Massachusetts top court considers challenge to ban on assisted suicide

Euthanasia/assisted suicide illustration nito/Shutterstock

The highest court in Massachusetts considered a challenge brought by two doctors against the state’s prohibition of physician-assisted suicide on Wednesday.

The Massachusetts Supreme Judicial Court heard arguments March 9 in Kligler v. Healey, which asks “Whether a physician may be prosecuted for manslaughter for prescribing medication used by a competent, terminally ill person to commit suicide.”

The two doctors — Roger Kligler, who wants the ability to access drugs that will kill him, and Alan Steinbach, who wants the ability to prescribe such drugs — argued in a brief that they supported “Medical Aid in Dying," which they opposed to “Physician-assisted Suicide.”

“MAID is defined narrowly as a practice where a doctor, who determines, according to accepted medical standards, that her adult, terminally ill patient who is mentally competent, may, at her patient’s request, prescribe medication that her patient can self-ingest to hasten the time of their death,” the brief reads. “‘Assisted suicide,’ on the other hand, is a much broader term, defined as ‘suicide committed by someone with assistance from another person.’”

State Attorney General Maura Healey's office argued that the legislature, rather than the courts, should decide the issue. 

“There is no fundamental constitutional right to assistance in suicide, and the policy discussion about the pros and cons of legalization properly belongs in the legislatiure, where it is currently taking place,” Assistant Attorney General Maria Granik said. 

While the practice is allowed in ten states and Washington, D.C., Granik argued, “it was legalized by statutes” or laws. 

Both Granik and Chris Schandevel, who argued before the court on behalf of Euthanasia Prevention Coalition USA, stressed the state’s interest in the human life of its citizens. 

“Who’s looking out for Dr. Kligler as he’s dying, and he’s dying painfully?”Justice Serge Georges, Jr., countered, referring to the doctor diagnosed with cancer. “What interests do we have in that? What interest does the government have in that?”

Schandevel, who serves as senior counsel for faith-based legal organization Alliance Defending Freedom (ADF), remained confident following the arguments.

“Any practice that abandons healing and turns to killing puts patients at risk and corrupts and degrades the practice of medicine,” he told CNA. “Massachusetts’ law protects all human life until natural death; the government should not give out licenses to kill the most vulnerable.”

“After today’s oral argument at the state’s High Court,” he concluded, “we are encouraged and optimistic that the terminally ill and disabled will continue to be protected against life-ending procedures.”

ADF filed an amicus brief in the case on behalf of Euthanasia Prevention Coalition USA, a national network that opposes euthanasia and assisted suicide.

Several others filed amicus briefs against physician-assisted suicide and assisted death from a diverse set of backgrounds, including an atheist, Dr. Kevin Yuill, and four Catholic bishops in Massachusetts.

Cardinal Seán P. O’Malley of Boston, Bishop Robert Joseph McManus of Worcester, Edgar M. da Cunha of Fall River, and Bishop William D. Byrne of Springfield warned that, if the physicians succeed, “Massachusetts common law would act to lessen the value of human life—along with the other interests identified above—having grave, long-lasting, and far-reaching negative effects for society.”


Religion came up multiple times during the arguments. At one point, a judge interrupted Granik after she stated that there is “no fundamental right to assisted suicide.”

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Justice Elspeth B. Cypher asked if Granik’s position was based on tradition and history or religion: “What’s the origin of that prohibition on suicide?” 

Granik responded that the “prohibition on suicide and assistance in suicide is grounded both in historical and legal tradition.”

When Cypher asked whether the prohibition is historical because of religious beliefs, Granik went into more detail.

“The historical and legal tradition recognizes various justifications for the prohibition on suicide, and one of the primary ones being the state’s important reasons in protecting the life of all of its citizens,” she said. 

“We would submit this is not the religious worldview or the moral or ethical judgment about suicide,” she added. “Rather it’s rational for the legislature here to prohibit Medical Aid in Dying as it prohibits other forms of assistance on suicide.”

Cypher posed a similar question to Schandevel, asking, “What in the history of the nation and the history in our traditions is not related to religion in this area? Is there anything in this area that shows that this is not a religious issue?” 

Citing previous court decisions, he answered, “there is never an assertion that the common law prohibition on suicide, assisted suicide, is based on religious beliefs.”

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“It’s always based on the government’s interest in protecting human life,” he echoed Granik. 

During his arguments, Schandevel reminded the court that “only rights that are deeply rooted in the history and tradition of this commonwealth and the nation can qualify as fundamental rights under the Massachusetts constitution.”

“So-called Medical Aid in Dying,” he said, is not — for at least three reasons.

“Suicide and assisted suicide both have been long prohibited in this commonwealth and throughout our nation’s history,” he began. “Second, so-called Medical Aid in Dying is assisted suicide and, third, as this court explained and clearly stated in Guardianship of Doe, ‘It is well settled that withdrawing or refusing life-sustaining medical treatment is not equivalent to attempting suicide.’”

Attorney John Kappos, who represented Kligler, described “medical-aid dying” as a “compassionate, peaceful” opinion for his client.
Kligler “spent 32 years of his career as a physician helping to treat the citizens of the commonwealth,” Kappos of the California law firm O'Melveny and Myers began. “Now, Dr. Kligler is asking the commonwealth to help him.”

Kligler, who has stage 4 prostate cancer, “faces the very real prospect that he will experience an unbearably painful death when he reaches the final days of his illness,” Kappos described.

His client, he said, wanted the option to end his life on his own terms.

Kligler “wants a prescription for a medical aid-in-dying drug that will allow him to peacefully and painlessly pass if his suffering becomes overwhelming,” Kappos said. “[H]e realizes that his illness will overcome him eventually and he does not want to be forced to endure unbearable suffering.” 

Granik later proposed, “there’s absolutely no reason that anyone should die a painful death.”

“In this state, palliative care, excellent palliative care, is available to many people,” she said. “There are various ways in which patients at the end of life — as patients throughout their life — can access pain relief and other forms of, as I mentioned, palliative care and comfort at the end of life.”

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