The Irish Case Against Assisted Suicide: An American PerspectiveDemetra M. Pappas 
This past week, the Irish Supreme Court ruled that 59-year-old multiple sclerosis patient Marie Fleming does not have the right to an assisted death. Suicide has been decriminalized in Ireland since 1993; however, the judgment of the Court, delivered by Chief Justice Susan Denham said that the Irish Constitution does not encompass an “explicit right to commit suicide, or to determine the time of one’s own death.”
When Fleming, a former university (college) lecturer, argued her appeal in February, she was using a wheelchair. She noted that she was in constant pain, but more than that, argued that her inability to swallow would probably cause her to choke to death. This is a constant fear of those afflicted with illnesses such as Huntington’s Disease, ALS and MS. Indeed, in the 60 Minutes “Death by Doctor” tape of Jack “Dr. Death” Kevorkian, in which he narrated his medical euthanasia of 52-year-old ALS patient Tom Youk, Kevorkian noted that Youk was “terrified of choking, terrified.” Kevorkian was convicted, but many at the trial and sentencing (myself included) were of the view that the jury verdict was more a result of him sending the tape of himself euthanizing Youk to CBS, and then narrating it for moderator Mike Wallace. In this comment, I am not arguing in favor of (or opposition to) assisted suicide. This is, I believe, a personal choice which may as a matter of law be made by patients in jurisdictions where assisted suicide is lawful. Ireland is not one of those jurisdictions. There is a difference between decriminalizing suicide and affirmatively allowing for suicide – medically assisted or otherwise. Suicide, or self-homicide, has been decriminalized in Anglo-American jurisdictions, so as not to forfeit the suicidant’s property to the state or the Crown and so as not to impose the Anglo-American penalty of burial at crossroads. In a sense, this is (and I say this secularly, although I imagine that it holds theologically) literally so as not to visit the sins of the parent upon the descendants. Moreover, even where assisted suicide is lawful, in some jurisdictions (such as Oregon), the ability to self-administer has been a mandatory element to meet the threshold. A compelling example of this was given in the HBO’s (Sundance award-winning) film, *How to Die in Oregon*, by the story of 84-year old Ray Carny, who ultimately died in the hospital, physically unable to give himself the lethal cocktail, one of the requirements of the Oregon Death With Dignity law. As a daughter of a man who unsuccessfully attempted to commit suicide (by self-starvation) after he became symptomatic with Huntington’s Disease, and had to withstand a parade of physical and psychiatric horrors for another 20 years until his death (by “pneumonia”), I empathize enormously with Ms. Fleming’s desire for personal autonomy. As a lawyer, I can certainly understand the judicial wish to protect the public interest by protecting those who might be vulnerable by declining to relax the law. This comes from a concern that to do otherwise would begin a slide down what Yale Kamisar (among others) called the slippery slope to medical euthanasia, with its potential for abuses, such as those most notoriously exemplified by the Nazi experience. As a concluding commentary, I predict that no jury would convict Fleming’s 65-year-old partner, Tom Curran, notwithstanding the technical legal criminal liability and potential 14-year sentence (who would be unlikely to be prosecuted in the first place). This last is an educated guess, based upon cases against doctors and “civilians.” As to doctors, there are examples of grand juries that have declined to indict doctors – who are held to a higher standard of law – such as in New York’s case against hospice physician Dr. Timothy Quill in 1991, which precipitated a civil case that went to the United States Supreme Court, and that of Louisiana’s Dr. Anna Pou, who engaged in euthanasia of a number of elderly patients in the wake of Hurricane Katrina. Likewise, trial juries have engaged in jury nullification (such as New Hampshire’s Dr. Hermann Sander in 1950, and the Kevorkian juries of 1994, and two more in 1996) and courts have declined to incarcerate (such as Winchester Crown Court in the 1992 case against Nigel Cox). Even in the most complicated of circumstances – such as Georgia’s Carol Carr, who shot two sons as they lay side-by-side in a nursing home, with end-stage Huntington’s Disease and most recently Arizona’s George Sanders, who received probation after shooting his MS-afflicted wife -- compassion for the “assister” has been the norm. I emphasize that these were in gun shooting cases (it should not make a difference that there is blood involved, but in reality it does). I suspect that Fleming’s purpose in going to court had little to do with the practicality of the law in action, rather than the law on the books. The first person through any door of activism is sure to get bloody, wheelchair or not. Fleming may be a physically disabled patient, but she is also unquestionably a vigorous activist. Her success, whether she realizes it or not, was in getting into that courtroom in the first place, as painful as the process of the litigation and as difficult the death trajectory.
 DDemetra M. Pappas, JD, MSc, PhD currently teaches in the Department of Sociology and Criminal Justice at St. Francis College, where she was named the 2012 SGA Faculty Member of the Year. Her first book, Historical Guides to Controversial Issues in America: The Euthanasia/Assisted Suicide Debate, (Greenwood Press, 2012) (100 year study of US and UK doctors prosecuted for medical euthanasia/assisted suicide and role of meI dia) has been nominated for the2013 BSC Criminology Book Prize. Her PhD, from the London School of Economics and Political Science, Department of Law and Department of Sociology (dual registration), was awarded in 2009, based upon her dissertation of an ethnography entitled, The Politics of Euthanasia and Assisted Suicide: A Comparative Case Study of Emerging Criminal Law and the Criminal Trials of Jack ‘Dr. Death’ Kevorkian, in which she studied the chief prosecuting attorneys/judges, juries, patient’s family members and the media, as well as the changes in law and court culture pertaining to Kevorkian.  Review by Demetra M. Pappas, How to Die in Oregon, HBO Documentary Films,” in The New York Resident/Resident Health (August 2011), p. 61  Demetra M. Pappas, "Euthanasia and Assisted Suicide: Are Doctors' Duties when Following Patients' Orders a Bitter Pill to Swallow?", in G. Howarth and P. Jupp (eds.), Contemporary Issues in the Sociology of Death, Dying and Disposal, Macmillan, Inc. (1996).