Wash.2d 114, 123, 660 P.2d 738, 743 (1983) [D]eath occurs after sustaining natural causes''); American Medical Association, Council Ethical Judicial Affairs, Physician-Assisted Suicide, 10 Issues Law & Medicine 91, 92 (1994) declined, primarily disease''). Furthermore, withdraws, honors patient's begin, purposefully intends, intend, only respect wishes cease useless futile degrading patient] longer stands benefit them.'' Assisted Suicide Hearing before Subcommittee House Committee Judiciary, 104th Cong., 2d Sess., 368 (1996) (testimony Dr. Leon R. Kass). true doctor provides aggressive palliative care; cases, painkilling death, physician's purpose intent is, be, ease pain. A assists "must, necessarily indubitably, intend made dead.'' 367. Similarly, commits specific her discontinues might 351, A.2d, 1224 (patients "may harbor die'' instead "fervently live, free technology, surgery, drugs''); Superintendent Belchertown Saikewicz, 373 743, n. 11, 370 N.E.2d 417, 426, 11 (1977) [I]n die''). used actors' distinguish result. 575 (1980) [T]he common homicide often distinguishes knows result conduct another's life''); Morissette 342 246, 250, 240, 243, 96 288 (1952) (distinctions based "universal persistent mature law''); M. Hale, Pleas Crown 412 (1847) ("If A., prevent gangrene beginning hand doth without advice cut off hand, dies, thereby felo de se tho voluntary act, yet kill himself''). Put differently, actions taken "because of'' given "in spite unintended foreseen consequences. 279, 2296; Compassion Dying Washington, 79 790, 858 (C.A.9 1996) (Kleinfeld, dissenting) Eisenhower ordered soldiers onto beaches Normandy, knew sending many His purpose, though, liberate Europe Nazis''). 12 Given these principles, surprising including carefully distinguished Fosmire Nicoleau, 75 N.Y.2d 218, 227, 2, 551 N.Y.S.2d 876, 881, 77, 82, (1990) [M]erely declining care considered suicidal act'').7 fact, first state-court decision explicitly authorize "real self-infliction deadly harm self-determination against support.'' Quinlan, 70 10, 43, 52, 9, 355 647, 665, 670, denied sub nom. Garger Jersey, 429 922, 97 50 289 (1976). And recently, Michigan also rejected argument "between artificially sustain curtail life'' merely "distinction significance-a meaningless exercise semantic gymnastics,'' insisting "the disagreed we.'' Mich., 471, N.W.2d, 728.8 13 legislatures drawn clear 2262-2263, 2265-2267. "nearly states expressly disapprove either dealing durable powers attorney health-care "living will' statutes.'' 478-479, nn. 53-54, 731-732, 53-54.9 Thus, move protect promote dignity remain opposed 14 point. enacted current 1965.10 Since then, acted several times common-law Act Aug. 7, 1987, ch. 818, §1, 1987 N.Y. Laws 3140 ("Do Not Resuscitate Orders'') (codified amended Pub. Health §§2960-2979 (McKinney 1994 Supp.1997)); July 22, 1990, 752, §2, 1990 3547 ("Health Care Agents Proxies'') §§2980-2994 Supp.1997)). doing, approved Quite opposite: reaffirmed "killing'' "letting die.'' §2989(3) 1994) ("This article intended permit euthanasia''); Task Force Life Law, Life-Sustaining Treatment: Making Decisions Appointing Agent 36-42 (July 1987); Do Orders: Proposed Legislation Report 15 (Apr.1986). More studied euthanasia and, 1994, unanimously recommended legalization. When Death Sought: Euthanasia Context vii (1994). Force's "allowing decisions forego radically consequences meanings policy.'' 146. die. 278, 2851, 224 (1990), principle constitutionally protected liberty interest inferred prior decisions,'' assumed existence purposes case, 2851-2852. But assumption grounded supposed, proposition abstract "right death,'' 727-728, established, bodily integrity freedom touching, Cruzan, 278-279, 2851-2852; observed country imposing criminal penalties 280, 2852. notion "nothing For reasons, disagree Brief 44.11 Granted, possible.12 By everyone follows longstanding distinction. 17 distinction-including discussed greater detail end.13 18 19 ordered. 20 21 Even I conclude recognition time, accord claims raised Glucksberg high degree importance, requiring commensurate justification. _________, 2286-2293 (SOUTER, judgment). lead me arbitrary under due process standard assistance banned, termination death-hastening medication, permitted. accordingly concur * syllabus constitutes part prepared Reporter convenience reader. Detroit Timber Lumber Co., 200 337, 26 282, 287, 499. Penal §125.15 1987) ("Manslaughter second degree'') provides: "A guilty manslaughter (3) He causes aids Manslaughter C felony.'' Section 120.30 ("Promoting attempt'') states: promoting Promoting E generally, 2262-2267, ---- (1997). established death.'' (S.D.N.Y.1994); Art. 29-B, 1993 Supp.1997) ("Orders Resuscitate'') (regulating "adult capacity'' direct issuance orders resuscitate); (allowing appointment agents make health principal's behalf,'' treatment). Declaration D., 42-49; 68-74; Grossman, 84-89; 716, 719 1996). stated had chance recovery, faced "prospect progressive loss function increasing suffering,'' desired lives. 25-26; William Barth, 96-98; George Kingsley, 99-102; Jane 105-109. acknowledged "do impinge [or] classifications,'' subject rational-basis judicial scrutiny. 726-727. Association emphasizes "fundamental demanding life-ending treatment.'' (1994); Near End Life, 267 JAMA 2229, 2230-2231, 2233 (1992) withholding inherently contrary beneficence nonmaleficence,'' tools medicine cause death''); 108 [Professional organizations] consistently treatments risk side effects''); Amici Curiae 18-25. Of lawsuit demonstrates, there differences profession question. Force, Sought, 104-109. erred reading creating death''; instead, authorities cited nowhere equate Schloendorff Society Hospital, 211 125, 129-130, 105 N.E. 92, (1914), contains Cardozo's famous statement [e]very human being adult years sound mind determine what done body,'' simply informed-consent case. Rivers Katz, 67 485, 495, 504 74, 80, 495 343 (1986) (right antipsychotic absolute, limited presents danger himself''); Storar, 52 363, 377, 6, 438 266, 273, 420 64, 71, 454 858, 309, 153 (1981). Many courts Kevorkian Thompson, 947 1152, 1178, 20-21 (E.D. Mich.1997); Fiori, 543 Pa. 592, 602, 673 905, 910 (1996); Singletary Costello, 665 So.2d 1099, 1106 (Fla.App.1996); Laurie Senecal, 666 806, 808-809 (R.I.1995); ex rel. Schuetzle Vogel, 537 358, 360 (N.D.1995); Thor Superior Cal.4th 725, 741-742, Cal.Rptr.2d 357, 367368, 375, 385-386 (1993); DeGrella Elston, S.W.2d 698, 707 (Ky.1993); Adams, 216 Cal.App.3d 1431, 1440, 265 Cal.Rptr. 573-574 (1990); Guardianship 512, 522-523, 583 1263, 1270, Doe Gross, 503 950, 112 1512, 649 (1992); L. W., 167 Wis.2d 53, 83, 482 60, 71 Rosebush, 195 Mich.App. 675, 681, 491 633, 636, Donaldson Lungren, Cal.App.4th 1614, 1619-1625, 61-64 Lawrance, 579 32, 40, (Ind.1991); McKay Bergstedt, 106 Nev. 808, 822-823, 801 617, 626-627 Browning, 568 4, (Fla.1990); McConnell Beverly Enterprises-Connecticut, Inc., 209 Conn. 692, 710, 553 596, 605 (1989); McAfee, 259 Ga. 579, 581, 385 S.E.2d 651, 652 Grant, 109 545, 563, 747 445, 454-455 (1987); Gardner, 534 947, 955-956 (Me.1987); Farrell, 335, 349-350, 529 404, Rasmussen Fleming, 154 Ariz. 207, 741 674, 685 Bouvia 179 1127, 1144-1145, 225 297, 306 (1986); Von Holden Chapman, 87 Div.2d 66, 70, 450 623, 627 (1982); Bartling 163 186, 196-197, 220, 225-226 (1984); Foody Manchester Memorial 40 Conn.Supp. 127, 137, 713, 720 P.V. 424 1015, 1022 (La.1982); Leach Akron Center, 68 Ohio Misc. 426 809, 815 (Ohio Comm. 1980); Severns, 425 156, 161 (Del.Ch.1980); Satz Perlmutter, 362 160, 162-163 (Fla.App.1978); Application President Directors Georgetown College, 331 F.2d 1000, 1009 (C.A.D.C.), 377 978, 1883, 746 (1964); Brophy England Sinai 398 439, 626, 638 (1986). British Lords Airedale N.H.S. Trust Bland, W.L.R. 316, Ala.Code §22-8A-10 Alaska Stat. Ann. §§18.12.080(a), (f) Ariz.Rev.Stat. §36-3210 (Supp.1996); Ark.Code §§20-13-905(a), (f), 20-17-210(a), (g) (1991 Supp.1995); Cal. Safety Code §§7191.5(a), (West Supp.1997); Prob.Code §4723 (West.Supp.1997); Colo.Rev.Stat. §§15-14-504(4), 15-18-112(1), 15-18.5-101(3), 15-18.6-108 (1987 Supp.1996); Gen.Stat. §19a-575 Del.Code Ann., Tit. 16, §2512 D.C.Code §§6-2430, 21-2212 (1995 Fla. §§765.309(1), (Supp.1997); Ga.Code §§31-32-11(b), 31-36-2(b) Haw.Rev.Stat. §327D-13 Idaho §39-152 Ill. Comp. Stat., 755, §§35/9(f), 40/5, 40/50, 45/2-1 Ind.Code §§16-36-1-13, 16-36-4-19, 30-5-5-17 (1994 Iowa §§144A.11.1-144A.11.6, 144B.12.2 (1989 West Kan. §65-28, (1985); Ky.Rev.Stat. §311.638 (Baldwin Supp.1992); La.Rev.Stat. 40: §§1299.58.10(A), (B) 1992); Me.Rev.Stat. 18-A, §§5-813(b), (c) Gen. 201D, §12 Md. §5-611(c) §700.496(20) 1995); Minn.Stat. §§145B.14, 145C.14 Miss.Code §§41-41-117(2), 41-41-119(1) (Supp.1992); Mo.Rev.Stat. §§459.015.3, 459.055(5) Mont.Code §§50-9-205(1), (7), 50-10-104(1), (6) Neb.Rev.Stat. §§20-412(1), 30-3401(3) N.H.Rev.Stat. §§137-H:10, 137-H:13, 137-J:1 §§26:2H-54(d), (e), 26:2H-77 1996); N.M. §§24-7A-13(B)(1), (C) (Supp.1995); Nev.Rev.Stat. §449.670(2) N.C. §§90-320(b), 90-321(f) N.D. Cent.Code §§23-06.4-01, 23-06.5-01 (1991); Rev.Code §2133.12(A), (D) Okla. 63, §§3101.2(C), 3101.12(A), (G) Cons.Stat. §5402(b) R.I. §§23-4.10-9(a), 23-4.11-10(a), S.C.Code §§44-77-130, 44-78-50(A), (C), 62-5-504(O) S.D. Codified §§34-12D-14, 34-12D-20 Tenn.Code §§32-11-110(a), 39-13-216 Tex. §§672.017, 672.020, 672.021 Utah §§75-2-1116, 75-2-1118 Va.Code §54.1-2990 Vt. 18, §5260 V.I.Code 19, §§198(a), Wash. §§70.122.070(1), 70.122.100 W. §§16-30-10, 16-30A-16(a), 16-30B-2(b), 16-30B-13, 16-30C-14 Wis. §§154.11(1), (6), 154.25(7), 155.70(7) Wyo. §§3-5-211, 35-22-109, 35-22-208 Supp.1996). also, 42 U.S.C. §14402(b)(1), (2), (4) ("Assisted Funding Restriction 1997''). crime, statute law, Marzen, O'Dowd, Crone, Balch, Suicide: Constitutional Right?, 24 Duquesne L.Rev. 205-210 (Appendix). argue irrationally "terminal sedation,'' respondents characterize "induc[ing] barbiturate coma starv[ing] 48-50; insist, ""[a]lthough proponents contend sedation covert euthanasia, concept sedating pharmacotherapy informed consent double effect.''' Reply Rousseau, Terminal Sedation Patients, 156 Archives Internal Med. 1785, 1785-1786 (1996)). Just refusal, "double effect'' hastening death. ("It ethically professionally acceptable alleviate discomfort, death''). STEVENS suggests, - -- 2309-2310 (concurring opinion), significant physicians, families [in withdrawal-of-treatment physician-assisted-suicide cases].'' 2298-2299, supra [A] pain'') added). absence omniscience, act reasonableness observes today "does foreclose possibility applications impose intolerable intrusion freedom.'' —--- 2310, opinion). true, but, observe 24, 2275, plaintiff hoping show unconstitutional need present considerably stronger arguments advanced here.

Classification Label: 4