The highest court in Massachusetts said in a decision Monday that allowing doctors to prescribe a lethal dose of medication to mentally competent patients with terminal illnesses is not protected by the state constitution.
“Although we recognize the paramount importance and profound significance of all end-of-life decisions, after careful consideration, we conclude that the Massachusetts Declaration of Rights does not reach so far as to protect physician-assisted suicide,” the Supreme Judicial Court wrote in its decision. “We conclude as well that the law of manslaughter may prohibit physician-assisted suicide, and does so, without offending constitutional protections.”
The high court, while noting the sensitive nature of the case, said the ultimate decision on physician-assisted suicide — also known as medical aid in dying — lies with the state Legislature.
The court said “every one of us is free to vote and encourage our legislators to enact laws, and to craft appropriate procedural safeguards, with respect to one of the only human experiences that will affect us all.”
The court also drew a distinction between physician-assisted suicide and a patient's voluntary choice to refuse medical treatment or nutrition, saying “whereas withdrawing or withholding medical care is not the primary cause of a patient’s death, physician-assisted suicide is."
The suit was originally filed in 2016 by Dr. Roger Kligler, a retired physician with stage 4 prostate cancer, and another doctor who feared prosecution on manslaughter charges if he prescribed end-of-life medications to terminally ill patients.
“People are going to die suffering because of this decision," Kligler, 70, said in a telephone interview from his Cape Cod home.
Kligler, who said he is “not doing well” and in “chronic pain,” pledged to continue fighting as long as he is able.
“I will continue urging lawmakers to respect the bodily autonomy of dying Massachusetts residents by passing the End of Life Options Act,” he said.
More than a dozen bills to legalize physician-assisted suicide in the state have been introduced in the Legislature but none has ever been put to a vote. In addition, Massachusetts voters in 2012 rejected a ballot question allowing terminally ill patients to receive a lethal dose of drugs, the court noted.
The office of state Attorney General Maura Healey, which argued the case on behalf of the state, also said the Legislature is the best place to address the issue.
“Our office understands the complexities of end of life care," attorney general's spokesperson Jillian Fennimore said in a statement. “We are pleased that the Court has affirmed our position that the Legislature is the most appropriate place to have a discussion about this important public policy issue. AG Healey has said she supports legislative action to allow medical aid in dying, provided it includes sufficient safeguards for both patients and providers.”
Healey, a Democrat, takes over as governor next month.
The decision was lauded by organizations opposed to physician-assisted suicide.
“Patients should be able to trust their doctors to support and care for them," said Chris Schandevel, senior counsel for the nonprofit Alliance Defending Freedom, which filed a friend-of-the-court brief in the case on behalf of Euthanasia Prevention Coalition. “Offering terminally ill or disabled patients a ‘quick exit’ through death-inducing drugs destroys that trust.”
Medical aid in dying is allowed in 10 states and Washington D.C., according to the advocacy group Compassion and Choices.