With Dignity: a Policy Evaluation Study of Assisted Suicide Laws in 20 Jurisdictions in the United States of America
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The “Right to Die” With Dignity: A Policy Evaluation Study of Assisted Suicide Laws in 20 Jurisdictions in the United States of America A Dissertation submitted to the Graduate School Valdosta State University in partial fulfillment of requirements for the degree of DOCTOR OF PUBLIC ADMINISTRATION in the Department of Political Science of the College of Humanities and Social Sciences 2018 Anthony W. Duva M.P.A., University of Central Florida, 1997 J.D., University of Florida College of Law, 1973 B.S., University of Florida, 1971 © Copyright 2018 Anthony W. Duva All Rights Reserved. ABSTRACT The phrase “Right to Die with Dignity” has long been a tag-line for the topic of assisted suicide. This dissertation tackles that topic through a qualitative policy evaluation study that includes a review and analysis of assisted suicide laws in 19 States in the United States, the District of Columbia, six countries other than the United States, and Supreme Court cases and other court decisions that are relevant to the topic. The dissertation also considers whether the time is right for assisted suicide policy development, based on recent court interpretations of the Fifth, Tenth and most specifically the Fourteenth Amendment(s) and how recent court decisions have been influenced by either the Constitution or public policy. The purpose of the dissertation is to recommend a public policy that establishes a new federal policy that represents a dignified, compassionate, and common-sense approach to assisted suicide. The primary methodology is the use of the “legal lens of study approach,” which lays the foundational groundwork for the five research questions this dissertation explores. Analysis of the common elements of the existing laws was a first step in this policy evaluation and helped identify principles that should be included in any new policy. Also key to the analysis and the proposal of a new federal policy was the legal study of most relevant assisted suicide cases from several states and from the federal court system, including Supreme Court cases involving the Fourteenth Amendment in decisions concerning socially relevant issues that involve liberty interests and individual rights. Critical historical events concerning assisted suicide were uncovered in order to chronologically interpret the issue of assisted suicide over the past 45 years and how i these cases and more recent court decisions might create opportunities for policy changes. Results indicate that leaving the issue of assisted suicide to be dealt with by each individual state or waiting for the Supreme Court to make a ruling that would finalize the issue on a national level has created an intolerably diverse quagmire for society as a whole and especially for those competent adult individuals who would prefer to choose this end-of-life option. ii Table of Contents I. INTRODUCTION ....................................................................................................................... 1 General overview, explanation of the issue and conceptual framework ............................ 2 Purpose of the study ............................................................................................................ 5 Definition of terms .............................................................................................................. 6 Procedures and organization of dissertation ....................................................................... 7 Significance of study......................................................................................................... 11 II. LITERATURE REVIEW ......................................................................................................... 12 An important national concern .......................................................................................... 12 Suicide and assisted suicide statistics ............................................................................... 13 Reporting, state laws and laws of other countries............................................................. 14 Five critical events concerning assisted suicide ................................................................ 17 United States Constitution–14th Amendment Summary ................................................... 20 Supreme Court of the United States 14th Amendment cases–1990 to 2018 ..................... 21 Foundational litigation and case law from 1990 to 2018 .................................................. 21 Federal trial court–state of Washington–1994 .................................................................. 21 Federal trial court–state of New York–1994 .................................................................... 26 Washington and Vacco–Journey to the Supreme Court–1997–All nine justices weigh in on assisted suicide ......................................................................................................... 28 A decade+ of expanding “individual rights” under the 14th Amendment–1997–2018…. 36 State legislation from 1994 to 2018 .................................................................................. 39 Precedent (stare decisis) .................................................................................................... 42 Final consideration from a legal perspective–an individual’s ability to manipulate information rationally ....................................................................................................... 44 Theoretical underpinnings–1801 to 2018 ......................................................................... 45 Professor John A. Rohr (1934–2011) ............................................................................... 45 Jeffrey R. Toobin .............................................................................................................. 49 Synopsis ............................................................................................................................ 57 iii III. METHODOLOGY ................................................................................................................. 61 Research and data collection ............................................................................................. 61 Methodology overview ..................................................................................................... 61 Legal lens of study approach defined ............................................................................... 67 Secondary methodology considerations ........................................................................... 67 The importance of legal research in informing policy, in academia and in qualitative policy evaluation dissertation studies in public administration ........................................ 70 States and countries selected ............................................................................................. 72 Statistics, state laws and statutes, U.S. Constitution, case law and legal precedent ......... 75 Theoretical underpinnings ................................................................................................ 81 Synopsis ............................................................................................................................ 83 IV. FINDINGS ………………………………………………………………………….………85 Overview ........................................................................................................................... 85 Introduction ....................................................................................................................... 87 Research Question 1 ......................................................................................................... 92 Figure 1 ............................................................................................................................. 95 Table 1 .............................................................................................................................. 95 Table 2 ............................................................................................................................ 103 Table 3 ............................................................................................................................ 107 Research Question 2 ....................................................................................................... 108 Table 4 ............................................................................................................................ 111 Research Question 3 ....................................................................................................... 112 Research Question 4 ....................................................................................................... 115 Research Question 5 ....................................................................................................... 134 Conclusion ...................................................................................................................... 138 V. CONCLUSION ………………………………………………………………………….… 141 Introduction ..................................................................................................................... 141 Research Questions, Findings and Implications ............................................................. 145 Part A – Individual State Legislation–Research Questions 1, 2 and 3 ........................... 146 Research Question 1 ......................................................................................................