With Nelson Lund, Commentary, December 1996.
That we die is certain. When and how we die is not. Because we want to live and not to die, we resort to medicine to delay the inevitable. Yet medicine’s increasing success in prolonging life has been purchased at a heavy price, paid in the coin of how we die: often in conditions of unrelievable pain and suffering, irreversible incompetence, and terminal loss of control. While most people still look forward to further triumphs in medicine’s war against mortality, many Americans increasingly want also to exercise greater command over the end of life. Some even wish to elect death to avoid the burdens of lingering on. Ironically, they also seek assistance in doing so from the death-defying art of medicine. People no longer talk only about refusing medical treatment. The demands of the day are for assisted suicide and euthanasia.
Nearly everyone recognizes that such practices raise profound moral and social issues: human dignity, the sanctity of life, the morality of suicide, the ethic of medicine, protection of the vulnerable, duties of care, and the government’s obligation to control the use of lethal force and to protect innocent life. But because of the nature of our political system, large moral questions in America are often recast in terms of individual rights. Predictably, the complicated and delicate issues surrounding the end of life are now being addressed in the context of a demand for a “right to die.” To secure such a right against existing governmental interference, protagonists have sued in the courts. And so, vexed questions of death and dying have now become a matter for constitutional adjudication.