Assisted-suicide laws advance, but issue still divides Americans

(Photo by Lee J. Haywood under a Creative Commons Attribution-NoDerivs 2.0 Generic licence)

An aging population and the associated end-of-life challenges have combined to keep assisted suicide at the center of the nation’s moral concerns. But few other debates so sharply divide the public as the question of whether or when to end the life of someone who is dying or suffering.

In May 2013, Vermont became the fourth state to allow assisted suicide, and right-to-die laws have been under consideration recently in several other states.

But a proposal to legalize physician-assisted suicide in Massachusetts went down to defeat in a referendum in November 2012, despite predictions of a relatively easy passage. That underscored how unsettled Americans remain about this issue.

A Gallup poll in 2011 found that physician-assisted suicide is the most polarized moral issue in the country, with 45 percent saying it is morally acceptable and 48 percent saying it is wrong. Yet a Gallup survey in May of 2013 also showed that opinions on the matter vary widely depending on how the question is phrased.

Another notable point: While the nation’s religious communities are often lined up in opposition to assisted suicide, there is also an intense debate within faith groups about the morality of this hot-button topic, as well as about other end-of-life issues. Advances in technology that can prolong life add another level of complexity to the discussions, as do the costs of care and ongoing pressures to restrain federal and state budgets.

This edition of ReligionLink provides resources for journalists covering this ongoing story.

Background

  • Four states — Washington, Oregon, Montana and, most recently, Vermont — now allow physician-assisted suicide. Legalization proposals have been put forward in several other states as well, but so far without success. Massachusetts voters narrowly rejected a proposed assisted-suicide measure in November 2012.
  • Oklahoma has a new law designed to ensure that elderly or terminally ill patients can get life-preserving treatment as long as they or their health proxies want it, regardless of whether medical professionals think it is futile.
  • Gallup has reported that doctor-assisted suicide is the moral issue that divides Americans most. Support for euthanasia depends on how it is characterized, though, a subsequent Gallup poll found.
  • Caring for people in the final stages of life is one of the most expensive aspects of the nation’s health care system, accounting for as much as one-third of all health care costs, and about 30 percent of Medicare expenditures come in the last year of a patient’s life. Moreover, modern medicine is able to keep human beings — or at least their bodies — alive for increasingly long periods, often in what is known as a “persistent vegetative state.”

Articles and blog posts

Other resources

National sources

  • Margaret Pabst Battin

    Margaret Pabst Battin is a University of Utah philosophy professor and a leading figure in the public debate on end-of-life issues. She has written extensively on religious and ethical concerns in physician-assisted suicide and euthanasia and has researched active euthanasia and assisted suicide in the Netherlands. Her books include Ending Life: Ethics and the Way We Die and The Least Worst Death: Essays in Bioethics on the End of Life.

  • Nancy Berlinger

    Nancy Berlinger is deputy director and research scholar at the Hastings Center in Garrison, N.Y., and director of its Guidelines on End of Life Care project. She is the author of After Harm: Medical Error and the Ethics of Forgiveness.

  • Lucy Bregman

    Lucy Bregman is a professor of religion at Temple University in Philadelphia. Her writing focuses on religion, death and dying; her books include Death and Dying, Spirituality and Religions: A Study of the Death Awareness Movement.

  • Ira Byock

    Dr. Ira Byock is the executive director and chief medical officer for the Providence Institute for Human Caring. He was formerly the director of the palliative care program at Dartmouth-Hitchcock Medical Center in Lebanon, N.H. His books include Dying Well: Peace and Possibilities at the End of Life. A past president of the American Academy of Hospice and Palliative Medicine, he maintains information and resources about end-of-life care at the website DyingWell.org.

     

    Contact Yvonne Corbeil, the press and media contact.

  • Arthur Caplan

    Arthur Caplan is a professor of bioethics and director of the division of medical ethics at New York University’s school of medicine. He co-edited Assisted Suicide: Finding Common Ground.

  • Marie T. Hilliard

    Marie T. Hilliard is director of bioethics and public policy and an ethicist at the National Catholic Bioethics Center in Philadelphia.

  • Carol Keehan

    Sister Carol Keehan is president and chief executive officer of the Catholic Health Association, which has worked to improve children’s health care coverage through a partnership with the Campaign for Children’s Health Care. Contact Fred Caesar.

  • Aaron Mackler

    Aaron Mackler is an associate professor of theology at Duquesne University in Pittsburgh and a Conservative rabbi who has written extensively on health-care ethics, theological ethics and Jewish theology. He was ethicist for the New York State Task Force on Life and the Law, where he played a central role in writing reports on physician-assisted suicide and health-care decision-making. Mackler is a member of the Conservative Rabbinical Assembly’s Committee on Jewish Law and Standards, for which he is chairman of the subcommittee on biomedical ethics, and he serves as an ethics committee member for Pittsburgh Mercy Health System. He authored Introduction to Jewish and Catholic Bioethics: A Comparative Analysis, edited Life and Death Responsibilities in Jewish Biomedical Ethics and has written many articles in scholarly and professional journals.

  • Dr. Richard Payne

    Dr. Richard Payne is a professor of medicine and divinity at Duke University in Durham, N.C. He is an expert on end-of-life issues and Christianity.

  • John A. Robertson

    John A. Robertson holds the Vinson and Elkins Chair at the University of Texas School of Law in Austin. He has written and lectured widely on law and bioethical issues. His books include The Rights of the Critically Ill.

  • Carl E. Schneider

    Carl E. Schneider is Chauncey Stillman Professor for Ethics, Morality and the Practice of Law at the University of Michigan Law School. He served on the President’s Council on Bioethics and edited Law at the End of Life: The Supreme Court and Assisted Suicide.

  • Dr. Daniel Sulmasy

    Dr. Daniel Sulmasy is a professor of medicine and ethics at the University of Chicago. Sulmasy is a Franciscan friar and a physician. He also holds a doctorate in philosophy and has expertise in end-of-life decision-making. His writings include “Are Feeding Tubes Morally Obligatory?” in the January 2006 St. Anthony Messenger, examining Catholic teachings about extraordinary medical treatments.

Organizations

Christian

  • Focus on the Family

    Focus on the Family is a conservative group that supports churches’ right to campaign. The founder of this organization is James C. Dobson who was also former chairman and president.

    Focus on the Family’s issue analysts have posted resources about euthanasia and physician-assisted suicide, which the organization opposes.

    Contact: 800-232-6459.

Jewish

Muslim

  • Islamic Medical Association of North America

    The Islamic Medical Association of North America aims to provide a forum and resource for Muslim physicians and other health-care professionals, to promote a greater awareness of Islamic medical ethics and values among Muslims and the community at large, to provide humanitarian and medical relief and to be an advocate in health-care policy.

    It has a code of medical ethics that includes a discussion of end-of-life care. Dr. Hossam M. Fadel is chair of the ethics committee.

Right-to-die advocates

Major bioethics centers

  • Center for Bioethics and Human Dignity

    The Center for Bioethics and Human Dignity in Bannockburn, Ill., helps individuals and organizations address bioethical challenges, including end-of-life treatment, genetic intervention, euthanasia and reproductive technologies, from a Christian perspective. Its website contains articles with overviews on various topics in bioethics, some position statements, bibliographies and podcasts.

  • Kennedy Institute of Ethics

    The Kennedy Institute of Ethics is the oldest academic bioethics center. See a list of its scholars. Contact Kelly Heuer.

  • Bioethics Research Library

    The Bioethics Research Library at Georgetown University is part of the Kennedy Institute of Ethics. It has a multiformat collection of sources relevant to issues of ethics in science.

  • Center for Clinical Bioethics

    The Center for Clinical Bioethics was established in 1991 at Georgetown University Medical Center as a university-based bioethics resource for those who shape and give health care. Edmund D. Pellegrino is founding director.

    Contact: 202-687-1122.
  • Hastings Center

    The nonprofit Hastings Center in Garrison, N.Y., explores bioethics questions in health care, biotechnology and the environment. Recent research projects range from genetic paternity testing to newborn screening to palliative care. Susan Gilbert is the director of communications.

  • National Catholic Bioethics Center

    The National Catholic Bioethics Center in Philadelphia conducts research and consultations in health care and life sciences in accordance with teachings of the Catholic Church. It consults on life science and medical issues with the Vatican, U.S. bishops, public policy-makers, hospitals and international organizations of all faiths. It publishes two journals, Ethics and Medics and The National Catholic Bioethics Quarterly.

  • National Center for Bioethics in Research and Health Care

    Tuskegee University’s National Center for Bioethics in Research and Health Care was established in January 1999 as a partial response to the apology of President Clinton for the United States Public Health Service Study on syphilis conducted at Tuskegee, Macon County, Ala., from 1932 to 1972. The center addresses ethical issues in science, technology and health, with an emphasis on effects among people of color and other minorities.

  • University of Minnesota’s Center for Bioethics

    The University of Minnesota’s Center for Bioethics was founded 21 years ago and is one of the leading research centers for bioethics, with 15 full- and part-time faculty. The center conducts original interdisciplinary research, offers educational programs and fosters public discussion through community outreach. The center focuses on the policy level, working closely with policy-makers, health-care professionals and university communities. Projects include the Genetics and Identity Project, Genetics in Primary Care: Ethical and Professional Challenges, African Genealogy and Genetics: Looking Back to Move Forward and Blueprint of the Body on the Human Genome Project.

  • University of Pennsylvania Center for Bioethics

    The University of Pennsylvania Center for Bioethics in Philadelphia is one of the pre-eminent bioethics centers in the United States, with more than 20 faculty. The center’s staff includes experts in philosophy, medicine, law, anthropology, sociology and religion. Its website is an excellent place to start an exploration of any bioethics topic and is also home to The American Journal of Bioethics.

    Contact: 215-349-5964.
  • Center for Biomedical Ethics & Humanities

    The Center for Biomedical Ethics & Humanities at the University of Virginia combines the study of health care and illness with social science and humanity disciplines. Daniel M. Becker is director.

  • Stanford Center for Biomedical Ethics

    The Stanford Center for Biomedical Ethics at Stanford University does interdisciplinary research in biomedical ethics. David Magnus is director.

  • Online Ethics Center for Engineering and Research

    The Online Ethics Center for Engineering and Science is maintained by the National Academy of Engineering. It is part of the Center for Engineering, Ethics, and Society. The Online Ethics Center provides information on ethics as related to science and engineering.

Legal resources

  • Supreme Court of the United States

    The official website of the Supreme Court of the United States posts background information about the court, as well as court decisions and arguments.

    Contact: 202-479-3000.
  • United States courts

    The website of the federal judiciary — which includes the U.S. Court of Appeals, district courts and bankruptcy courts — posts court records, judicial statistics and information on judges. Contact through the website.

  • FindLaw.com

    FindLaw.com post links to case law and texts. Contact through the website.

Regional sources

In the Northeast

  • Dr. James L. Bernat

    Dr. James L. Bernat is professor of neurology and medicine at Dartmouth Medical School and heads the Bioethics Committee at Dartmouth-Hitchcock Medical Center in Lebanon, N.H. He is the author of Ethical Issues in Neurology, 3rd ed.

  • Christine Cassel

    Dr. Christine Cassel is a geriatrician, ethicist and co-editor of Approaching Death: Improving Care at the End of Life. She is the planning dean for the new Kaiser Permanente School of Medicine coming to Oakland, Calif. in 2019.

    Contact: 510-271-5953.
  • Elizabeth Chaitin

    Elizabeth Chaitin is director of the medical ethics and palliative care services at the University of Pittsburgh Medical Center Shadyside. She is also on the faculty of the Consortium Ethics Program and is an ethics consultant for the Ethics Consultation Service for the Center for Bioethics and Health Law of the University of Pittsburgh. She is a co-author of Ethics in End of Life Decisions in Social Work Practice.

  • Diane Coleman

    Diane Coleman, an attorney, is the founder of Not Dead Yet, a Forest Park, Ill.-based organization of people with disabilities who actively oppose euthanasia and physician-assisted suicide.

  • David Cummiskey

    David Cummiskey is a philosophy professor at Bates College in Lewiston, Maine. He specializes in medical ethics, including the right to die.

  • Dr. Thomas Duffy

    Dr. Thomas Duffy is a professor of medicine at Yale University School of Medicine in New Haven, Conn.; director of the Program for Humanities in Medicine; and chairman of the Working Group on End of Life Issues of Yale’s Interdisciplinary Center for Bioethics.

  • Dr. Joseph J. Fins

    Dr. Joseph J. Fins is chief of the division of medical ethics at Weill Cornell Medical College in Ithaca, N.Y., and professor of medicine, public health and medicine in psychiatry. He is also an associate at the Hastings Center. He wrote A Palliative Ethic of Care: Clinical Wisdom at Life’s End.

  • Carol Taylor

    Sister Carol Taylor is former director of the Center for Clinical Bioethics at Georgetown University. She also is a senior research scholar at the Kennedy Institute of Ethics and a professor of nursing at Georgetown. Her background is in philosophy, bioethics and nursing. She is experienced in caring for chronically and critically ill patients and their families.

In the South

  • William Allen

    William Allen holds law and divinity degrees and is associate professor and director of the Program in Bioethics, Law and Medical Professionalism at the University of Florida College of Medicine in Gainesville.

  • Robert M. Baird

    Robert M. Baird is a professor and chairman of the philosophy department at Baylor University in Waco, Texas. He co-edited the books Same-Sex Marriage: The Moral and Legal Debate, Caring for the Dying: Critical Issues at the Edge of Life, and The Ethics of Abortion: Pro-Life Vs. Pro-Choice.

  • Larry Churchill

    Larry Churchill is a professor of medical ethics at Vanderbilt University Medical Center and a professor at the graduate department of religion at the Vanderbilt Divinity School in Nashville, Tenn. An expert on the justice and allocation of health care resources, he wrote Self-Interest and Universal Health Care: Why Well-Insured Americans Should Support Coverage for Everyone.

  • Dr. David Doukas

    Dr. David Doukas is a faculty member in the Institute for Bioethics, Health Policy and Law, and he holds the William Ray Moore Endowed Chair of Family Medicine and Medical Humanism at the University of Louisville. He is a co-author of Planning for Uncertainty: Living Wills and Other Advance Directives for You and Your Family.

  • Arri Eisen

    Arri Eisen is director of the Program in Science and Society at Emory University’s Center for Ethics in Atlanta and a professor of pedagogy in the department of biology. Eisen teaches research ethics to faculty, undergraduates, graduate students, postdoctoral fellows and physicians. He researches the basic science of gene regulation and research ethics education. He is co-author of “The Absent Professor: Why We Don’t Teach Research Ethics and What to Do About It” (published in The American Journal of Bioethics) and co-editor of the  two-volume collection of essays titled Science, Religion and Society: An Encyclopedia of History, Culture and Controversy.

  • Chris Hackler

    Chris Hackler is director of the division of medical humanities and a bioethics professor at the University of Arkansas College of Medicine in Little Rock. He edited Health Care for an Aging Population and co-edited Advance Directives in Medicine.

  • John Hardwig

    John Hardwig is professor emeritus of philosophy at the University of Tennessee, Knoxville. His research interests include bioethics, especially end-of-life issues, and he is the editor of Is There a Duty to Die?: And Other Essays in Medical Ethics.

  • Stuart Rosenbaum

    Stuart Rosenbaum is a philosophy professor at Baylor University in Waco, Texas, and co-editor of Caring for the Dying: Critical Issues at the Edge of Life.

  • Abdulaziz A. Sachedina

    Abdulaziz A. Sachedina is a coordinator of the Islamic bioethics group of the International Association of Bioethics and is a professor of Islamic studies at the University of Virginia in Charlottesville. He contributed the entry on bioethics for The Oxford Dictionary of Islam.

  • Stephen Sapp

    Stephen Sapp is a professor and former chairman of the department of religious studies at the University of Miami, a member of the Alzheimer’s Association’s Ethics Advisory Panel and founding president of the association’s South Florida chapter. He is also past chairman of the Forum on Religion, Spirituality and Aging of the American Society on Aging. He was a panelist discussing end-of-life ethics at the university’s 2011 Global Business Forum.

  • Raymond Whiting

    Raymond Whiting is a professor of political science at Augusta State University in Georgia and author of A Natural Right to Die: Twenty-Three Centuries of Debate.

In the Midwest

  • Jos V.M. Welie

    Jos V.M. Welie is a professor of medical and dental ethics in the Center for Health Policy and Ethics at Creighton University in Omaha, Neb. He is co-author of Death and Medical Power: An Ethical Analysis of Dutch Euthanasia Practice.

  • Susan M. Wolf

    Susan M. Wolf is McKnight Presidential Professor of Law, Medicine and Public Policy, as well as Faegre & Benson Professor of Law at the University of Minnesota law school. She is also a professor of medicine at the University of Minnesota Medical School and a faculty member in the university’s Center for Bioethics in Minneapolis. She previously directed the Hastings Center project that produced the influential book Guidelines on the Termination of Life-Sustaining Treatment and the Care of the Dying in 1987.

In the West

  • Silvia Sara Canetto

    Silvia Sara Canetto is a psychology professor at Colorado State University in Fort Collins. She has written extensively about assisted suicide.

  • Elliot Dorff

    Rabbi Elliot Dorff is the Sol & Anne Dorff Distinguished Service Professor in Philosophy at American Jewish University in Bel-Air, Calif. He is an expert in Jewish family issues, including adoption. He has focused on the Jewish perspective on assisted death and ethics in general. He is the author of Matters of Life and Death: A Jewish Approach to Modern Medical Ethics.

  • Roberta Springer Loewy

    Roberta Springer Loewy is an associate clinical professor of bioethics at the University of California, Davis. She is co-author of The Ethics of Terminal Care: Orchestrating the End of Life and the author of Integrity and Personhood: Looking at Patients From a Bio/Psycho/Social Perspective.

  • Donn Moyer

    Donn Moyer is the special communication project manager at Washington Department of Labor & Industries. He can discuss the department’s 2013 report on Washington’s Death With Dignity Act; the report tracked the number of individuals who made use of the law and how many doctors and pharmacists assisted them.

    Contact: 360 902-5288.

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