The Background and Current Legal Statutes on Euthanasia

The current federal legal statutes on euthanasia or physician-assisted suicide in the United States are clear. The upper court has repeatedly reaffirmed that euthanasia is not one of the many rights covered by the U.S constitution, as witnessed by the majority opinion in the 1997 landmark supreme court case of Washington vs. Glucksberg. In that case, the high court, in a unanimous decision, decided that the State of Washington’s prohibition of assisted suicide does not violate the fourteenth amendment’s due process clause. Furthermore, it was stated that assisted suicide goes against our nation’s longstanding traditions, practices, and values. The sixth and sixteenth articles of this final opinion further elaborated that the ban on assisted suicide is not an innovation by the State of Washington but rather a common legal consensus among almost all western democracies. In addition, when applied to the rational basis test, it was found that the State of Washington’s outlawing of assisted suicide met the rational standard of preserving human life. It was also noted as an act that upholds the standards of its state’s medical ethics (Legal Information Institute, Washington, et al., petitioners, V. Harold Glucksberg et al..). It is crucial to know that this decision is still in effect today and is a well-established judicial precedent that the lower courts use to model their own judicial opinions for this particular type of litigation.

Interestingly, in the decades following this landmark decision, the U.S public opinion over this issue has also drastically changed. According to a recent Gallup poll conducted in 2017 with a random sample of more than 1000 adults across all fifty states. The results concluded that more than 70% of the survey respondents favor legalizing euthanasia (McCarthy, 2017). Also, in 2018, in light of the limited sample size the first time around and to assess the accuracy of this poll, Gallup conducted the poll again with similar sample size. The final result was near-identical to the results back in 2017 (Brenan, 2018). Combined with the fact that these results came with a 95% confidence level and a margin of error of plus or minus 4%, it further enhances its overall credibility. It is abundantly clear that the issue of euthanasia is worth taking a second look at to re-evaluate why it might be fair to legalize it federally. Therefore, let us take deeper dive into this very issue and reexamine the case through the scope of the various economic benefits, morality concerns, and the global judicial consensus.

The Economic Benefits

Most people might find it hard to assign a monetary value to a living person’s livelihood. Sadly, however, the reality is that crippling medical bills may sometimes pose more torture than the actual disease itself under our current medical system. According to a JAMA research study from earlier last year, four researchers performed an analysis by pulling a random sample of 10% of all U.S consumer credit reports from TransUnion. Out of the 10% sampled credit reports, the researchers have reached a shocking conclusion that about 17.8% of all individuals in the U.S had some sort of medical debt in debt collection as of June 2020 (Kluender, PhD et al., 2021). It is worth pointing out that the 10% sample credit reports were pulled primarily between January 2009 and June 2020. This timeframe means that this particular sample is a collection of data that only represents medical debt prior to the pandemic. This fact, in essence, means that it is safe to assume that if the researchers were to pull a 10% sample, including the data from the last three years of the pandemic, the figure would have likely been even higher.

Now, people might be thinking, how on earth are medical debts related to the topic of euthanasia? It does because every one of those sampled credit reports is, in some way, representative of a family. According to one of the top three credit reporting agencies, Experian, medical debts are not discharged when a person dies. Instead, the debt collectors could potentially go after the assets of a deceased person to recoup and repay that medical debt (Axelton, 2020). For example, if the deceased owns a real estate together with their spouse, in that case, the surviving spouse may have no choice but to sell this house to pay for the deceased spouse’s medical debts. As many people may see, this outcome is very cruel in nature because, on top of losing their loved ones, the surviving spouse may also have to deal with the potential of losing a place to live, or worst, losing all assets and spiral down to a total financial collapse.

One of the best ways to alleviate this issue is not to rack up this debt in the first place. Nevertheless, people that want to receive euthanasia are more likely than not chronically ill patients suffering from intolerable discomfort and excruciating pain. Therefore, in order to keep them “alive,” well, and temporarily out of the agonizing misery, some special medical procedures and medications may be necessary. Unfortunately, it is also more often than not that these treatments are incredibly expensive, and sometimes, they might not even work depending on the severity of that chronic disease. Therefore, without the possibility for the patient to elect to receive active euthanasia, they inevitably have no choice but to accumulate this debt in an effort to stay in the treatment plan in hopes of alleviating this unbearable pain while also knowing that they will have no way to recover from this torment and that they will evitably face death.

Back in late 1996, two researchers from the anesthesiology department of the University of Pittsburgh performed an interesting study to see how much it would cost patients suffering from cardiac arrests to “cheat death.” This study eventually concluded that it might cost upwards of a couple of hundred thousand dollars (Abramson et al., 1996). Now, looking back on this study, the only limitations are that it only counted the accumulative costs for patients who have survived for more than six months and also that the CPR treatment is nowhere near as expensive now as it was back in 1996. However, it is essential to know that our current-day advancements in medicines are just like older-day CPR treatments. Therefore, although CPR treatments are not as expensive as they used to cost, the newer life-sustaining treatments will still be very costly and will remain this way for the foreseeable future.

The Moral Concerns

People on the other side of the aisle may argue that giving up on a patient solely based on economic benefits will arouse the worst of human nature and expose the inner greed and evil. Does this argument has a valid point? Absolutely, but there is a way around this concern. Legalizing active euthanasia at the federal level will require a rigorous licensing procedure. There must also be an established independent oversight committee that oversees the licensing procedures and sets regulations and standards for this entire industry.

One of the best active euthanasia examples is the Netherlands’ implementation of the “Due Care Criteria.” Basically, in the Netherlands, for a euthanasia request to go through, a specific number of requirements must be met. For example, the Netherlands’ government page for euthanasia explicitly notes that in order for a physician to be immune to criminal prosecution, the physician must consult with another independent physician to evaluate the patient’s illness. In addition, the patient must be fully aware of his or her diagnosis and make a formal request that they would like to request euthanasia. Finally, the patient must also explicitly states that they see euthanasia as the only viable alternative to escape from their sufferings. Only then will the physicians be allowed to proceed with notifying respective authorities and start the proper review procedures (Veiligheid, 2017).

To test out if this newly implemented euthanasia law does what it is tasked to do, in 2006, a group of research scientists performed a study by sending a questionnaire to a random stratified sample of dutch physicians. Out of the total 21,000 questionnaires sent, about 11,760 physicians responded. Out of the 11,760 total responded physicians, 75%, or 8,820 of them have noted that they have received at least one formal request from chronically ill patients requesting euthanasia. In addition, out of that pool, about 25%, or 2,205 of them, noted that they have encountered at least one difficulty in satisfying the “Due Care Criteria. (Buiting et al., 2008).” This signifies that although the implementation is not perfect, it successfully created a necessary barrier to prevent unnecessary and potentially wrongful euthanasias.

The Global Judicial Consensus

Now, let us set morality and economics aside for a moment and circle back to the U.S landmark case of Washington vs. Glucksberg. One of the more eye-catching parts of the U.S supreme court’s final opinion was the inclusion of one of the Canadian supreme court cases, Rodriguez vs. British Columbia(AG). In article 8 of this majority opinion, the U.S supreme court stated that this Canadian landmark case is evidence that assisted suicide should be stopped at all costs and used it to justify that the prohibition of assisted suicide is, in fact, a norm for western democracies. However, the funny part about this was that it backfired against the U.S supreme court, against the notion that it is just a norm for western democracies. Because in 2015, the supreme court of Canada, in a unanimous decision, decided to overturn this 1993 ruling on Rodriguez vs. British Columbia(AG) with the litigation of what later became Carter vs. Canada(AG). Ultimately shifting away from their original stance of the previous five to four rulings in which they upheld the provisions of euthanasia in its criminal codes. This is a significant ruling because it decriminalizes euthanasia in its entirety across Canada by giving Canadian adults the green light to request euthanasia without fearing potential legal consequences. It resembles the incorporation clause of the fourteenth amendment in the U.S constitution that mandates states to implement certain amendments into their state constitutions. This ruling is very similar to that because it took provincial litigation, overturned it, and incorporated it into Canadian federal statutes, converting it into a constitutional statute that all provinces must obey and follow.

Last but not least, euthanasia may seem morally wrong for us to advocate for at first because, after all, all human life is a precious gift from God. However, if we let religious beliefs take total control of our legislative effort, we will not progress and move forward as a society. Unfortunately and sadly, this may be the necessary evil that we have to allow to happen so people can stop suffering needlessly. We have what it takes to implement it successfully. At the end of the day, however, it is ultimately up to us to decide when it is morally right and justified to act.

References

Abramson, N. S., Lee, K. H., & Angus, D. C. (1996, December 24). Cardiopulmonary resuscitation: What cost to cheat death? Critical care medicine. Retrieved May 23, 2022, from https://pubmed.ncbi.nlm.nih.gov/8968275/

Axelton, K. (2020, September 13). What happens to medical debt when you die? Experian. Retrieved May 23, 2022, from https://www.experian.com/blogs/ask-experian/what-happens-to-medical-debt-when-you-die/

Brenan, M. (2018, May 31). Americans’ strong support for euthanasia persists. Gallup.com. Retrieved May 22, 2022, from https://news.gallup.com/poll/235145/americans-strong-support-euthanasia-persists.aspx

Buiting, H. M., Gevers, J. K. M., Rietjens, J. A. C., Onwuteaka-Philipsen, B. D., Maas, P. J. van der, Heide, A. van der, & Delden, J. J. M. van. (2008, September 1). Dutch criteria of due care for physician-assisted dying in medical practice: A physician perspective. Journal of Medical Ethics. Retrieved May 23, 2022, from https://jme.bmj.com/content/34/9/e12.long

Kluender, PhD, R., Mahoney, PhD, N., Wong, PhD, F., & Yin, PhD, W. (2021, July 20). Medical debt in the U.S., 2009-2020. JAMA. Retrieved May 22, 2022, from https://jamanetwork.com/journals/jama/fullarticle/2782187

Legal Information Institute. (n.d.). Washington, et al., petitioners, V. Harold Glucksberg et al.. Legal Information Institute. Retrieved May 22, 2022, from https://www.law.cornell.edu/supremecourt/text/521/702

McCarthy, J. W. and J. (2017, June 12). Majority of Americans remain supportive of euthanasia. Gallup.com. Retrieved May 22, 2022, from https://news.gallup.com/poll/211928/majority-americans-remain-supportive-euthanasia.aspx

Veiligheid, M. van J. en. (2017, June 6). Euthanasia, assisted suicide and non-resuscitation on request. Euthanasia | Government.nl. Retrieved May 23, 2022, from https://www.government.nl/topics/euthanasia/euthanasia-assisted-suicide-and-non-resuscitation-on-request