c. 1997 Religion News Service

(Rabbi Rudin is the national interreligious affairs director of the American Jewish Committee.)

UNDATED _ It was good news indeed that the Supreme Court decided to tackle the complex and emotional issue of physician-assisted suicides. And it is even better news that the Court has acted to uphold two state laws _ in Washington and New York _ that placed a ban on doctors aiding the terminally ill in committing suicide.

The High Court, ruling unanimously, said the Constitution does not guarantee Americans the right to commit suicide with the help of a doctor. And while pointing to the value of human life, the Court put more stress on the issue of states’ rights, leaving open the possibility that states could pass legislation allowing assisted suicide.

Still, the justices did confront some of the arguments advanced by the lower courts, which ruled the New York and Washington laws banning assisted suicide were unconstitutional.

As a member of the New York State Task Force on Life and Law, an official body that deals with bioethical questions, I had serious problems with both lower court rulings overturning the state bans.

Let me spell out some of my reasons.

In 1994, after an intensive 18-month study, the Task Force members unanimously concluded assisted suicide should not be made legal, believing such public policy”would pose profound risks to many patients … and would be unwise and dangerous …” The Washington and New York rulings were based on the constitutional rights of individuals to make decisions about terminating their lives. But the U.S. Constitution does not grant individuals a”right”to suicide assistance.

Indeed, the Supreme Court ruling stressed that the state”has an interest in preventing suicide … and treating its causes.” The two lower court decisions also protected physicians from criminal prosecution if they assist patients in ending their lives. The New York judgment stipulated that only mentally competent patients who are terminally ill are entitled to make such momentous decisions.

But if that reasoning is followed, who, after all, will decide whether a person is truly competent to make life-ending decisions about oneself? Because critically ill people are often severely depressed and in acute pain, it is not hard for a family member or a physician to extract the patient’s wish to end it all.

But is such an irreversible decision made by a truly mentally competent person?

As Chief Justice William Rehnquist recognized in his majority opinion,”many people who request physician-assisted suicide withdraw that request if their depression and pain are treated.” As health costs continue to soar, insurance companies and hospitals will increasingly seek the most cost-efficient means of treating patients.

Clearly, it is more expensive to treat an individual’s physical pain and mental depression than it is to help a person die. The financial bottom line will always prefer assisted suicide over the more costly treatment for pain and depression.

The lower court decisions presuppose careful deliberation of assisted suicide by all interested parties: patients, physicians, hospitals or nursing homes, and families. But such ideal circumstances rarely exist in intensive care units or hospital corridors.

In the real world of medicine, the first people likely to get assistance to end their lives will be those without family or friends, the poor, the elderly, the disabled, and the uninsured.

As Rehnquist wrote,”The state has an interest in protecting vulnerable groups _ including the poor, the elderly, the disabled persons _ from abuse, neglect, and mistakes. … If physician-assisted suicide were permitted, many might resort to it to spare their families the substantial financial burden of end of life health care costs.” Just as abortion has become America’s most fevered issue, assisted suicide has the potential to polarize Americans of every religious, racial, and ethnic group. The unanimous Supreme Court ruling should slow that polarization.

MJP END RUDIN