Assisted suicide is a suicide by a person terminally ill or with an unmanageable pain committed with the assistance of a third person. In other words, assisted suicide is a form of suicide that involves a person other than the person taking his/her own life and the other person assists in giving effect to the suicide in a direct or indirect manner.
Under some jurisdictions, it is established that a competent person can refuse medical treatment[i] even if the withdrawal of such treatment will result in death. However, whether life sustaining treatment can be withheld or withdrawn from an incompetent patient depends upon the consideration of the rights of a competent patient to refuse medical treatment[ii]. An incompetent person has the right to have life sustaining medical treatment terminated if it is established that such person expressed the desire to invoke that right when s/he was competent.
The doctrine of informed consent requires that if there is no emergency, then a physician must obtain consent from the patient before performing any medical procedure after explaining the nature of the treatment and substantial risks or risk of the imposition of civil liability upon his/her failure to obtain informed consent[iii]. There are three basic prerequisites for informed consent[iv]:
- Patient must have the capacity to reason and make judgments;
- Decision must be voluntary and without coercion,;
- Patient must have a clear understanding of the risks and benefits of the proposed treatment alternatives or nontreatment, along with a full understanding of the nature of the disease and the prognosis.
According to some statutes, it is a criminal offense if a person[v]:
- Provides the means by which an individual attempts to kill himself/herself or kills himself/herself;
- Participates in an act by which an individual attempts to kill himself/herself or kills himself/herself
- Helps the individual plan or attempt to kill himself/herself or kills himself/herself.
Under certain jurisdictions, the right to refuse medical treatment includes refusal of artificial nutrition and hydration[vi]. However, as a result of incurable illness, if a patient cannot chew or swallow and a death delaying feeding tube is withdrawn in scrupulous accordance with law, then the cause of such death is the illness and not the withdrawal[vii].
[i] DeGrella v. Elston, 858 S.W.2d 698 (Ky. 1993)
[ii] Delio v. Westchester County Medical Center, 129 A.D.2d 1 (N.Y. App. Div. 2d Dep’t 1987)
[iv] Cruzan v. Harmon, 760 S.W.2d 408 (Mo. 1988)
[v] Cooley v. Granholm, 291 F.3d 880 (6th Cir. Mich. 2002)
[vi] In re Estate of Longeway, 133 Ill. 2d 33 (Ill. 1989)
[vii] In re Estate of Greenspan, 137 Ill. 2d 1 (Ill. 1990)