vacco attorney general new york et al quill et argued january decided june held new york prohibition assisting suicide violate equal protection clause pp equal protection clause embodies general rule must treat like cases alike may treat unlike cases accordingly plyler doe new york statutes outlawing assisted suicide neither infringe fundamental rights involve suspect classifications washington glucksberg ante therefore entitled strong presumption validity heller doe faces neither assisted suicide ban law permitting patients refuse medicaltreatment treats anyone differently anyone else draws distinctions persons everyone regardless physical condition entitled competent refuse unwanted lifesaving medical treatment one permitted assist suicide generally laws apply evenhandedly unquestionably comply equal protection new york city transit authority beazer disagrees second circuit submission ending refusing lifesaving medical treatment nothing less assisted suicide distinction letting patient die making patient die important logical rational well established comports fundamental legal principles causation see people kevorkian cert denied intent see bailey recognized least implicitly cruzan director mo dept health concurring widely recognized endorsed medical profession state courts overwhelming majority state legislatures like new york permitted former prohibiting latter therefore disagrees respondents claim distinction arbitrary irrational line two acts may always clear certainty required even possible logic contemporary practice support new york judgment two acts different new york may therefore consistent constitution treat differently pp new york reasons recognizing acting distinction refusing treatment assisting suicide including prohibiting intentional killing preserving life preventing suicide maintaining physicians role patients healers protecting vulnerable people indifference prejudice psychological financial pressure end lives avoiding possible slide towards euthanasia valid important public interests easily satisfy constitutional requirement legislative classification bear rational relation legitimate end see glucksberg ante pp reversed rehnquist delivered opinion scalia kennedy thomas joined filed concurring opinion ginsburg breyer joined part stevens souter ginsburg breyer filed opinions concurring judgment notice opinion subject formal revision publication preliminary print reports readers requested notify reporter decisions wash ington typographical formal errors order corrections may made preliminary print goes press dennis vacco attorney general new york et petitioners timothy quill et al writ certiorari appeals second circuit june chief justice rehnquist delivered opinion new york crime aid another commit attempt suicide patients may refuse even lifesaving medical treatment question presented case whether new york prohibition assisting suicide therefore violates equal protection clause fourteenth amendment hold petitioners various new york public officials respondents timothy quill samuel klagsbrun howard grossman physicians practice new york assert although consistent standards medical practice prescribe lethal medication mentally competent terminally ill patients suffering great pain desire doctor help taking lives deterred new york ban assisting suicide app respondents three gravely ill patients since died sued state attorney general district urged new york permits competent person refuse life sustaining medical treatment refusal treatment essentially thing physician assisted suicide new york assisted suicide ban violates equal protection clause quill koppell supp sdny district disagreed hardly unreasonable irrational state recognize difference allowing nature take course even severe situations intentionally using artificial death producing device noted new york obvious legitimate interests preserving life protecting vulnerable persons concluded nder constitution federal system establishes resolution issue left normal democratic processes within state appeals second circuit reversed determined despite assisted suicide ban apparent general applicability new york law treat equally competent persons final stages fatal illness wish hasten deaths final stages terminal illness life support systems allowed hasten deaths directing removal systems similarly situated except previous attachment life sustaining equipment allowed hasten death self administering prescribed drugs view ending life withdrawal life support systems nothing less assisted suicide emphasis added citation omitted appeals examined whether supposed unequal treatment rationally related legitimate state interests concluded extent new york statutes prohibit physician prescribing medications self administered mentally competent terminally ill person final stages terminal illness rationally related legitimate state interest granted certiorari reverse equal protection clause commands state shall deny person within jurisdiction equal protection laws provision creates nosubstantive rights san antonio independent school dist rodriguez stewart concurring instead embodies general rule must treat like cases alike may treat unlike cases accordingly plyler doe constitution require things different fact opinion treated law though quoting tigner texas legislative classification distinction neither burdens fundamental right targets suspect class uphold long bears rational relation legitimate end romer evans slip new york statutes outlawing assisting suicide affect address matters profound significance new yorkers alike neither infringe fundamental rights involve suspect classifications washington glucksberg ante see san antonio school system alleged discrimination class defines none traditional indicia suspectness courts must look constitution importance asserted right deciding whether asserted right fundamental laws therefore entitled strong presumption validity heller doe faces neither new york ban assisting suicide statutes permitting patients refuse medical treatment treat anyone differently anyone else draw distinctions persons everyone regardless physical condition entitled competent refuse unwanted lifesaving medical treatment one permitted assist suicide generally speaking laws apply evenhandedly unquestionably comply equal protection clause new york city transit authority beazer see personnel administrator mass feeney laws affect certain groups unevenly even though law treats differently members class described law appeals however concluded terminally ill people life support systems treated differently former may hasten death ending treatment latter may hasten death physician assisted suicide conclusion depends submission ending refusing lifesaving medical treatment nothing less assisted suicide ibid unlike appeals think distinction assisting suicide withdrawing life sustaining treatment distinction widely recognized endorsed medical profession legal traditions bothimportant logical certainly rational see feeney supra basic classification rationally based uneven effects upon particular groups within class ordinarily constitutional concern distinction comports fundamental legal principles causation intent first patient refuses life sustaining medical treatment dies underlying fatal disease pathology patient ingests lethal medication prescribed physician killed medication see people kevorkian cert denied matter conroy feeding tube removed death result patient underlying medical condition colyer eath occurs removal life sustaining systems natural causes american medical association council ethical judicial affairs physician assisted suicide issues law medicine life sustaining treatment declined patient dies primarily underlying disease furthermore physician withdraws honors patient refusal begin life sustaining medical treatment purposefully intends may intend respect patient wishes cease useless futile degrading things patient patient longer stands benefit assisted suicide hearing subcommittee constitution house committee judiciary testimony leon kass true doctor provides aggressive palliative care cases painkilling drugs may hasten patient death physician purpose intent maybe ease patient pain doctor assists suicide however must necessarily indubitably intend primarily patient made dead similarly patient commits suicide doctor aid necessarily specific intent end life patient refuses discontinues treatment might see matter conroy supra patients refuse life sustaining treatment may harbor specific intent die may instead fervently wish live free unwanted medical technology surgery drugs superintendent belchertown state school saikewicz mass refusing treatment patient may specific intent die law long used actors intent purpose distinguish two acts may result see bailey common law homicide often distinguishes person knows another person killed result conduct person acts specific purpose taking another life morissette distinctions based intent universal persistent mature systems law hale pleas crown intent prevent gangrene beginning hand doth without advice cut hand dies thereby felo de se tho voluntary act yet intent kill put differently law distinguishes actions taken given end actions taken spite unintended foreseen consequences feeney compassion dying washington kleinfeld dissenting general eisenhower ordered american soldiers onto beaches normandy knew wassending many american soldiers certain death purpose though liberate europe nazis given general principles surprising many courts including new york courts carefully distinguished refusing life sustaining treatment suicide see fosmire nicoleau erely declining medical care considered suicidal act fact first state decision explicitly authorize withdrawing lifesaving treatment noted real distinction self infliction deadly harm self determination artificial life support quinlan cert denied sub nom garger new jersey recently michigan also rejected argument distinction acts artificially sustain life acts artificially curtail life merely distinction without constitutional significance meaningless exercise semantic gymnastics insisting cruzan majority disagreed kevorkian similarly overwhelming majority state legislatures drawn clear line assisting suicide withdrawing permitting refusal unwanted lifesaving medical treatment prohibiting former permitting latter glucksberg ante nearly expressly disapprove ofsuicide assisted suicide either statutes dealing durable powers attorney health care situations living statutes kevorkian nn nn thus even move toprotect promote patients dignity end life remain opposed physician assisted suicide new york case point state enacted current assisted suicide statutes since new york acted several times protect patients common law right refuse treatment act ch laws resuscitate orders codified amended pub health law mckinney supp act july ch laws health care agents proxies codified amended pub health law mckinney supp however state neither endorsed general right hasten death approved physician assisted suicide quite opposite state reaffirmed line killing letting die see pub health law mckinney article intended permit promote suicide assisted suicide euthanasia new york state task force life law life sustaining treatment making decisions appointing health care agent july resuscitate orders proposed legislation report new york state task force life law apr recently new york state task force life law studied assisted suicide euthanasia unanimously recommended legalization death sought assisted suicide euthanasia medical context vii task force view allowing decisions forego life sustaining treatment allowing assisted suicide euthanasia radically different consequences meanings public policy also recognized least implicitly distinction letting patient die making patient die cruzan director mo dept health concluded principle competent person constitutionally protected liberty interest refusing unwanted medical treatment may inferred prior decisions assumed existence right purposes case assumption right refuse treatment grounded appeals supposed proposition patients general abstract right hasten death well established traditional rights bodily integrity freedom unwanted touching cruzan concurring fact observed majority country laws imposing criminal penalties one assists another commit suicide cruzan therefore provides support notion refusing life sustaining medical treatment nothing less suicide reasons disagree respondents claim distinction refusing lifesaving medical treatment assisted suicide arbitrary irrational brief respondents granted insome cases line two may clear certainty required even possible logic contemporary practice support new york judgment two acts different new york may therefore consistent constitution treat differently permitting everyone refuse unwanted medical treatment prohibiting anyone assisting suicide new york law follows longstanding rational distinction new york reasons recognizing acting distinction including prohibiting intentional killing preserving life preventing suicide maintainingphysicians role patients healers protecting vulnerable people indifference prejudice psychological financial pressure end lives avoiding possible slide towards euthanasia discussed greater detail opinion glucksberg ante valid important public interests easily satisfy constitutional requirement legislative classification bear rational relation legitimate end judgment appeals reversed ordered nos washington et petitioners harold glucksberg et al writ certiorari appeals ninth circuit dennis vacco attorney general new york et petitioners timothy quill et al writ certiorari appeals second circuit june justice concurring death different us many last days spent physical pain perhaps despair accompanies physical deterioration loss control basic bodily mental functions seek medication alleviate pain symptoms frames issue case whether due process clause constitution protects right commit suicide includes right assistance ante concludes nation history legal traditions practices support existence right join opinions agree generalized right commit suicide respondents urge us address narrower question whether mentally competent person experiencing great suffering constitutionally cognizable interest controlling circumstances imminent death see need reach question context facial challenges new york washington laws issue see ante washington statute issue case prohibits aid ing another person attempt suicide thus question us whether liberty specially protected due process clause includes right commit suicide includes right assistance parties amici agree patient suffering terminal illness experiencing great pain legal barriers obtaining medication qualified physicians alleviate suffering even point causing unconsciousness hastening death see rev code brief petitioners brief respondents light even assuming recognize interest agree state interests protecting truly competent facing imminent death whose decisions hasten death truly voluntary sufficiently weighty justify prohibition physician assisted suicide ante post stevens concurring judgments post souter concurring judgment every one us point may affected family member terminal illness reason think democratic process strike proper balance interests terminallyill mentally competent individuals seek end suffering state interests protecting might seek end life mistakenly pressure recognizes presently undertaking extensive serious evaluation physician assisted suicide related issues ante see post souter concurring judgment circumstances challenging task crafting appropriate procedures safeguarding liberty interests entrusted laboratory first instance cruzan director mo dept health concurring citing new state ice liebmann sum need address question whether suffering patients constitutionally cognizable interest obtaining relief suffering may experience last days lives dispute dying patients washington new york obtain palliative care even hasten deaths difficulty defining terminal illness risk dying patient request assistance ending life might truly voluntary justifies prohibitions assisted suicide uphold nos washington et petitioners harold glucksberg et al writ certiorari appeals ninth circuit dennis vacco attorney general new york et petitioners timothy quill et al writ certiorari appeals second circuit june justice stevens concurring judgments ends opinion important observation holding today fully consistent continuation vigorous debate morality legality practicality physician assisted suicide democratic society ante write separately make clear also room debate limits constitution places power punish practice morality legality practicality capital punishment subject debate many years upheld constitutionality ofthe practice cases coming us georgia florida texas cases concluded state power place lesser value lives others absolute requirement state treat human life equal right preservation state legislatures sufficiently narrowed category lives state terminate enacted special procedures ensure defendant belonged limited category concluded statutes unconstitutional face later cases coming us however found applications statutes unconstitutional today decides washington statute prohibiting assisted suicide invalid face say cases might applied holding however foreclose possibility applications statute might well invalid originally filed case presented challenge washington statute face applied three terminally ill mentally competent patients four physicians treat terminally ill patients district issued opinion holding statute placed undue burden right commit physician assisted suicide see compassion dying washington supp wd three patients died although appeals considered constitutionality applied prescription life ending medication use terminally ill competent adult patients wish hasten deaths compassion dying washington individual plaintiff seeking hasten death doctor threatened prosecution assisting suicide particular patient analysis eventual holding statute unconstitutional limited particular set plaintiffs appropriate standard applied cases making facial challenges state statutes subject debate within see janklow planned parenthood sioux falls clinic upholding validity federal bail reform act stated salerno facial challenge legislative act course difficult challenge mount successfully since challenger must establish set circumstances exists act valid believe ever actually applied strict standard even salerno doesnot appear apply salerno nevertheless conceive respondents claim facial challenge addressing application statute particular set plaintiffs constitutionality statute categorical prohibition aid ing another person attempt suicide ante internal quotation marks omitted citing rev code accordingly requires plaintiffs show interest liberty protected fourteenth amendment includes right commit suicide includes right assistance ante history tradition provide ample support refusing recognize open ended constitutional right commit suicide much state paternalistic interest protecting individual irrevocable consequences ill advised decision motivated temporary concerns stake truth john donne observation man island state interest preserving andfostering benefits every human may provide community community thrives exchange ideas expressions affection shared memories humorous incidents well material contributions members create support value others person life far precious allow individual claim constitutional entitlement complete autonomy making decision end life thus fully agree liberty protected due process clause include categorical right commit suicide includes right assistance ante conclusion capital punishment always unconstitutional preclude later decisions holding sometimes impermissibly cruel equally clear decision upholding general statutory prohibition assisted suicide mean every possible application statute valid state like washington authorized death penalty thereby concluded sanctity human life require always preserved must acknowledge situations interest hastening death legitimate indeed interest sometimes legitimate also convinced times entitled constitutional protection cruzan director mo dept health assumed interest liberty protected fourteenth amendment encompassed right terminally ill patient direct withdrawal life sustaining treatment courtcorrectly observes today assumption simply deduced abstract concepts personal autonomy ante instead supported common law tradition protecting individual general right refuse unwanted medical treatment ibid recognized however common law right refuse treatment neither absolute always sufficiently weighty overcome valid countervailing state interests justice brennan pointed cruzan dissent upheld legislation imposing punishment persons refusing vaccinated citing jacobson massachusetts justice scalia pointed concurrence state ordinarily right interfere attempt commit suicide example forcibly placing bandage self inflicted wound stop flow blood cases individual constitutionally protected interest physical autonomy including right refuse unwanted medical treatment give way state interest preserving human life cruzan however normal case given irreversible nature illness progressive character suffering nancy cruzan interest refusing medical care incidental basic interest controlling manner timing death finding best interests served cutting nourishment kept alive trial simply vindicate cruzan interest refusing medical treatment essence authorized affirmative conduct hasten death reviewed case upheld missouri requirement beclear convincing evidence establishing nancy cruzan intent life sustaining nourishment withdrawn made two important assumptions liberty interest refusing unwanted treatment protected due process clause liberty interest end inquiry might outweighed relevant state interests agree assumptions insist source nancy cruzan right refuse treatment common law rule rather right aspect far broader basic concept freedom even older common law freedom embraces merely person right refuse particular kind unwanted treatment also interest dignity determining character memories survive long death recognizing state interests outweigh nancy cruzan liberty interest refusing medical treatment cruzan rested simply common law right refuse medical treatment least implicitly even fundamental right make deeply personal decision concurring thus common law right protection battery included right refuse medical treatment circumstances mark outer limits substantive sphere liberty supported cruzan family decision hasten nancy death planned parenthood southeastern casey limits never precisely defined generally identified importance character decision confronted individual whalen roe whatever outer limits concept may definitely includes protection matters central personal dignity autonomy casey includes individual right make certain unusually important decisions affect family destiny referred decisions implicating basic values fundamental dignified history tradition character language inthese cases brings mind origins american heritage freedom abiding interest individual liberty makes certain state intrusions citizen right decide live life intolerable fitzgerald porter memorial hospital footnotes omitted cert denied agree cruzan decide issue presented cases cruzan give recognition vague unbridled notions autonomy specific interest making decisions confront imminent death although absolute right physician assisted suicide cruzan makes clear individuals longer option deciding whether live die already threshold death constitutionally protected interest may outweigh state interest preserving life costs liberty interest stake case like differs stronger common law right refuse medical treatment unbridled interest deciding whether live die interest deciding rather whether critical threshold shall crossed state interests supporting general rule banning practice physician assisted suicide force cases first foremost interests unqualified interest preservation human life ante quoting cruzan equated sanctity life ante quoting american law institute model penal code comment official draft revised comments interest justifies commands maximum protection every individual interest remaining alive turn commands protection decisions whether commence terminate life support systems administer pain medication may hasten death properly viewed however interest collective interest always outweigh interests person pain incapacity sedation finds life intolerable rather aspect individual freedom many terminally ill people find lives meaningful even filled pain dependence others find value living suffering abiding desire witness particular events families lives many believe sin hasten death individuals different religious faiths make different judgments choices whether live circumstances want continue aggressive treatment prefer terminal sedation seek withdrawal life support systems death gradual starvation dehydration although general matter state interest contributions person may make society outweighs person interest ending life interest force terminally ill patient faced choice whether live die allowingthe individual rather state make judgments quality life particular individual may enjoy ante quoting cruzan mean lives terminally ill disabled people less value lives healthy see ante rather gives proper recognition individual interest choosing final chapter accords life story rather one demeans values poisons memories see brief bioethicists amici curiae see also dworkin life dominion whether someone best interests life end one way rather another depends much else special shape character life sense integrity critical interests uniform collective decision possibly hope serve everyone even decently similarly state legitimate interests preventing suicide protecting vulnerable coercion abuse preventing euthanasia less significant context agree state compelling interest preventing persons committing suicide depression coercion third parties state legitimate interest preventing abuse apply individual victimized abuse suffering depression makes rational voluntary decision seek assistance dying although new york task force report discusses diagnosing depression mental illness always easy mental health workers professionals expert working dying patients help patients cope depression pain help patients assess options see brief washington state psychological association et al amici curiae relatedly state amici express concern patients whose physical pain inadequately treatedwill likely request assisted suicide encouraging development ensuring availability adequate pain treatment utmost importance palliative care however alleviate pain suffering see orentlicher legalization physician assisted suicide modest revolution boston college rev galley greater use palliative care reduce demand assisted suicide eliminate see also brief coalition hospice professionals amici curiae citing studies showing death becomes imminent pain suffering become progressively difficult treat individual adequately informed care alternatives thus might make rational choice assisted suicide individual state interest preventing potential abuse mistake minimally implicated final major interest asserted state interest preserving traditional integrity medical profession fear rule permitting physicians assist suicide inconsistent perception serve patients solely healers patients physician refusal dispense medication ease suffering make death tolerable dignified inconsistent healing role see block billings patient request hasten death archives internal med doctor refusal hasten death may experienced dying patient abandonment rejection expression inappropriate paternalistic authority doctors long standing relationships patients given patients advice alternative treatments attentive patient individualized needs knowledgeable pain symptom management palliative care options see quill death dignity case individualized decisionmaking new england med heeding patient desire assist suicide serve harm physician patient relationship furthermore physicians already involved making decisions hasten death terminally ill patients termination life support withholding medical treatment terminal sedation fact significant tension traditional view physician role actual practice growing number cases new york state task force life law recognized state prohibition assisted suicideis justified fact ideal case patients screened depression offered treatment effective pain medication available patients supportive committed family doctor usual case new york state task force life law death sought assisted suicide euthanasia medical context may although concludes today potential harms sufficient support state general public policy assisted suicide always outweigh individual liberty interest particular patient unlike appeals say categorical matter state interests invalid entire class terminally ill mentally competent patients however foreclose possibility individual plaintiff seeking hasten death doctor whose assistance sought prevail particularized challenge future cases determine whether challenge may succeed new york doctor must respect competent person decision refuse discontinue medical treatment even though death thereby ensue doctor guilty felony provided patient assistance committing suicide today hold equal protection clause violated resulting disparate treatment two classes terminally ill people may interest hastening death agree distinction permitting death ensue underlying fatal disease causing occur administration medication means provides constitutionallysufficient basis state classification unlike however see vacco ante persuaded cases fact significant difference intent physicians patients families two situations may little distinction intent terminally ill patient decides remove life support one seeks assistance doctor ending life situations patient seeking hasten certain impending death doctor intent might also prescribing lethal medication terminating life support doctor fails administer medical treatment one dying disease intent harm kill patient conversely doctor prescribes lethal medication necessarily intend patient death rather doctor may seek simply ease patient suffering comply wishes illusory character differences intent causation confirmed fact american medical association unequivocally endorses practice terminal sedation administration sufficient dosages pain killing medication terminally ill patients protect excruciating pain even clear time death advanced purpose terminal sedation ease suffering patient comply wishes actual cause death administration heavy doses lethal sedatives intent causation may exist doctor complies patient request lethal medication hasten death thus although differences majority notes causation intent terminating life support assisting suicide support rejection respondents facial challenge distinctions may inapplicable particular terminally ill patients doctors holding today vacco quill equal protection clause violated new york classification like holding washington glucksberg washington statute invalid face foreclose possibility applications new york statute may impose intolerable intrusion patient freedom remains room vigorous debate outcome particular cases necessarily resolved opinions announced today cases may decided depend specific facts judgment however clear called unqualified interest preservation human life cruzan glucksberg ante sufficient outweigh interest liberty may justify possible means preserving dying patient dignity alleviating intolerable suffering dennis vacco attorney general new york et petitioners timothy quill et al writ certiorari appeals second circuit june justice souter concurring judgment even though conclude assisted suicide fundamental right entitled recognition time accord claims raised patients physicians case washington glucksberg high degree importance requiring commensurate justification see washington glucksberg ante souter concurring judgment reasons lead conclude glucksberg prohibition assisted suicide arbitrary due process standard also support distinction assistance suicide banned practices termination artificial life support death hastening pain medication permitted accordingly concur judgment footnotes penal law mckinney manslaughter second degree provides person guilty manslaughter second degree intentionally causes aids another person commit suicide manslaughter second degree class felony section promoting suicide attempt person guilty promoting suicide attempt intentionally causes aids another person attempt suicide promoting suicide attempt class felony see generally washington glucksberg ante established new york law competent person may refuse medical treatment even withdrawal treatment result death quill koppell supp sdny see pub health law art mckinney supp orders resuscitate regulating right adult capacity direct issuance orders resuscitate health care agents proxies allowing appointment agents make health care decisions principal behalf including decisions refuse lifesaving treatment declaration timothy quill app declaration samuel klagsbrun declaration howard grossman three patients stated chance recovery faced prospect progressive loss bodily function integrity increasing pain suffering desired medical assistance ending lives app declaration william barth declaration george kingsley declaration jane doe acknowledged new york assisted suicide statutes impinge fundamental rights involve suspect classifications subject rational basis judicial scrutiny american medical association emphasizes fundamental difference refusing life sustaining treatment demanding life ending treatment american medical association council ethical judicial affairs physician assisted suicide issues law medicine see also american medical association council ethical judicial affairs decisions near end life jama withdrawing withholding life sustaining treatment inherently contrary principles beneficence nonmaleficence assisted suicide contrary prohibition using tools medicine cause patient death new york state task force life law death sought assisted suicide euthanasia medical context professional organizations consistently distinguish assisted suicide euthanasia withdrawing withholding treatment provision palliative treatments medical care risk fatal side effects brief american medical association et al amici curiae course respondents lawsuit demonstrates differences opinion within medical profession question see new york task force death sought supra thus second circuit erred reading new york law creating right hasten death instead authorities cited recognize right refuse treatment nowhere equate exercise right suicide schloendorff society new york hospital contains justice cardozo famous statement human adult years sound mind right determine shall done body simply informed consent case see also rivers katz right refuse antipsychotic medication absolute may limited patient presents danger matter storar cert denied many courts recognized distinction see kevorkian supp nn ed fiori singletary costello app laurie senecal state ex rel schuetzle vogel thor superior cal degrella elston people adams cal app cal rptr guardianship jane doe mass cert denied sub nom doe gross rosebush app donaldson van de kamp cal app cal rptr lawrance ind mckay bergstedt browning mcconnell beverly enterprises connecticut state mcafee grant gardner matter farrell rasmussen fleming bouvia superior cal app cal rptr von holden chapman app div bartling superior cal app cal rptr foody manchester memorial hospital sup la leach akron general medical center ohio misc ohio comm pleas severns del ch satz perlmutter app application president directors georgetown college cadc cert denied brophy new england sinai hospital mass british house lords also recognized distinction airedale trust bland see code alaska stat ann rev stat ann supp ark code ann supp cal health safety code ann west supp cal prob code ann west supp rev stat supp stat supp del code tit supp code ann supp stat supp code ann haw rev stat idaho code supp comp ch ind code supp iowa code west supp stat ann rev stat ann baldwin supp la rev stat ann west rev stat tit west supp mass laws supp md health code ann comp laws ann west stat supp miss code ann supp mo rev stat mont code ann neb rev stat rev stat ann stat ann west stat ann supp pub health law rev stat stat cent code ohio rev code ann supp stat tit cons stat supp laws code ann supp codified laws code ann supp tex health safety code ann utah code ann code ann stat tit code tit rev code supp code stat supp wyo stat supp see also assisted suicide funding restriction act always crime either statute common law assist suicide new york see marzen crone balch suicide constitutional right duquesne rev appendix respondents also argue state irrationally distinguishes physician assisted suicide terminal sedation process respondents characterize induc ing barbiturate coma thenstarv ing person death brief respondents see petitioners insist however lthough proponents physician assisted suicide euthanasia contend terminal sedation covert physician assisted suicide euthanasia concept sedating pharmacotherapy based informed consent principle double effect reply brief petitioners quoting rousseau terminal sedation care dying patients archives internal med state may prohibit assisting suicide permitting patients refuse unwanted lifesaving treatment may permit palliative care related refusal may foreseen unintended double effect hastening patient death see new york task force death sought supra widely recognized provision pain medication ethically professionally acceptable even treatment may hasten patient death medication intended alleviate pain severe discomfort cause death insist justice stevens suggests ante concurring opinion cases fact significant difference intent physicians patients families withdrawal treatment physician assisted suicide cases see supra physician withdraws honors patient refusal begin life sustaining medical treatment purposefully intends may intend respect patient wishes true doctor provides aggressive palliative care physician purpose intent may ease patient pain emphasis added absence omniscience however state entitled act reasonableness distinction justice stevens observes holding today foreclose possibility applications new york statute may impose intolerable intrusion patient freedom ante concurring opinion true observe glucksberg ante particular plaintiff hoping show new york assisted suicide ban unconstitutional particular case need present different considerably stronger arguments advanced respondents justice ginsburg concurs judgments substantially reasons stated opinion justice breyer joins opinion except insofar joins opinions gregg georgia proffitt florida jurek texas see godfrey georgia enmund florida penry lynaugh see ante actually applied salerno standard action taken paragraphs identify situations washington statute validly enforced salerno needed look whether statute constitutionally applied arrestees analysis superfluous see dorf facial challenges state federal statutes stan rev arguing salerno standard taken literally litigant succeed facial challenge unless also succeeded applied challenge cases contexts imposed significantly lesser burden challenger lenient standard applied requires challenger establishthat invalid applications statute must real substantial well judged relation statute plainly legitimate sweep broadrick oklahoma opinion demonstrates washington statute prohibiting assisted suicide plainly legitimate sweep demonstration provides sufficient justification rejecting respondents facial challenge mean every application statute upheld casts eye sun rises takes eye comet breaks bends ear bell upon occasion rings remove bell passing piece world man island entire every man piece continent part main clod washed away sea europe less well promontory well manor thy friend thine man death diminishes involved mankind therefore never send know belltolls tolls thee donne meditation devotions upon emergent occasions raspa ed see either bill rights laws sovereign create liberty due process clause protects relevant constitutional provisions limitations power sovereign infringe liberty citizen relevant state laws either create property rights curtail freedom citizen must live ordered society course law essential exercise enjoyment individual liberty complex society source liberty surely exclusive source thought self evident men endowed creator liberty one cardinal unalienable rights basic freedom due process clause protects rather particular rights privileges conferred specific laws regulations meachum fano stevens dissenting nancy cruzan interest life less person includes interest thought death whose opinions mattered doubt life made dear family others dies affect life remembered cruzan director mo dept health stevens dissenting us interest kind memories survive death end individual decisions often motivated impact others member kind family identified trial findings case likely normal interest minimizing burden illness imposes others also interest memories filled predominantly thoughts past vitality rather current condition note evidence significant number physicians support practice hastening death particular situations survey published new england journal medicine found responding doctors michigan preferred legalizing assisted suicide explicit ban bachman et attitudes michigan physicians public toward legalizing physician assisted suicide voluntary euthanasia new england med survey oregon doctors responding doctors supported legalizing assisted suicide terminally ill patients see lee et legalizing assisted suicide views physicians oregon new england med another study showed physicians polled washington state reported asked terminally ill patients prescriptions hasten death year prior study physicians complied requests see back wallace starks perlman physician assisted suicide euthanasia washington state jama see also doukas waterhouse gorenflo seld attitudes behaviors physician assisted death study michigan oncologists clinical oncology reporting responding michigan oncologists reported active participation assisted suicide slome moulton huffine gorter abrams physicians attitudes toward assisted suicide aids acquired immune deficiency syndromes reporting responding physicians treat aids patients likely grant patient request assistance hastening death see vacco quill ante nn american medical association recognized distinction supported nancy cruzan continues recognize distinction support cases doctor prescribes lethal drugs self administered patient clear physician intent thatthe patient made dead ante internal quotation marks omitted many patients prescribed lethal medications never actually take merely acquire sense control process dying availability medications provides see back supra see also quill new england describing patients fear death less feel option physician assisted suicide