Case # / Date
(chronological Case Summary
order)
1. In re Quinlan In 1975, 21-year-old Karen Ann Quinlan was
(PDF 106KB) admitted to the hospital in a coma, and was
70 N.J. 10 later declared by doctors to be in a "persistent
Mar. 31, 1976 vegetative state." After five months on a
ventilator, her parents requested that the
ventilator be removed and that Ms. Quinlan be
allowed to die. After doctors refused, her
parents brought the matter to court.
The New Jersey Superior Court denied her
parents' request, but the New Jersey Supreme
Court reversed and ruled that Quinlan's "right to
privacy" included her right to be removed from
the ventilator.
2. Cruzan v. Director, Nancy Beth Cruzan was involved in an
Missouri Dept. of automobile accident that left her in a "persistent
Health (PDF 284KB) vegetative state." After being sustained for
497 U.S. 261 several weeks by artificial feedings, her parents
June 25, 1990 attempted to end life-support, but state hospital
officials refused to do so without court approval.
Excerpts From Court Ruling
"Although the Constitution does not explicitly
mention a right of privacy, Supreme Court
decisions have recognized that a right of
personal privacy exists and that certain areas of
privacy are guaranteed under the Constitution."
(p. 23)
"We think that the State's interest contra
weakens and the individual's right to privacy
grows as the degree of bodily invasion
increases and the prognosis dims. Ultimately
there comes a point at which the individual's
rights overcome the State interest. It is for that
reason that we believe Karen's choice, if she
were competent to make it, would be vindicated
by the law. Her prognosis is extremely poor..."
(p. 24)
"Our affirmation of Karen's independent right of
choice, however, would ordinarily be based
upon her competency to assert it. The sad truth,
however, is that she is grossly incompetent and
we cannot discern her supposed choice based
on the testimony of her previous conversations
with friends, where such testimony is without
sufficient probative weight... Nevertheless we
have concluded that Karen's right of privacy
may be asserted on her behalf by her guardian
under the peculiar circumstances here present."
(p. 24)
"The termination of treatment pursuant to the
right of privacy is, within the limitations of this
case, ipso facto lawful. Thus, a death resulting
from such an act would not come within the
scope of the homicide statutes proscribing only
the unlawful killing of another. There is a real
and in this case determinative distinction
between the unlawful taking of the life of
another and the ending of artificial life-support
systems as a matter of self-determination." (p.
34)
"The United States Constitution does not forbid
Missouri to require that evidence of an
incompetent's wishes as to the withdrawal of
life-sustaining treatment be proved by clear and
convincing evidence." (p. 1)

A state trial court authorized the termination of
feeding, but the Missouri Supreme Court
reversed. In a 5-4 decision, the U.S. Supreme
Court upheld the ruling of the Missouri Supreme
Court, finding that the State of Missouri's actions
to preserve human life were constitutional in the
absence of "clear and convincing evidence" that
Cruzan desired treatment to be withdrawn.
3. Washington v. Harold Glucksberg, MD, along with three other
Glucksberg (PDF doctors, three gravely ill patients, and the
62KB) nonprofit organization Compassion in Dying,
521 U.S. 702 brought a suit challenging the state of
June 26, 1997 Washington's ban on physician-assisted suicide.
The plaintiffs asserted that the Washington ban
was unconstitutional, arguing that the existence
of a liberty interest protected by the Fourteenth
Amendment allows mentally competent,
terminally ill adults to commit physician-assisted
suicide. The District Court ruled that the ban
was unconstitutional, and the Ninth Circuit
affirmed.
The Supreme Court, in a 9-0 decision, reversed,
finding that the ban on physician-assisted
suicide does not violate the Fourteenth
Amendment.
4. Vacco v. Quill Timothy Quill, MD, along with two other
(PDF 36KB) physicians and three gravely ill patients,
526 U.S. 793 challenged the constitutionality of New York
June 26, 1997 state's ban on physician-assisted suicide. The
plaintiffs argued that New York's ban violated
"A competent person has a liberty interest under
the Due Process Clause in refusing unwanted
medical treatment... However, the question
whether that constitutional right has been
violated must be determined by balancing the
liberty interest against relevant state interests.
For purposes of this case, it is assumed that a
competent person would have a constitutionally
protected right to refuse lifesaving hydration and
nutrition. This does not mean that an
incompetent person should possess the same
right." (p. 2)
"The Due Process Clause does not require a
State to accept the 'substituted judgment' of
close family members in the absence of
substantial proof that their views reflect the
patient's." (p. 3)
"In almost every State -- indeed, in almost every
western democracy -- it is a crime to assist a
suicide. The States' assisted suicide bans are
not innovations. Rather, they are longstanding
expressions of the States' commitment to the
protection and preservation of all human life."
(p. 2)
"The decision to commit suicide with the
assistance of another may be just as personal
and profound as the decision to refuse
unwanted medical treatment, but it has never
enjoyed similar legal protection. Indeed, the two
acts are widely and reasonably regarded as
quite distinct." (p. 10)
"That many of the rights and liberties protected
by the Due Process Clause sound in personal
autonomy does not warrant the sweeping
conclusion that any and all important, intimate,
and personal decisions are so protected." (p.
10)
"The asserted 'right' to assistance in committing
suicide is not a fundamental liberty interest
protected by the Due Process Clause." (p. 11)
"New York's statutes outlawing assisting suicide
affect and address matters of profound
significance to all New Yorkers alike. They
neither infringe fundamental rights nor involve
suspect classifications." (p. 2)
 the Equal Protection Clause of the Fourteenth
Amendment, as the law allowed for patients to
refuse life-sustaining treatment, but not for them
to receive assistance in suicide.
The District Court ruled in favor of the State of
New York, and the Second Circuit reversed in
favor of Dr. Quill. The Supreme Court, in a 9-0
ruling, upheld the constitutionality of New York's
ban on physician-assisted suicide.
5. People v. Fifty-two year old Thomas Youk was suffering
Kevorkian (PDF from Lou Gehrig's disease when, upon Youk's
148KB) request, Jack Kevorkian, MD, administered a
No. 221758 lethal drug to Youk, who died as a result.
Nov. 20, 2001
Dr. Kevorkian filmed Youk's death and the trial
court jury, who saw the videotapes in court,
convicted Kevorkian of second-degree murder,
despite his claims that he had committed a
"mercy killing." The Michigan Court of Appeals
affirmed the conviction.
6. Bush v. Schiavo Theresa Schiavo had been in a persistent
(PDF 292KB) vegetative state since 1990. The Second District
No. SC04-925
"We think the distinction between assisting
suicide and withdrawing life sustaining
treatment, a distinction widely recognized and
endorsed in the medical profession and in our
legal traditions, is both important and logical."
(p. 3)
"Even as the States move to protect and
promote patients' dignity at the end of life, they
remain opposed to physician assisted suicide."
(p. 4)
"Our assumption of a right to refuse treatment
was grounded not, as the Court of Appeals
supposed, on the proposition that patients have
a general and abstract 'right to hasten death'...
but on well established, traditional rights to
bodily integrity and freedom from unwanted
touching." (p. 5)
"Succinctly put, there is no principled basis for
us to legalize euthanasia." (p. 2)
"In summary, defendant does not, nor could he,
ask us to hold that his actions were legally
justifiable because he simply helped Youk
exercise his right to refuse medical care.
Defendant does not, nor could he, ask us to
hold that he was lawfully attempting to alleviate
Youk's pain and suffering by any means other
than causing his death. Defendant does not, nor
could he, ask us to hold that his actions
constituted a legal form of assisted suicide. In a
nutshell, and using his own terminology,
defendant asks us to legalize euthanasia." (p. 9)
"Defendant's argument that the people have
reserved the right to euthanasia under the Ninth
Amendment and its Michigan counterpart is
basically formless." (p. 9)
"It is one thing to assert, as defendant does, that
there is a large body of case law suggesting that
due process sometimes relies on the right to
privacy to protect fundamental liberty interests.
It is quite another thing, however, to conclude
that the right to privacy encompasses
euthanasia." (p. 10)
"In this case, the undisputed facts show that the
guardianship court authorized Michael to
Sep. 23, 2004 Court of Florida allowed for the removal of her
nutrition and hydration tube on Oct. 15, 2003.
On Oct. 21, 2003, the Florida Legislature
enacted chapter 2003-418, and Governor Jeb
Bush signed the Act into law, issuing executive
order No. 03-201 to stay the continued
withholding of nutrition and hydration from
Theresa.
Michael Schiavo, Theresa's husband and
guardian, challenged the Act in circuit court, and
the circuit court ruled in his favor, finding the Act
unconstitutional. The Florida Supreme Court
affirmed.
7. Gonzales v. In 1994, Oregon passed the Death with Dignity
Oregon (PDF 405KB) Act, the first state law permitting physicians to
Docket # 04-623 prescribe lethal doses of controlled substances
Jan. 17, 2006 to terminally ill patients. U.S. Attorney General
John Ashcroft declared in 2001 that the Act
violated the Controlled Substances Act of 1970,
and threatened to revoke the medical licenses
of physicians who engaged in physician-
assisted suicide.
Oregon sued the Attorney General in federal
district court. The district court and the Ninth
Circuit both held that Ashcroft's directive was
illegal.
The U.S. Supreme Court, in a 6-3 opinion, also
held that the Controlled Substances Act did not
authorize the Attorney General to ban the use of
controlled substances for physician-assisted
suicide.
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proceed with the discontinuance of Theresas
life support after the issue was fully litigated in a
proceeding in which the Schindlers were
afforded the opportunity to present evidence on
all issues... Thus, the Act, as applied in this
case, resulted in an executive order that
effectively reversed a properly rendered final
judgment and thereby constituted an
unconstitutional encroachment on the power
that has been reserved for the independent
judiciary. (p. 15)
"The Act is unconstitutional on its face because
it delegates legislative power to the Governor."
(p. 18)
"The CSA [Controlled Substances Act] does not
allow the Attorney General to prohibit doctors
from prescribing regulated drugs for use in
physician-assisted suicide under state law
permitting the procedure." (p. 2)
"The Attorney General has rulemaking power to
fulfill his duties under the CSA. The specific
respects in which he is authorized to make
rules, however, instruct us that he is not
authorized to make a rule declaring illegitimate
a medical standard for care and treatment of
patients that is specifically authorized under
state law." (p. 16)
"In the face of the CSAs silence on the practice
of medicine generally and its recognition of state
regulation of the medical profession it is difficult
to defend the Attorney Generals declaration
that the statute impliedly criminalizes physician-
assisted suicide." (p. 30)
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