THE RIGHT TO DIE: THE INTERNATIONAL HUMAN RIGHTS
CONTEXT
Paul Morris
This set outs the international context for the New Zealand debate about the right to die issue.
I start with a caveat and what I hope are useful clarifications and definitions before
considering a number of polities and their legal deliberations and decisions on what I will by
then have further defined. First the caveat. Writing and thinking about this issue is made
much more difficult by its dynamic newsworthiness as the fraught, personal, complex and
unstable situations and information conveyed by the news media needs almost ceaseless
updating, rendering this paper out of date even before it is published. It is important to note
that New Zealand is part of a broad international debate over the management and morals of
end of life concerns.
Definitions and clarifications
I understand the ‘right to die’ as a shorthand for a number of inter-related issues relating to
decisions made by a person as to whether given certain conditions they can be permitted to
die: (a) by refusing medical treatment; or (b) by the withdrawal of artificial or heroic medical
means; or (c) by suicide before death occurs with the assistance of a prescribing physician,
including with direct assistance to administer lethal drug doses (physician-assisted suicide).
Some commentators make a moral distinction between (a) and (b), and others between (a)
and (b) from (c), taking the former to be passive and the latter active, but I do not consider
this a morally sustainable distinction.
Although not without controversy there is broad acceptance of (b), some acceptance of (a),
while (c) involves another expert actor and is currently widely debated. My contention is that
debates concerning all three impact upon and intersect with each other. As we shall see, the
separation of the three, legally and ethically, is both conceptually artificial and is at the heart
of many of the dilemmas and unresolved issues facing legislators and commentators. Many
polities now have relatively recent laws making physician-assisted suicide unlawful in
specific response to the assisted suicides by doctors such as Philip Nitschke and Jack
Kevorkian.i
Deliberations and decisions
Canada
The first challenge to the illegality of physician-assisted suicide was by a British Columbia
woman, Sue Rodriquez, suffering from amyotrophic lateral sclerosis (ALS aka Lou Gehrig’s
disease) in 1993. It was defeated by 5/4 in Canada’s Supreme Court.ii However, on 6
February 2015, the Supreme Court of Canada in Carter v Canada (AG) ruled that “denying
the right to assisted suicide is unconstitutional”, thus striking down the country’s law against
physician-assisted suicide by the unanimous ruling of all nine judges.iii (Specifically, sections
14 and 241b of the Criminal Code, Article 14 states that “no person is entitled to consent to
have death inflicted on him” and section 241b forbids anyone from counselling, aiding or
abetting someone to commit suicide.)iv The Court recognised the right of clearly consenting
adults who are enduring intolerable physical or mental suffering to end their lives with the aid
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of a physician. The Canadian government established a panel in June 2015 to consult the
public. The Supreme Court gave a year for legislative change by the Federal Government,
although in the first week of December 2015 the Attorney General’s office requested a
minimum of six months’ extension. The impetus for the delay comes from support from
Nova Scotia, Manitoba, Prince Edward Island, Saskatchewan and Ontario, i.e. five of the 10
provinces. In January 2016, the Court granted an additional four month extension in order for
the new Federal Government to engage in further public consultation and prepare draft
legislation. As a stop gap measure the Court also ruled that applications for euthanasia can be
approved by provincial courts until the new law is enacted.v
The language used by the Supreme Court in its ruling is problematic. Unlike other polities
Canada has not restricted its deliberations to those already terminal, i.e. dying, or expected to
die, imminently or within a short given time, or at any time at all. Suitable patients do have to
be a “competent adult person” who “clearly consents to the termination of life” and has a
medical condition that is “grievous and irremediable”, “including an illness, disease or
disability, that causes enduring suffering that is intolerable to the individual in the
circumstances of his or her condition”.
In December 2015, a spokesman for the Prime Minister of Canada, Justin Trudeau, reported
that the new government would “draw inspiration” from the right to die legislation passed by
the National Assembly of Québec in 2014 (Bill 52).vi The law was scheduled to take effect on
10 December 2015, but the week before Québec Superior Court judge, Michel Pinsonnault,
claimed that a number of sections contradict the Criminal Code of Canada and that provincial
law must be in line with federal law. Québec's three-judge Court of Appeal panel overturned
the Québec Superior Court judgment on 22 December 2015, ruling that the Québec law does
not contravene sections of the Criminal Code related to assisted dying because they were
struck down by Canada’s Supreme Court last February. So, the situation in Canada is very
much up in the air at this time but clearly moving towards physician-assisted suicide.vii
Britain
I now consider Britain (England and Wales), with the recently published decision by Mr
Justice MacDonald. Technically this is not a physician-assisted suicide case, but rather one
concerned with the mental capacity to decide to forgo medical interventions required to
ensure survival. This was the November 2015 case of the 50-year-old woman, described in
court as “C”. Hers was described as a life of excess and hedonism, and drinking. The four
times married, mother of three, overdosed on paracetamol (acetaminophen) and champagne
in a suicide attempt after learning that she had breast cancer in September 2015. She was
diagnosed as requiring dialysis for the organ damage caused in order to secure a near full
recovery.
Normally courts approve of life-saving treatments in the interests of a rational patient unless
there is demonstrable likely loss of functions or unbearable pain. Justice MacDonald ruled
that the Court of Protection (a superior court of record under the Mental Capacity Act 2005
with jurisdiction over the property, financial affairs and personal welfare of people who it
deems lack the mental capacity to make decisions for themselves) could not compel her to
undergo dialysis.
London’s King’s College Hospital asked the court to “impose” the treatment on her, using
sedation if necessary.viii Justice MacDonald concluded that she was mentally competent and
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that her argument that she did not want to live sans “her sparkle” and suffering the side
effects of chemotherapy was accepted. He said that the woman’s decision to refuse treatment
could be characterised as “unwise”, and some might even consider it “immoral”, but she was
the “sovereign” of her “own body and mind” and this entitled to make such a decision. The
Court of Protection decided on 11 December 2015 to extend C’s name suppression even
though she died on 28 November 2015 as a direct result of her refusal to undergo treatment.ix
The Suicide Act 1961 makes it an offence to encourage or assist a suicide or a suicide attempt
in England and Wales – anyone doing so faces up to 14 years in prison. There is a similar law
in Northern Ireland. MPs in England and Wales voted 330 to 118 (74% versus 72% in 1997;
some 2015 public polls reported 82% support) against the Assisted Dying No. 2 Bill 2015-16
(proposed by Rob Marris, Labour, Wolverhampton South West Private Member’s Bill,
essentially Lord Falconer’s Bill from June 2014 during the last parliament) in a free vote
(“conscience”) in the House of Commons on 11 September 2015.x The failure of the Bill to
pass its second reading means that it will make no further progress.xi
The (Hansard) debate is fulsome with a clear contrast between supporters and opponents, and
some real anxieties about safeguards, especially for the vulnerable.xii The Bill proposed that
people with fewer than six months to live could be prescribed a lethal dose of drugs, which
they had to be able to take themselves, with each case being separately approved by two
independent doctors and a High Court judge. The Director of Public Prosecutions (DPP)
already has to approve any assisted suicide court action in England, Wales and Northern
Ireland. In 2010, Keir Starmer, then the DPP, issued guidance that made it clear that family or
friends who travelled with a loved one to the Swiss suicide group Dignitas would not risk
prosecution. The guidelines were the result of a case brought by Debbie Purdy, a terminally
ill woman, who in 2009 won a Hose of Lords ruling requiring the DPP to set out whether her
husband would be committing an offence if he accompanied her to Dignitas to end her life.xiii
Scotland is a little different as there is no specific law on assisted suicide generating a degree
of uncertainty. MPs rejected the Assisted Suicide Scotland Bill in May 2015 by 82 votes to
36 (nine did not vote) following a free vote at Holyrood. The Bill would have allowed those
with terminal illnesses to seek the help of a doctor to end their own life. It is not illegal to
attempt suicide in Scotland, but helping someone take their own life can lead to prosecution.
United States
The Supreme Court has determined that no right exists for physician-assisted suicide. States,
however, can enact laws that allow it. Currently, Oregon is the only state that allows
physician-assisted suicide. Technically, however, a death under that state’s Death with
Dignity Act 1994 is not deemed suicide, assisted suicide or homicide.xiv This law has
successfully survived a number of legal challenges since it was enacted. In January 2006,
former Attorney General John Ashcroft attempted to argue that it was illegal under federal
law in the US Supreme Court (Gonzales v Oregon).xv In 1997, President Clinton signed the
Assisted Suicide Funding Restriction Act of 1997. This law was designed “to clarify Federal
law with respect to restricting the use of Federal funds in support of assisted suicide,
euthanasia or mercy killing”.
The Act banned the funding of assisted suicide through Medicaid, Medicare, military and
federal employee health plans, veterans’ health care systems and other federally funded
programs. It also prohibited the use of taxpayer funds to subsidise legal assistance or other
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advocacy in support of legal protection for assisted suicide.xvi In two cases from 1997, the US
Supreme Court ruled that physician-assisted suicide is not a protected liberty interest under
the Constitution. However, the rulings in Vacco v Quillxvii and Washington v Glucksberg left
the door open for states to permit physician-assisted suicide.xviii
Washington v Glucksberg dealt with the constitutionality of a Washington statute that made it
a felony for a person to assist in the suicide of another. According to the statute, “A person is
guilty of promoting a suicide attempt when he knowingly causes or aids another person to
attempt suicide”. The maximum punishment for conviction was five years’ imprisonment and
a $10,000 fine. Washington’s Natural Death Act 1979 states, “Withholding or withdrawal of
life-sustaining treatment” at a patient’s direction “shall not, for any purpose, constitute a
suicide”. A number of physicians and their terminally ill patients brought suit to challenge the
constitutionality of the assisted suicide law. These plaintiffs claimed “the existence of a
liberty interest protected by the Fourteenth Amendment which extends to a personal choice
by a mentally competent, terminally ill adult to commit physician-assisted suicide”.
The district court agreed with the doctors and patients. The court ruled that the law placed an
undue burden on the exercise of a constitutionally protected liberty interest. The state
appealed the case to the Ninth Circuit Court of Appeals. A three-judge panel reversed the
district court. According to that opinion, this country has never recognised a “constitutional
right to aid in killing”. However, a subsequent en banc hearing before all the judges of the
Ninth Circuit resulted in victory for the doctors. According to the en banc decision, “the
Constitution encompasses a due process liberty interest in controlling the time and manner of
one’s death – that there is, in short, a constitutionally-recognized ‘right to die’”. Furthermore,
Washington’s law was unconstitutional, “as applied to terminally ill competent adults who
wish to hasten their deaths with medication prescribed by their physicians”.
The state appealed, and the Supreme Court reversed the decision. The opinion, written by
Chief Justice William Rehnquist, offered a history of assisted suicide. The Court noted that
there were few exceptions to the rules against assisted suicide anywhere in the Western
democracies and states. Also, the punishment or disapproval of suicide or assisted suicide
reaches back more than 700 years. The earliest statute to outlaw assisted suicide came in
1828, but in common law it has been recognised as crime for centuries. The Court noted that
advances in medicine and technology have led many states to re-examine their positions on
assisted suicide.
In the main, states have reaffirmed traditional bans on assisted suicide. To rule in support of
the doctors, the Court noted would require the reversal of “centuries of legal doctrine and
practice, and strike down the considered policy choice of almost every State”. Referring to
another case, the Court recognised that if something has been practised for 200 years by
common consent, it will “need a strong case for the Fourteenth Amendment to affect it”.
The Court also noted the dangers of permitting policy preferences of the members of the
Court to undermine and change constitutional law. Drawing on the history of assisted suicide
laws in the United States, the Supreme Court ruled that there is no fundamental liberty
interest in a right to assisted suicide that is protected by the due process clause. Further, the
ban on assisted suicide, as in Washington’s law, was rationally linked to legitimate
government interests. Those include: “To preserve life; To prevent suicide; To avoid the
involvement of third parties and the use of arbitrary, unfair, or undue influence; To protect
the integrity of the medical profession; To avoid future movement toward euthanasia and
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other abuses.” While the Supreme Court did not ban assisted suicide, the opinion recognised
the right of states to engage “in serious, thoughtful examinations of physician-assisted
suicide”. In contrast to jurisdictions such as Washington and Oregon, the ruling of the
Supreme Court did not restrict the right to assisted suicide to people with terminal illness who
are facing imminent death.
Physician-assisted suicide is not legal across the United States, but six states do allow doctors
to prescribe lethal doses of medication: Oregon, Washington, Vermont, Montana, New
Mexico, and most recently California. Oregon (1997), Washington (2009) and Vermont
(2013) have laws that allow terminally ill adult patients to obtain lethal doses of medication
from their doctors. Also in 2009, the Montana Supreme Court ruled that nothing in state law
prohibits physician-assisted suicide and provides legal protection for physicians in the case
that they write a prescription for lethal medication at a patient’s request. In early 2014, a New
Mexico Second District Judge Nan Nash ruled that terminally ill patients have the right to aid
in dying under the state constitution, i.e. making it legal for a doctor to prescribe a lethal dose
of medication to a terminally ill patient. However, in August 2015, the three-panel New
Mexico Court of Appeals ruled two to one that the Bernalillo County District Court had erred
in determining that “aid in dying is a fundamental liberty interest”, thus overturning the lower
court’s ruling that had established physician-assisted suicide in the state. xix
California has seen five previous efforts to pass an aid-in-dying law since 1992, when state
voters rejected a ballot initiative by a 54 to 46 margin. Similar laws failed to emerge from
state legislatures four times between 1995 and 2008. In September 2015, the California
legislature passed so-called assisted suicide legislation in a special session after it had been
defeated in a regular legislative session was signed into law in October by Governor Brown.
Hence, this it will not take effect for three months after the end of the legislative session,
perhaps not until late 2016. Before the drugs can be prescribed, two California doctors must
agree that such a person has no more than six months to live. It is then the patient’s choice
whether to take the drugs. Those who want to must affirm their intention 48 hours in advance
and must take the drugs on their own, without help.xx
Colorado is one of 14 states currently considering physician-assisted death. In February 2016,
a Colorado bill to allow physician-assisted death for terminally ill patients was introduced in
each chamber. It failed to make progress in the Senate (Colorado End-of-Life Options Act –
SB 16-025), but did pass a House panel (Colorado End-of-Life Options Act – HB 16-1054)
and so made some but as yet limited progress. The Colorado Bill would make it legal for
doctors to prescribe self-administered medication (“aid-in-dying medication”) that would
hasten death for terminally ill patients who want it (“judged of sound mind and who
personally make two oral requests for the fatal prescription separated by at least 15 days”),
and patients would be required to attest to being in the final stages of a terminal illness, with
physicians’ second opinions to confirm this.xxi
Europe
In The Netherlands since 2002, euthanasia assisted by doctors is legal in cases of “hopeless
and unbearable” suffering, i.e. for those suffering from serious medical conditions (including
mental illness) and in considerable suffering like pain, hypoxia or exhaustion. Legal
requirements include the patient’s request, the patient’s suffering (unbearable and hopeless),
information provided to the patient, the presence of reasonable alternatives, consultation of
another doctor and the applied means of ending life. Currently under discussion is Uit Vrije
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Wil (Out of Free Will) that would allow all Dutch people over 70 to have the right to
professional help in ending life.xxii
There have been a steady increase in the number of such suicides in The Netherlands and also
of the numbers of other euthanasia cases. Assisted suicide is legal in Luxembourg (2009),
Belgium (2002) and Switzerland, where it has been legal since 1942. In Switzerland, lethal
drugs may be prescribed but the recipient must play an active part in administering them.
More than 1,000 people have died at Dignitas in Zurich since it was set up in 1998 for people
with a sound mind, a psychiatrist’s report and a serious physical or mental condition. Most
people coming to Dignitas do not plan to die but need insurance in case their illness becomes
intolerable. Of those who receive the green light, 70% never return to Dignitas. Twenty-one
percent of people receiving assisted suicide in Dignitas do not have a terminal or progressive
illness, but rather “weariness of life”.xxiii
This last point is significant in that the majority of those go to Dignitas elect not to follow
through but know that they can if they decide/need to. Last November a 21 minute
documentary, “24 and Ready to Die”, was released by The Economist about a depressed
Belgium woman, Emily (aka Laura), aged 24 who secured permission for an assisted suicide
after a history of suicide attempts and depression last summer. However, she cancelled the
lethal injection, and although she reports that she would still rather die than live, she is not
ready to die just yet. The documentary follows her two-year process, including her mother’s
objections and support from her two doctors, as well as her discussion of her funeral with her
friends.
In November 2015, Germany enacted a new law making it illegal to change a fee for a
“euthanasia- suicide business”. The parliamentary debates there highlighted the sensitivity of
the issues by reference to the 200,000 people with mental and physical disabilities who were
euthanised during the Nazi era. The new law has penalties up to three years’ imprisonment,
even if doctors perform the procedure to relieve suffering. Single instances of suicide
assistance – by a doctor or relative for altruistic reasons – are permitted under the new
legislation, i.e. terminating treatment for incurable patients or providing them with assistance
in ending their own lives, which is referred to in the Act as “suicide assistance”. Earlier in
2015, the French parliament voted overwhelmingly in favour of a law allowing terminally ill
patients who are suffering to cease treatment and enter a “deep sleep” until they die. The law
stops short of legalising euthanasia, but the government reports that the new law would give
patients on the brink of death more control at the end of their lives. The measure allows
patients with hours or days to live to request to be placed under general anaesthetic until they
die.xxiv
Australia
The Criminal Code Amendment (Suicide Related Material Offences) Act 2005 restricts
information about euthanasia and suicide. Euthanasia was legalised in Australia’s Northern
Territory by the Rights of the Terminally Ill Act 1995, but this was voided by the Euthanasia
Laws Act 1997 which removed the power of states and territories to legalise euthanasia. In a
study in early 2015, it was reported that more than a third of Australian surgeons said they
had given their patients higher doses of pain-relieving drugs than were necessary for pain
relief alone which they knew would hasten death. Known as “slow euthanasia”, or terminal
sedation, patients are rendered unconscious and thus freed of pain with lives shortened, often
dramatically, from days to hours. This anonymous survey raises issues about the gaps
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between legal and medical realities. Other international studies support this gap between law
and realities and realities and public debates.
Conclusion
In summary, while there are subtle and substantial differences between polities there are
considerable overlapping concerns with safeguards, limits and extents and the dangers of
entering uncharted moral realms. We in New Zealand are part of a global debate on the
morality and legality of the end of life matters. So much of the reportage is personalised,
focusing on tragic individual cases, and while these are the game changing cases that serve to
change laws and public opinion, the personal necessarily obscures the underlying moral
issues and of course introduces specific circumstances and complexities into the discussions.
We have had our own tragic cases of Lesley Martin and Sean Davison. In most polities
prosecutions are rare; euthanasia takes place on a broad scale unlawfully on medical rather
than legal grounds – de facto rather than de jure which further serves to morally complicate
the debate.
The two other papers in this issue look closely consider the Lecretia Seales case and our
unique contribution to the international debate – the potential contradiction between our
rights under the Human Rights Act 1993, the NZ Bill of Rights Act 1990 and the Crimes Act
1961. ACT’s only MP, David Seymour, has launched his private member’s the End of Life
Choice Bill to legalise voluntary euthanasia on libertarian principles in response to Justice
David Collins’ ruling that parliament was the only body to make euthanasia legal. Our
previous attempts at legislative change have been crude, unsophisticated and clumsy and the
latest proposal does little to offer the necessary guidelines. I hope this paper shows that there
are a wide variety of approaches and options that we should openly consider before plunging
ahead or back.xxv
I consider that Durkheim was right that death and discussions of death are anomic, i.e. they
challenge the nomos or rationale and laws of everyday life by raising more fundamental and
problematic questions about meaning and purpose against the backdrop of the certainty of
death. We need to tread carefully when opening up the abyss of unmeaning and the anomic
challenge. And, as Ernst Becker in his Pulitzer prize-winning The Denial of Death contends,
these discussions raise the most fundamental of questions – questions that we might not want
to leave exclusively to lawyers or politicians.
Endnotes
i
See the arguments and responses to legislative change in: Kevorkian, J. (1991).
Prescription: Medicide, The Goodness of Planned Death. Prometheus Books; Kevorkian, J.
(1988). “The last fearsome taboo: Medical aspects of planned death”. Medicine and Law 7
(1): 1–14; Nitschke, P. and Stewart, F. (2005). Killing Me Softly: Voluntary Euthanasia and
the Road to the Peaceful Pill. Penguin; Nitschke, P. and Stewart, F. (2012). The Peaceful Pill
Handbook. Exit International.
ii
Rodriguez v British Columbia (AG), Supreme Court of Canada Judgment, 1993, 3 S.C.R.
519, # 23476: http://scc-csc.lexum.com/scc-csc/scc-csc/en/item/1054/index.do.
iii
Carter v. Canada (AG), Supreme Court of Canada Judgment, 2015, SCC 5, Report: [2015]
1 SCR 33: https://scc-csc.lexum.com/scc-csc/scc-csc/en/item/14637/index.do.
iv
Criminal Code (R.S.C., 1985, c. C-46): http://laws-lois.justice.gc.ca/eng/acts/C-46/
7
v
In October 2015, Justin Trudeau became Prime Minister of Canada leading a Liberal
government that has historically been more supportive of euthanasia that the outgoing Harper
Conservative government.
vi
Bill 52 is an Act respecting end-of-life care: file:///C:/Users/Paul/Downloads/13-052a.pdf.
vii
Margaret Somerville’s Death Talk: The Case against Euthanasia and Physician-Assisted
Suicide (McGill-Queens University Press, 2nd edition, 2014) offers a critical but informed
account of developments in Canada.
viii
Kings College Hospital NHS Foundation Trust v C & Anor [2015] EWCOP 80 (30
November 2015): www.bailii.org/ew/cases/EWCOP/2015/80.html.
ix
At the hearing on 9 December 2015 the Daily Mail, the Times, the Daily Telegraph and the
Independent contended that there was public interest in C being named. Mr Justice Charles
ruled that while he “struggled” with their argument he gave the media the opportunity to file
evidence setting out why it is in the public interest for C to be named and has reserved
judgment until their evidence is received. As yet this has not been pursued.
x
Assisted Dying Bill [HL] 2014-15:
xi
Assisted Dying (No. 2) Bill 2015-16 (HC Bill 7): http://services.parliament.uk/bills/201516/assisteddyingno2.html; http://services.parliament.uk/bills/2014-15/assisteddying.html.
xii
www.publications.parliament.uk/pa/cm201516/cmhansrd/cm150911/debtext/1509110001.htm#15091126000003.
xiii
The relevant cases and a summary of debates can be found at
http://researchbriefings.files.parliament.uk/documents/SN04857/SN04857.pdf;
R (on the application of Purdy) v The Direction of Public Prosecutions [2009] UKHL 45 R:
www.mentalhealthlaw.co.uk/R_(Purdy)_v_DPP_(2009)_UKHL_45.
xiv
Death with Dignity Act (DWDA) enacted in 1997:
https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDi
gnityAct/Documents/statute.pdf. The State of Oregon publishes an annual data summary
reporting deaths under the Act, Oregon Death with Dignity Act 2105 Data Summary:
https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDi
gnityAct/Documents/year18.pdf. It is interesting to note: (1) the number of people receiving
prescriptions for lethal medications (218 in 2015) under the Oregon DWDA is, and has been,
consistently and considerably higher than those who died from ingesting the medications
prescribed (125 in 2015; 57%); and, (2) the numbers for both rose steadily from 1997 to 2013
(average 12.1% p.a.) and has risen in the last two years (24.4% in 2014-2015).
xv
Gonzales v. Oregon (formerly Oregon v Ashcroft) (04-623):
www.law.cornell.edu/supct/cert/04-623.
xvi
H.R. 1003 (105th): Assisted Suicide Funding Restriction Act of 1997:
www.govtrack.us/congress/bills/105/hr1003/text/enr.
xvii
The Supreme Court of the United States ruled unanimously (9-0) that a New York ban on
physician-assisted suicide was constitutional and that there was no constitutional “right to
die.” Vacco v Quill, 521 U.S. 793 (1997):
https://supreme.justia.com/cases/federal/us/521/793/case.html.
xviii
Washington v Glucksberg, 521 U.S. 702 (1997): http://caselaw.findlaw.com/us-supremecourt/521/702.html.
xix
Morris v King (AG), Court of Appeals of the State of New Mexico, 33630 (2015):
www.adfmedia.org/files/KingAppealsDecision.pdf.
xx
State of California, End of Life Option Act (ABX2 15):
https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520162AB15.
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xxi
Colorado End-of-Life Options Act (SB 16-025/HB 16-1054):
www.leg.state.co.us/clics/clics2016a/csl.nsf/fsbillcont3/177327DC50AD352687257F240063
F245?open&file=1054_01.pdf.
xxii
www.uitvrijewil.nu/. This Dutch citizens’ initiative attracted more than 117,000 letters of
support in 2010 for its proposal to extend assisted dying to all persons over 70 who are “tired
of life”. A 2013 Netherlands poll reported that 57% agreed that everyone should have a right
to euthanasia, and a similar proportion agreed that everyone has the right to determine their
own life and death. Twenty-six percent agreed with the vignette in which a doctor helps an
elderly person to die who is tired of living. Twenty-one percent agreed with the statement:
“In my opinion, euthanasia should be allowed for persons who are tired of living without
having a serious disease.” Fifty-two per cent agreed and 25% neither agreed nor disagreed
(Schoonman, M. K., van Thiel, G. J., van Delden, J. J. (2013). “Non-physician-assisted
suicide in The Netherlands: a cross-sectional survey among the general public”, Journal of
Medical Ethics 40: 842-848.
xxiii
Fischer, S., Huber, C. A., Imhof, L., Mahrer Imhof, R., Furter, M., Ziegler, S.J. and
Bosshard, G. (2008). Suicide Assisted By Two Swiss Right-to-Die Organisations. Journal of
Medical Ethics 34(11): 810-14.
xxiv
The European Court of Human Rights produced a report, “End of life and the European
Convention on Human Rights”, in July 2105:
www.echr.coe.int/Documents/FS_Euthanasia_ENG.pdf.
xxv
End of Life Choice: Member’s Bill:
https://d3n8a8pro7vhmx.cloudfront.net/eolc/pages/37/attachments/original/1444699434/End_
of_Life_Choice_Bill_FINAL.pdf?1444699434 .
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