Right-To-Die Movement

Although interest in end-of-life issues has waxed and waned during the 20th century, a recent resurgence of public attention to this topic has occurred in the United States. Specifically, a host of social and cultural forces have spurred an effort to legalize terminally ill patients' rights to control the manner and circumstances surrounding their death. Factors such as the rapid growth of medical technology and an increased emphasis on personal autonomy have given rise to the right-to-die movement. This large-scale social initiative has advocated for the right of terminally ill patients to refuse medical treatment, to forego life-sustaining technology, and to request options such as physician-assisted suicide and euthanasia.

Although some scholarly discussion of individuals' right to die appeared as early as the 19th century, the right-to-die movement in the United States did not emerge as a significant social force until the 1970s. The event that pushed right-to-die issues to the forefront of public attention was a New Jersey Supreme Court ruling concerning patients' rights to withhold life-support intervention. The case, known as In re Quinlan, was instigated by Karen Ann Quinlan's parents, who fought for the legal right to discontinue their daughter's life support. After considering the Quinlans' arguments, the New Jersey Supreme Court ruled that patients and their surrogates have a right to refuse unwanted medical treatment, even if this action hastens the patient's death. This ruling established a legal precedent for patients' rights to refuse life-support interventions. It also had a dramatic impact by instigating statewide legal action supporting the use of advanced directives. Finally, In re Quinlan drew tremendous social attention, bringing end-of-life issues to the forefront of public discussion and giving momentum to the right-to-die movement.

Taking advantage of the public attention raised by Quinlan's case, in 1980 the British journalist Derek Humphry founded the Hemlock Society, a right-to-die organization that aimed to further expand patients' options near the end of life. Specifically, Humphry argued that terminally ill patients should not only be able to refuse unwanted medical treatment but also to request active aid-indying by means of assisted suicide and euthanasia. The foundation of the Hemlock Society marked a shift in attention from refusal of treatment to the legalization of physician-assisted suicide. Over the next 2 decades, the Hemlock Society became a major force in the right-to-die movement and spurred efforts to legalize assisted suicide at the state and national levels. It was soon joined by other right-to-die groups, such as Compassion in Dying, which was founded in 1993 in Washington State.

During the 1990s, the Hemlock Society and Compassion in Dying made considerable efforts to legalize aid-in-dying and to decriminalize assisted suicide. In 1990, the Hemlock Society sponsored Washington State's Initiative 119, the first state referendum asking voters to decide on the issues of legalizing physician-assisted suicide. The Washington State initiative was quickly followed by a similar referendum in California. However, the [Page 849]majority of voters in both states refused to support the proposed measures. Oregon became the first state to endorse the legalization of physician-assisted suicide, with the passing of the Death With Dignity Act in 1994.

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