The right to die: state courts lead where legislatures fear to tread

The right to die may be among the most legally complex and culturally sensitive areas of civil rights to emerge in our time. The thorny issues associated with a terminally ill individual's right to self-determination, and the disposition of individuals who are incompetent to make right to die decisions for themselves, promises to keep all parties involved - health care professionals, medical ethicists, families, lawyers, judges, and state legislators -busy for some time to come. To this point, the state courts have taken the lead in the right to die debate, while the state legislatures have tended to drag their collective feet. This article lays the case law groundwork for right to die decision making, then goes on to assay the legislative responses to the issue that have been rendered in the fifty states.     

Therapeutic response to assisted suicide request

The authors review the first publicly reported case of legal assisted suicide in the United States and discuss possible clinical responses other than assistance in suicide. Psychiatric observers have noted that acceptance of assisted suicide or euthanasia as a medical option has resulted in loss of knowledge about how to respond to suicidal ideation in the seriously ill. The authors discuss specific therapeutic interventions that may be appropriate for seriously ill patients requesting suicide.     

Court dismisses appeal for right to assisted suicide

On 29 November 2001, the Ontario Court of Appeal issued a lengthy decision overturning a lower-court judgment in favour of three hemophiliacs infected with HIV in 1985 through contaminated blood-factor concentrate. The joint decision in the three cases of Robb, Rintoul, and Farrow is the latest decision in litigation dating back to 1992. The plaintiffs alleged negligence by the Canadian Red Cross Society and the Canadian government for delays in introducing heat-treated concentrate after the risks posed by unheated product were known.     

Court dismisses constitutional challenge to ban on assisted suicide

On 6 February 2001, the Ontario Superior Court of Justice dismissed a constitutional challenge by Jim Wakeford, a Toronto man with HIV/AIDS and an advocate for access to medical marijuana, to the sections of the Criminal Code that outlaw assisted suicide in Canada.     

Justins v The Queen: assisted suicide, juries and the discretion to prosecute

Juries are often a crucial protection for citizens against unjust or highly controversial laws. The decision whether to proceed with a prosecution rests on the discretionary powers of prosecutors. In cases where the community is deeply divided over right and wrong, it appears that there is, at times, a transference from the public of thwarted law reform aspirations which can create difficult tensions and expectations. This case commentary considers an appeal by Shirley Justins following her conviction for manslaughter by gross criminal negligence as a result of her involvement in the mercy killing of her partner, Mr Graeme Wylie. The morally unsettled nature of the charges brought against her, her own initial plea, the directions given to the jury by the trial judge and even the basis of her appeal resulted in a convoluted and complicated legal case. Spigelman CJ and Johnson J ordered a new trial, Spigelman CJ stating that it was open for a new jury to consider (a) if Mr Wylie lacked capacity; and (b) whether there was criminal involvement by one person in another's death. Simpson J found that further prosecution on the count of manslaughter would amount to an abuse of process and that an acquittal should be entered. This case highlights how fundamentally unsettled are the publicly much debated and persistently contentious issues of euthanasia, assisted suicide, the right of a person to die a dignified death and the way their capacity in that respect should be assessed. It perhaps asks us to reconsider the role of juries and the exercise of discretion by Directors of Public Prosecutions in areas of law where the community and law-makers are deeply and intractably divided.