RIGHT-TO-DIE RULING HAS MANY UPSET\Critics fear case may embolden doctors, relatives of terminally\ill.

Byline: Tamar Lewin The New York Times

In striking down a Washington state law that made assisted suicide a felony - and strongly upholding individuals' right to decide "how and when to die" - a U.S. appeals court has squarely taken sides in the nation's difficult, and increasingly divisive, debate over the right to die.

The decision, handed down Wednesday by the U.S. Court of Appeals for the 9th Circuit, in San Francisco, is binding only on the nine Western states in the circuit. Of those, Alaska, Arizona, California, Hawaii, Idaho, Montana and Nevada have either statutes or judicial rulings prohibiting assisted suicide.

In Oregon, the other state in the circuit, the ruling raises the odds that a law permitting doctor-assisted suicide, passed in 1994 but never put into effect, will be upheld. While Oregon is the only state to have passed a law allowing doctor-assisted suicide, eight others are considering such legislation.

"Whatever the legal issues, this clearly stands as a reminder to the medical profession that the public regards it as having failed it abysmally, with the high-tech prolonging of life, in terms of assuring that a patient's wishes will be respected," said Alexander Capron, a professor of law and medicine at the University of Southern California.

But many opponents of the right to die were horrified by the breadth of the decision, and concerned that it would be used to justify killing those who do not want to die, but whose relatives or doctors make them feel that swift death is the best course.

"The so-called right to die will quickly become the duty to die," said Burke Balch, director of the medical ethics department of the National Right to Life Committee.

The American Medical Association also worried about the effects of the ruling, reiterating its position that assisting in a suicide is "fundamentally incompatible with the physician's role as healer and care-giver."

Although Wednesday's ruling has no direct effect outside the West, some legal and bioethics experts say it will create ripples across the nation, both because it is the first of its kind and because it is a lengthy, carefully reasoned decision by all the judges of the circuit court.

"At the bedside, it leaves some doctors to feel they've got society's affirmation for an underground practice that's not uncommon, of hastening death for some people," said Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania. "That's going to embolden some doctors who think it's the right thing to do."

Caplan added: "I'm worried that the court's written this 100-page-plus pronouncement on the right to die. It's as though we didn't learn anything from 30 years of abortion fighting. If anyone thinks they're going to settle anything morally from a court decision, they're nuts. And as a matter of public policy, it puts us in the bizarre situation of staggering toward becoming a society that guarantees the right to die at the hand of a physician, with no right to treatment at the hand of a physician."

Some suggest that the ruling goes so far that it is likely to be reversed.

"In the last 10 years, the 9th Circuit has probably been reversed by the Supreme Court more than any other," said Erwin Chemerinsky, a professor of constitutional law at the University of Southern California.