Washington v. Glucksberg

Summary

Washington had made it a crime to aid a suicide since its first territorial legislature acted in 1854. In January 1994 four physicians who treat terminally ill patients, led by Dr. Harold Glucksberg, joined three gravely ill patients (who died while the case was pending) and the nonprofit group Compassion in Dying in a suit in federal court. They challenged the statute as applied to physicians aiding competent, terminally ill adults at their request. The District Court agreed; a panel of the Ninth Circuit reversed; and the full Ninth Circuit, sitting en banc, held the law invalid as applied, reasoning that there is a liberty interest in determining the time and manner of one's death. The question was whether the Due Process Clause of the Fourteenth Amendment protects a right to assistance in committing suicide. The physicians argued that the Court's decisions in Planned Parenthood v. Casey (1992) and Cruzan (1990) recognized a sphere of personal autonomy over intimate decisions about one's body and the end of life, and that a dying patient's choice deserved the same protection. Washington answered that the asserted right had no root in the nation's legal traditions, and that the state had compelling reasons to keep the ban: preserving life, preventing suicide, protecting the ethics of medicine, shielding vulnerable people from pressure, and avoiding a slide toward euthanasia. On 26 June 1997 the Court reversed, with all nine justices concurring in the judgment. Chief Justice Rehnquist began with history from Bracton through Blackstone and the early state statutes, finding a consistent rejection of assisted suicide. Substantive due process, he wrote, protects only fundamental rights that are deeply rooted in the nation's history and tradition, and it requires a careful description of the right asserted. Described carefully, the claim was a right to commit suicide with another's assistance, which no tradition supported; and the right to refuse unwanted treatment assumed in Cruzan rested on the distinct common-law rule against forced medical touching. Because the ban was rationally related to legitimate state interests, it was valid. Justice O'Connor joined the Court but wrote that there was no need to decide whether a dying person might have an interest in relief from suffering, since palliative care was lawful in Washington. Justice Souter, concurring in the judgment, proposed a different method drawn from Justice Harlan's Poe v. Ullman dissent, weighing liberty against state interests through reasoned judgment. Justice Breyer, also concurring in the judgments, suggested that a right to die with dignity might deserve consideration in a case where the state barred relief from severe pain. Justice Stevens and Justice Ginsburg wrote separately as well; their opinions are not in the library text. The library text gives Rehnquist's and O'Connor's opinions, part of Souter's and all of Breyer's, without the reporter's notes. The Glucksberg history-and-tradition test was later central to the majority in Dobbs v. Jackson Women's Health Organization (2022).

Top Lessons

• History and tradition as a test

  The Chief Justice held that unenumerated rights protected by the Due Process Clause must be objectively rooted in the nation's history and legal traditions. Supporters see this as a check that keeps judges from writing their own views into the Constitution; critics think it ties liberty too closely to the past.

• Describing a right carefully

  The Ninth Circuit asked whether there is a right to die; the Court asked whether there is a right to commit suicide with another's assistance. How broadly a right is described often determines whether a court will find it in the nation's traditions, and the justices disagreed over the right level of generality.

• Refusing treatment and seeking aid in dying

  Rehnquist distinguished the right to refuse unwanted medical treatment, assumed in Cruzan, from a right to assistance in ending one's life. He rested the first on the old law of battery; the respondents argued that both involve the same choice about the end of life.

• The vulnerable and the law

  Washington defended its ban partly as protection for the poor, the elderly, people with disabilities and those suffering from depression. The Court accepted these concerns as legitimate, while O'Connor stressed that palliative care remained lawful for those in pain.

Verified Quotes

Medical Lens

Glucksberg sets the constitutional frame for physician-assisted dying in the United States, and its account of the state's interests draws directly on medical sources: the association of suicidal wishes with treatable depression, the American Medical Association's view that physician participation is incompatible with the healer's role, and the distinction between palliative care and assistance in ending life.

• Opinion of the Court, Part II, paragraph beginning Those who attempt suicide

  Relies on the New York Task Force for the link between suicidal wishes and depression, and for the concern that depression in seriously ill patients is often missed.

• Opinion of the Court, Part II, paragraph beginning The State also has an interest in protecting the integrity and ethics of the medical profession

  Sets the American Medical Association's opposition to physician-assisted suicide and testimony on patient trust against the Ninth Circuit's view that medicine's integrity was not at risk.

• Opinion of Justice Breyer, paragraph on pain-relieving drugs and hospice briefs

  Considers the testimony of hospice and medical organizations that pain can nearly always be controlled, and treats lawful palliative care as decisive for the case.