Krischer v. McIver
697 So. 2d 97, 1997 WL 414567 (1997)
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Rule of Law:
The Florida Constitution's privacy clause protects a patient's right to refuse medical treatment and allow the natural course of events to occur, but it does not extend to a right to physician-assisted suicide, as the state's compelling interests in preserving life, preventing suicide, and maintaining the integrity of the medical profession outweigh an individual's desire for affirmative medical intervention to end their life.
Facts:
- Charles E. Hall, a thirty-five-year-old man, suffers from acquired immune deficiency syndrome (AIDS) which he contracted from a blood transfusion.
- Mr. Hall was mentally competent, in obviously deteriorating health, clearly suffering, and terminally ill.
- Mr. Hall wished to hasten his own death at a time of his choosing by self-administering a fatal dose of prescription drugs.
- Cecil McIver, M.D., Mr. Hall's physician, professionally judged it medically appropriate and ethical to provide Mr. Hall with such assistance at some time in the future.
- Dr. McIver testified that he would assist Mr. Hall in committing suicide by intravenous means.
- The assistance sought involved Mr. Hall self-administering lethal medication only after consultation and a mutual determination by both physician and patient that Mr. Hall was competent, imminently dying, and prepared to die.
Procedural Posture:
- Charles E. Hall and Cecil McIver, M.D., filed suit in a Florida trial court (circuit court) seeking a declaratory judgment and an injunction.
- They requested a declaration that section 782.08, Florida Statutes, which prohibits assisted suicide, violated the Privacy Clause of the Florida Constitution and the Due Process and Equal Protection Clauses of the Fourteenth Amendment to the U.S. Constitution.
- After a six-day bench trial, the trial court issued a final declaratory judgment and injunctive decree, concluding that section 782.08 could not be constitutionally enforced against them.
- The trial court enjoined the state attorney from enforcing the statute against Dr. McIver if he assisted Mr. Hall, basing its decision on Florida's privacy provision and the federal Equal Protection Clause, but found no federal liberty interest under the Due Process Clause.
- The state attorney, Barry Krischer, appealed this judgment.
- The trial court then set aside the automatic stay that would typically be imposed during an appeal.
- The Fourth District Court of Appeal certified the case to the Florida Supreme Court as one of great public importance requiring immediate resolution.
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Issue:
Does the Privacy Clause of the Florida Constitution grant a competent, terminally ill adult the right to obtain assistance from a physician to self-administer a fatal dose of prescription drugs to hasten their death?
Opinions:
Majority - Grimes, Justice
No, the Privacy Clause of the Florida Constitution does not grant a competent, terminally ill adult the right to physician-assisted suicide. The U.S. Supreme Court's recent decisions in Washington v. Glucksberg and Vacco v. Quill affirmed that there is no federal constitutional right to assisted suicide under the Due Process or Equal Protection Clauses. While Florida's privacy provision establishes a right to refuse medical treatment, allowing the natural course of events to occur, this is fundamentally different from physician-assisted suicide, which is an affirmative act designed to cause death. The state has compelling interests that outweigh Mr. Hall's desire for assistance in suicide: (1) the unqualified preservation of life, (2) the prevention of suicide (given that those who attempt suicide often suffer from treatable depression or pain), and (3) the maintenance of the ethical integrity of the medical profession, as leading medical organizations oppose assisted suicide. Deferring to the legislature for establishing social policy on such a complex issue, the court concluded that Section 782.08, prohibiting assisted suicide, is constitutional.
Concurring - Overton, Justice
No, the absolute right to assisted suicide is not protected under Florida's right of privacy, and Section 782.08 is facially constitutional and constitutional as applied. While the decision to end one's life is deeply private, it does not mean an individual has an absolute right to third-party assistance. The state's long-standing policy of preventing suicide and the overwhelming risks associated with court-approved assisted suicide—including issues of competency, voluntariness, potential for abuse, and the definition of 'terminally ill'—establish compelling state interests that outweigh Mr. Hall's future desire for assistance. The privacy provision was not intended by voters to protect the absolute right to terminate one's life through 'death producing agents,' distinguishing it from refusing life-support. The legislature, with input from the medical and scientific community, is the appropriate body to address such complex issues and craft any exceptions, with suitable standards and safeguards, to the general prohibition on assisted suicide.
Concurring - Harding, Justice
No, the Florida constitutional right of privacy does not encompass physician-assisted suicide. While Florida's privacy right includes the right to choose or refuse medical treatment, upholding an individual's bodily integrity against invasive medical procedures, there is a meaningful distinction of such magnitude that physician-assisted suicide is not implicated. Refusing treatment allows the underlying disease to run its course, while assisted suicide is an affirmative act to cause death. The limitations proposed by the trial court (competent, imminently dying, prepared to die) highlight the immense differences and raise concerns about equal protection, as those unable to self-administer would be excluded. Allowing assisted suicide would also lead to a 'slippery slope,' potentially extending the right beyond the terminally ill, to unconscious patients, or those suffering from chronic pain. The complex regulations and safeguards needed for assisted suicide should be established by the legislature, not by the courts.
Dissenting - Kogan, Chief Justice
Yes, the right of privacy under the Florida Constitution should extend to competent, terminally ill adults seeking physician-assisted suicide when facing an agonizing and inevitable death. The traditional distinction between 'active' suicide and 'passive' dying by 'natural causes' is unworkable in the context of modern medicine and terminal illness. Florida's privacy right, established in cases like Satz v. Perlmutter (refusing artificial respiration) and In re Guardianship of Browning (removing feeding tube), has already moved beyond the common law definition of suicide. When death is imminent and painful, the state's interest in preserving life is no longer compelling; instead, the state is only preserving indignity and suffering. The right of privacy attaches with unusual force at the deathbed, protecting an individual's self-determination against majoritarian disapproval. While the 'slippery slope' problem is a concern, courts have previously established adequate standards to guard against abuse. Furthermore, it is the court's fundamental duty to enforce constitutional rights, including privacy, against legislative overreaches, and not to defer such critical individual liberties to the political process.
Analysis:
This case is highly significant as it firmly distinguishes between a constitutional right to refuse life-sustaining medical treatment and a constitutional right to physician-assisted suicide under Florida's broad privacy clause. By upholding the state's criminal prohibition, the Florida Supreme Court aligned itself with federal precedent established in Glucksberg and Quill, effectively rejecting the notion that a constitutional 'right to die' extends to active assistance in ending one's life. The ruling emphasizes the judiciary's deference to the legislature on complex moral and social policy issues, particularly where significant societal risks and the integrity of the medical profession are at stake, limiting judicial expansion of privacy rights in this sensitive area.
