Baxter v. Montana: What the Montana Supreme Court said about dying, dignity, and palliative options of last resort

摘要

In his thoughtful and heartfelt editorial on the Montana Supreme Court decision concerning the case of Baxter v. Montana (2009), William Breitbart expressed the hope that readers of this journal would submit guest editorials on the topic of legalizing the provision of a lethal prescription at the request of a terminally ill patient. His editorial focused on the language of the Montana Constitution cited by the plaintiffs in the litigation and the decision of the trial court, as well as the reasons for the medical profession's traditional opposition to assisted suicide and euthanasia. My response to this invitation will delve more deeply into what the Montana Supreme Court majority decision actually concluded and why, the plight of the patient who was the lead plaintiff in the case and others who seek this option, and the implications of the reasoning underlying this decision for palliative medicine, in particular the clinical, ethical, and legal perspectives on the purported ethical distinction between palliative sedation and a lethal prescription, as well as that between killing and allowing to die in the context of terminal illness.