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Assisted suicide ruling increases lawsuits, legislation and lobbying

October 12, 1997

NEW YORK (AP) _ For 10 long and frustrating years, Diane Coleman talked to legislators, wrote to newspapers and organized demonstrations, trying with little success to get out the message that assisted suicide could be used to get rid of healthy but disabled people _ like her.

But everything changed for Coleman this summer, when the issue went to the U.S. Supreme Court.

The high court issued a very narrow ruling, upholding laws in New York and Washington state that ban assisted suicide but taking no position on future laws allowing the practice.

After years of waiting as the case dragged on, activists on all sides agreed: The future of assisted suicide will be decided state by state, and that meant war.

Like other advocates, Coleman has seen a flurry of change since the June ruling. Not Dead Yet, the Forest Park, Ill.-based group she founded, now has a board of directors, a mailing list of 2,000 people and a Web site that’s been visited 20,000 times. The group is regularly consulted by assisted suicide conference organizers and the media.

``The court just left the door open for a states’ rights struggle,″ said Coleman, who has a neuro-muscular disorder that put her in a wheelchair at age 11. ``We know (proponents) are ready, they’re moving.″

Lawyers on all sides have begun preparing for battle in state courts and legislatures. Bills are in the works, new interest groups have formed, small groups have become national players, medical organizations are highlighting the subject at conferences and medical schools are talking about it with their students.

The Supreme Court’s ruling had another, perhaps more significant effect _ it put the issue of assisted suicide on the mind of the public.

``It’s a common kitchen table conversation now,″ said Barbara Coombs Lee, executive director of the Seattle-based Compassion in Dying, a nonprofit group that brought the cases that landed at the Supreme Court.

Since the ruling, Compassion in Dying has opened two new offices, in Oregon and Northern California. It has also created the Center for End of Life Law and Policy that will look for ways to bring the issue into state courts.

Lori Andreas can attest to the change. As a clinical nurse at Oregon Health Sciences University in Portland, she sees it all the time. Last month, the family of a patient who had lingered in a coma for nearly a year asked Andreas: Can we give him something to make this end?

``I don’t know that that discussion would have gone on before,″ Andreas said. ``What it’s done is opened communication about what people feel they have the choice over or don’t. We have more discussions with terminally ill patients about, `Can I have medications to end my life?‴

Predictions vary wildly about the future of assisted suicide and whether state courts, legislators and the public will agree with the Supreme Court.

In its ruling, the Supreme Court said New York and Washington were not violating their citizens’ constitutional rights by banning assisted suicide.

Terminally ill people do not have a constitutional right to assisted suicide, the court said, and helping end another’s life conflicts with ``our nation’s history, legal traditions and practices,″ wrote Chief Justice William H. Rehnquist.

However, the court left the door open for legalizing assisted suicide, and several justices noted that the two state laws don’t forbid doctors from giving patients pain medication even if there’s a risk that the drugs will kill.

Thirty-five states now outlaw assisted suicide, nine states consider it a crime through common law, five states have never decided either way and Oregon has legalized it _ the only state to do so.

Three years after Oregon voters approved the law through a referendum, however, legal challenges have stalled it. Pressured by assisted suicide opponents, legislators have called for a vote Nov. 4 on whether to repeal the law.

Regardless of what happens with legalization, the assisted suicide cases have already forced changes in how the medical industry approaches end-of-life care, and pain management in particular.

Medical schools, including Oregon Health Sciences, have expanded their programs in palliative care, which focuses on treating physical and emotional pain. The American Medical Association says it will teach every doctor in the country how to properly treat dying patients before the year 2000.

``I think what everyone recognizes here is that there wouldn’t be an enormous cry unless there was a strong feeling that people who are dying and people with disabilities and chronic pain are not getting adequate services,″ said Burke Balsch, medical ethics director for the National Right to Life Committee in Washington.

The committee sponsored a weekend retreat for legislators after the ruling, laying out potential anti-assisted suicide bills: one to allow patients’ relatives to sue anyone who helped in an assisted suicide, another to protect doctors who dole out lots of pain medicine from civil and criminal charges or those from state medical boards.

Meanwhile, the new Center for End of Life Law and Policy is looking to press the issue in state courts.

Kathryn Tucker, the center’s director, said she plans to sue doctors who fail to relieve their patients’ pain, challenge state laws that limit medication and seek protection for assisted suicide under state constitutions.

Among the grassroots groups suddenly in the national spotlight since the ruling is the Tallahassee, Fla.-based Commission on Aging With Dignity.

Since June, commission director Jim Towey has been asked to speak at senior centers around the country, where he has distributed 100,000 copies of ``Five Wishes,″ a living will he says will alleviate people’s fears that they will die alone and in pain. The commission opposes assisted suicide.

``Since the rulings, there’s a ton of interest in the topic,″ he said. ``People are aware that America is aging and there’s a problem here.″

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