Vacco v. Quill

LOCATION: New York State Capitol

DOCKET NO.: 95-1858
DECIDED BY: Rehnquist Court (1986-2005)
LOWER COURT: United States Court of Appeals for the Second Circuit

CITATION: 521 US 793 (1997)
ARGUED: Jan 08, 1997
DECIDED: Jun 26, 1997

Dennis C. Vacco - Argued the cause for the petitioners, on behalf of the Petitioners
Laurence H. Tribe - Argued the cause for the respondents
Walter E. Dellinger, III - on behalf of the United States, as amicus curiae

Facts of the case

Dr. Timothy E. Quill, along with other physicians and three seriously ill patients who have since died, challenged the constitutionality of the New York State's ban on physician-assisted suicide. New York's ban, while permitting patients to refuse lifesaving treatment on their own, has historically made it a crime for doctors to help patients commit or attempt suicide, even if patients are terminally ill or in great pain. Following a District Court ruling favoring the State of New York, the Second Circuit reversed and the Supreme Court granted New York certiorari.


Did New York's ban on physician-assisted suicide violate the Fourteenth Amendment's Equal Protection Clause by allowing competent terminally ill adults to withdraw their own lifesaving treatment, but denying the same right to patients who could not withdraw their own treatment and could only hope that a physician would do so for them?

Media for Vacco v. Quill

Audio Transcription for Oral Argument - January 08, 1997 in Vacco v. Quill

Audio Transcription for Opinion Announcement - June 26, 1997 in Vacco v. Quill

I have the opinions of the Court to announce in three cases.

The first of them is No. 95-1858, Vacco against Quill.

In New York, as in most States, it is a crime to assist a suicide, but patients are allowed to refuse unwanted medical treatment even if that treatment is necessary to save their lives.

The question presented in this case is whether this distinction is so irrational that it violates the Equal Protection Clause of the Fourteenth Amendment.

The respondents here are New York doctors and they argue that refusing life sustaining medical treatment is really the same thing as physician-assisted suicide and so it does violate the Equal Protection Clause to permit one but not the other.

The District Court rejected this argument but the Court of Appeals for the Second Circuit agreed with it.

Under the Equal Protection Clause, States must treat -- must treat light cases alike but may treat unlike cases accordingly.

That is the proposition which we have followed for a long time and follow here and we therefore reverse the judgment of the Court of Appeals.

Respondents, as I have said, contend that some terminally ill people, those who are on life-support treatments are -- systems are treated differently than those who are not because the former may hasten death by ending treatment, but the latter may not hasten death through physician-assisted suicide.

This argument assumes though that ending lifesaving treatment is the same thing as assisting --assisted suicide and we reject this assumption.

The distinction between assisting suicide and ending life-sustaining treatment is widely recognized and endorsed in the medical profession and in our legal traditions.

In our opinion, we focus primarily on two important differences between the two practices.

First, a patient who commits physician assisted -- assisted suicide is killed by the lethal drug provided by the doctor, but when a patient refuses life-sustaining medical treatment he dies from his underlying disease or condition.

Second, a physician who honors a patient's request to end unwanted treatment does not necessarily intend that the patient die.

He may only intend to respect his patient's wishes and to cease doing futile or degrading things to the patient.

On the other hand, the doctor who assists suicide must necessarily intend primarily that the patient be made dead.

The law has long distinguished between actions taken because of a given result from actions taken in spite of they are intended but unforeseen consequences.

It is therefore not surprising that many courts, including this court in the -- our recent Cruzan opinion and the overwhelming majority of legislatures have drawn a clear line between assisting suicide and ending -- ending unwanted treatment.

We therefore reject respondent's claim that the distinction between the two is irrational or arbitrary.

Logic and contemporary practice support New York's judgment that the two acts are different and the Constitution permits New York to treat them differently.

Justice O'Connor has filed a concurring opinion which Justices Ginsburg and Breyer join in part.

Justice Stevens -- Justices Stevens, Souter, and Ginsburg, and Breyer had filed opinions concurring in the judgment.