SUPREME COURT RULINGS; NO; SUICIDE WITH DOCTOR'S AID.

Byline: John Aloysius Farrell The Boston Globe

The Supreme Court ruled unanimously Thursday that Americans suffering from painful or mortal illnesses do not have a constitutional right to take their lives with a doctor's help.

The court upheld laws in New York and Washington state that ban physician-assisted suicide. The justices found no absolute ``right to die'' in either the due process or equal protection clauses of the Constitution.

``The state has an interest in preventing suicide'' and that interest is ``unquestionably important and legitimate,'' said the court.

Among other worries, the court listed its fear that Americans could embark on a ``slippery slope'' toward the day when the aged, depressed and infirm are pressured to commit suicide to save society the burden of costly medical treatment.

Yet advocates of the ``death with dignity'' movement took solace from the court's implied suggestion that the Constitution may not bar the states from bestowing a right to assisted suicide to a select group of terminally ill patients.

Oregon, for example, allows physician-assisted suicide, and the court's decision seemed to favor the states as laboratories for debate and innovation.

``Americans are engaged in an earnest and profound debate about the morality, legality, and practicality of physician-assisted suicide,'' Chief Justice William Rehnquist wrote for the court. ``Our holding permits this debate to continue, as it should in a democratic society.''

Lawyers for the right-to-die forces also noted that five of the justices wrote concurring opinions stating that while there is no absolute right to suicide, hopelessly ill people have the right to request huge doses of drugs that bring on unconsciousness and a quick death.

``I join the court's opinion because I agree that there is no generalized right to `commit suicide,' '' and because ``the difficulty in defining terminal illness and the risk that a dying patient's request for assistance in ending his or her life might not be truly voluntary justifies the prohibitions on assisted suicide we uphold here,'' said Justice Sandra Day O'Connor in a pivotal concurring opinion.

But O'Connor underscored the fact that Thursday's decision left open the question of whether ``a mentally competent person who is experiencing great suffering has a constitutionally cognizable interest in controlling the circumstances of his or her imminent death.''

And O'Connor held that ``a patient who is suffering from a terminal illness and who is experiencing great pain has no legal barriers to obtaining medication, from qualified physicians, to alleviate that suffering, even to the point of causing unconsciousness and hastening death.''

O'Connor joined Rehnquist and Justices Antonin Scalia, Clarence Thomas and Anthony Kennedy in the lead majority opinion. Justices John Paul Stevens, David Souter, Ruth Bader Ginsburg and Stephen Breyer wrote concurring opinions that were much more open to the notion of assisted suicide in extreme cases.

President Clinton applauded the court's decision. ``This issue is unavoidably heart-rending, and we must never ignore the agony of terminally ill patients, but the Supreme Court made the right decision today,'' he said. ``The risks and consequences of physician-assisted suicide are simply too great.''

Harvard law Professor Laurence Tribe, who had represented the death-with-dignity forces before the Supreme Court, said Thursday, ``The court rendered a decision in these two cases that had the primary effect of leaving open for the future the drawing of all the difficult lines in this complicated and sensitive area of the rights of the dying.''

By limiting its decision to the New York and Washington laws, ``the court came as close as it could to punting,'' Tribe said.

``The general expectation was that a majority of this court would literally slam its door tight'' on the issue, said Tribe. ``The court, far from slamming the door, in fact left it open.''

Tribe's co-counsel, Kathryn Tucker, said, ``The court has given quite a green light for other states to proceed down the path'' that Oregon has taken to authorize physician-assisted suicide.

The Supreme Court joined most states in drawing a line between the right to passively refuse treatment, which is permitted, and the right to actively kill oneself. Medical professionals in most states can be prosecuted for supplying terminally ill patients who intend to kill themselves with a lethal overdose of prescription painkillers.

But Americans' ambiguity on the issue is illustrated by the case of Dr. Jack Kevorkian, the Michigan physician who has been charged with murder for helping patients end their lives, but who is consistently absolved of responsibility by the state's courts.

As Stevens noted in his opinion in the New York case, opponents of the ``right-to-die'' forces nevertheless support the practice of ``terminal sedation - the administration of sufficient dosages of pain-killing medication to terminally ill patients to protect them from excruciating pain even when it is clear that the time of death will be advanced.''

Though Stevens was convinced that there was no categorical right to suicide in the Constitution, the distinctions between withdrawing life support, terminal sedation and assisted suicide are so slender among terminally ill patients that he would not ``foreclose the possibility'' that there are some who have a right to ask for help in ending their lives.

Tribe represented a group of doctors and terminally ill patients before the Supreme Court in January. He was opposed by a powerful coalition that included the Clinton administration, the American Medical Association, the American Hospital Association, the Family Research Council, the Catholic Church and other religious organizations.

HIGHLIGHTS OF ACTIONS

A look at the highlights of actions taken Thursday by the Supreme Court:

In a unanimous decision that will echo through hospitals and homes, the court ruled that terminally ill people do not have a constitutional right to doctor-assisted suicide. Chief Justice William H. Rehnquist, whose wife died in 1991 after a long battle with ovarian cancer, wrote the decision. He said the idea of having someone help end another's life conflicts with ``our nation's history, legal traditions and practices.''

Congress violated free-speech rights when it tried to curb smut on the Internet, the court ruled. In its first venture into cyberspace law, the court invalidated a key provision of the 1996 Communications Decency Act. Congress' effort to protect children from sexually explicit material goes too far because it also would keep such material from adults who have a right to see it, the justices unanimously said.

The court gave President Clinton the authority, at least for now, to veto specific items in spending bills - unprecedented power sought by nearly every president over the past century but attained by none. The court cleared the way for Clinton to become the first U.S. president authorized to use the so-called line-item veto by ruling that six members of Congress lacked the proper legal standing to challenge the federal law that gave him such power. But the justices made clear that the law could be challenged by anyone affected by a line-item veto once the president exercises that authority.

Just one case, involving the Brady law, remains to be decided by the court this term:

At issue is a key provision of the federal gun law that requires local police to check backgrounds of prospective gun buyers. Two sheriffs from Montana and Arizona challenged the law, arguing that state law enforcement officials cannot be compelled to help enforce a federal law. The Brady law requires a five-day waiting period before the sale of a handgun can be completed.

CAPTION(S):

Photo, box

PHOTO Attorney Andrew Batavia argued in favor of doctor-assisted suicide.

Associated Press

BOX: Highlights of actions (see text)