As the public is well-aware by now, a Montana trial court ruled on Friday that persons in the state have 1) a right to die, and 2) a right to assistance in dying. Thus, Montana became the third state (after Oregon and Washington) to allow physician-assisted suicide (PAS). There are many problematic aspects of the decision, and I have written a legal summary of the decision here . But there are a number of practical issues that must be at the forefront of any discussion of the Montana decision.
First and foremost, the State of Montana has absolutely no safeguards in place to prevent abuse of PAS or use by non-terminally-ill patients. The court actually acknowledged that the state currently has no safeguards in place, and that there are no definitions of who is “competent” or “terminally-ill” and therefore eligible for assisted suicide. In fact, the court leaves that decision completely to physicians—with no legal guidance on how to determine whether a person is competent to choose assisted suicide.
Further, the plaintiffs had stated in prior pleadings that assisted suicide should be available to anyone who takes life-sustaining medications, who would die within a reasonable amount of time without taking those medications. That would include persons with controlled diabetes or asthma who, without taking their medications, would necessarily die within a “reasonable” amount of time.
In that regard, the status of PAS in Montana is completely unregulated. Contrary to Oregon and Washington, there are no so-called “safeguards” in place. (And even in Oregon, those safeguards have proven to be fairly ineffective, with the state health plan failing to cover treatments for terminally-ill patients but offering to provide assisted suicide instead.)
The court also made drastic statements degrading human life and the lives of terminally-ill patients. The court stated, “It is difficult to imagine a compelling interest in preserving the life of an individual who is suffering pain and the indignity of his disease….” Basically, the court stated that there is no compelling interest in saving a terminally ill person—that terminally-ill patients have no worth, and there is no compelling interest in ensuring that they are not killed.
Finally, not only is physician-assisted suicide completely unregulated under this opinion, but the court’s rationale totally supports active euthanasia by physicians. In determining that a patient has a right to die and die with assistance, the court stated that without assistance, the “constitutional right to die with dignity” of some patients would be defeated. But this rationale applies not only to patients who are still able to ingest lethal drugs, but also to patients whose diseases have left them without the ability to physically take the drugs themselves. The logical extension of the court’s rationale is that when patients’ dignity rights can be preserved only by obtaining assistance in death from physicians, that assistance can and must include the physician actually performing the act itself (i.e., committing the killing of the patient through euthanasia).
Moreover, the court acknowledged that, at this point, there are no safeguards for physicians who do not wish to participate in PAS or euthanasia—leaving the conscience rights of those physicians completely unprotected.
Thus, the public policy implications of this decision are tremendous—and dangerous. One judge has single-handedly allowed PAS and euthanasia throughout the state of Montana, and ignored the proper legislative process (at the end of the opinion, the court directs the legislature to “implement the right” to PAS). AUL is urging the state to appeal this extremely dangerous decision.
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