AMY BETH HANSON Associated Press Writer HELENA
Janet Murdock died a miserable death. The 67-year-old Missoula woman suffered from terminal ovarian cancer. And despite a court ruling that said physician-assisted suicide was a private medical decision protected by the Montana Constitution, she could not find a physician willing to prescribe her the needed drugs. Her friend, Bill Clarke, tried in vain to help her find a doctor. "To me, it's just insane. The sweetest thing we can imagine doing for one of our suffering pets is to have a veterinarian give it a shot, and it dies while we're talking to it and holding it and petting it," he said. But for people, "the best we can tell them is you're dying of cancer, you're suffering, you'd like to go early, but what we have for you is you can starve yourself to death, dehydrate yourself to death, and that's the best you can do." Murdock tried those things. "She was emaciated, it was gruesome," Clarke said. She died in mid-June, at least two months later than Clarke believes she would have if she had the option of physician- assisted suicide. Clarke plans to be in Helena Tuesday when the Montana Supreme Court hears arguments in the state's appeal of a District Court ruling that Montanans have a constitutional right to physician-assisted suicide. The arguments fall on either side of a line between allowing terminally ill patients to die and prescribing medication with the intent of ending their lives. The plaintiffs are asking the court to uphold a Dec. 5 ruling by District Judge Dorothy McCarter saying that mentally sound, terminally ill Montanans have a right to choose to end their lives using medication prescribed by doctors. The ruling also stated that doctors who prescribe such medicine should not be prosecuted under the state's homicide laws. "This case not only has to do with this end-of-life choice, it has to do with how strongly is the court going to stand by its tradition to protect private decisions about one's own body and medical care," said Kathryn Tucker with the Denver-based Compassion & Choices, one of the plaintiffs. The state's appeal argues that physician-assisted suicide violates state homicide laws and medical ethics because the medicine is given with the intent of causing a patient's death. The state attorney general's office notes the American Medical Association Code of Medical Ethics requires physicians to provide effective palliative care, or the reduction of pain or other symptoms, "even if it may foreseeably hasten death." The state argues that because palliative care is available to terminally ill patients, there is no need for physicianassisted suicide. "It is true that some terminally ill patients will obtain sufficient relief with palliative care and will not seek aid in dying to avoid prolonged suffering," Compassion & Choices argues in its brief. "Other patients, however, will not find adequate relief despite excellent palliative care, and fervently want and need the option of aid in dying." Shortly after McCarter's ruling, the Montana Medical Association issued a policy stating it "does not condone the deliberate act of precipitating the death of a patient." Oregon and Washington are the only states with assisted suicide laws. Oregon's Death with Dignity Act requires physicians to report prescriptions and deaths. In 2008, 88 prescriptions for lethal medications were written, 54 patients took the drugs and 22 died of their underlying disease. Twelve remained alive at the end of 2008. Six patients with earlier prescriptions took the medication and died in 2008. Since the Oregon law was passed in 1997, 401 patients have died under the terms of the law, state statistics show. The state of Montana said McCarter's ruling offers no guidelines for determining when a patient meets the qualifications of being mentally sound and terminally ill, no certain drug is mandated, types of illnesses aren't listed, and there are no requirements for reporting physician-assisted suicides. The state said the issue should be left to the Legislature and open to public debate, while Compassion & Choices said the court should decide whether physician-assisted suicide is constitutional, and then the Legislature could write guidelines. Compas s ion & Choices argues the only possible justifications for the state to criminalize what it calls aid in dying are to vindicate a specific moral view and to protect patients from their own actions. "It amazes me that we would think (allowing someone to suffer tremendously while dying) was humane or what God would want," Clarke said.