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Thursday, March 20, 2014

How Do You Define ‘Assisted’ In Assisted Suicide?

William Melchert-Dinkel, center, leaves the Rice County Courthouse with his attorney Terry Watkins, right, and wife, Joyce Melchert-Dinkel, Feb. 17, 2011. (Robb Long/AP)

William Melchert-Dinkel, center, leaves the Rice County Courthouse with his attorney Terry Watkins, right, and wife, Joyce Melchert-Dinkel, Feb. 17, 2011. (Robb Long/AP)

The Minnesota Supreme Court issued a decision yesterday on a very unusual assisted suicide case. The court ruled that a Minnesota law that makes illegal to “advise” or “encourage” people to take their own lives is too broad. But it said that to “assist” a suicide is still illegal.

The case involves a man who would troll online for people expressing suicidal thoughts. William Melchert-Dinkel would then pose as a sympathetic listener and encourage them to kill themselves. He told police he did it for, quote, the “thrill of the chase.”

Melchert-Dinkel was convicted in 2011 of two counts of aiding suicide. But Minnesota’s highest court says the language of the state law that bans people from encouraging or advising suicide is too broad — so broad that it violates the constitutional right to free speech.

Ethicist George Annas discusses the case with Here & Now’s Sacha Pfeiffer.

Guest

  • George Annas, chair of the Department of Health Law, Bioethics & Human Rights at Boston University.

Transcript

SACHA PFEIFFER, HOST:

This Minnesota Supreme Court has ruled that part of the state's ban on assisted suicide is unconstitutional because it violates the right to free speech. The decision said that encouraging or advising someone to take their own life is protected speech, but assisting them in that death is still illegal in the state of Minnesota.

The ruling came as the court overturned the conviction of a former nurse who convinced two people he met online to kill themselves. William Melchert-Dinkel would troll online for people expressing suicidal thoughts and egg them on. He told police he did it for, quote, "the thrill of the chase." For more on this we're joined by George Annas, chair of the Department of Health Law, Bioethics & Human Rights at Boston University. George, thanks for coming in.

GEORGE ANNAS: Happy to.

PFEIFFER: Could you tell me first, in general, your reaction to this ruling?

ANNAS: Well actually, I think the ruling is correct. I mean, the question was distinguishing between what you can say about suicide to someone and what acts you can perform to actually further the suicide itself.

PFEIFFER: So the question being is assisting simply talking to someone, is it physically aiding them?

ANNAS: That's right. I mean, what the court looked at this case is, is the Minnesota statute, which prohibits advising, encouraging and assisting another in taking their own live, is that a violation of the First Amendment of the Constitution, which guarantees us a right to free speech. And the court said insofar as the words advising and encouraging are concerned, that violates the First Amendment.

PFEIFFER: What makes this case unusual is that essentially there was a malicious intent here. This is a man who acknowledges that he wasn't trying to sort of benevolently help people who were suffering die. You know, he was giving them step-by-step instructions. And he got sort of what seems to be a perverted pleasure from it. Does that complicate this at all?

ANNAS: Well, he was a nasty person. I don't think there is any redeeming social value of having someone on the Net looking for people who are suicidal and trying to encourage them to kill themselves by even explaining different methods.

PFEIFFER: And he wanted to watch on a Webcam in some cases.

ANNAS: He did, he did. He even - he went so far as to say, well, let's do a suicide pact. We'll both commit suicide, and I want to watch you commit suicide first.

PFEIFFER: So is there a need here to redefine what assisted suicide means? We think in terms typically of Jack Kevorkian, who said look, I want to help people who are sick and have fatal illnesses. This is different. Do we need to think about it differently?

ANNAS: Well, Kevorkian actually was an easy case in assisted suicide because he developed his own what he called a suicide machine. He came to your house. He put an IV in your arm and showed you how to press the button to go ahead and kill yourself. This guy, as weird and evil as he was, never met these people. He didn't - he couldn't assist them, do an act to assist them. All he could do is talk to them.

And the Minnesota Supreme Court said, you know, we don't like this guy, obviously, but his speech doesn't come to the level of assisting. It does come to the level of advising and encouraging, but advice - you can advise and encourage. That's protected speech.

PFEIFFER: And we should note that this case has been sent back to a lower court, which now needs to decide whether this man did violate the portion of the Minnesota law that bans assisting suicide. So he's not totally out of jeopardy here.

ANNAS: Not yet, although Alan Page, a very distinguished and a senior associate judge on the Court of Minnesota, thinks it's a waste of time to send it back and dissented from that part of the opinion.

PFEIFFER: Why does he think it's a waste of time?

ANNAS: Judge Page thinks that this is not a case of assisted suicide, that assist requires an act, an act of helping or an act of either providing the instrument or actually helping you to use the instrument to kill yourself. And there were no acts involved here, only speech.

And assisted suicide actually turns out historically has required a lot. There's a famous case where a guy said, you know, I'd kill myself if I had a gun. And his friend said, well, I've got a gun, let's go home to my house and get a gun. And he gave him a shotgun. He said, well, I'd kill myself, but I don't know how to use a shotgun. And he said, well, I'll set it up for you to use.

And then he set it up for him. And then he said, well, but I can't reach the trigger. He said here, let me get a piece of string, and I'll set it up so you can reach the trigger. And ultimately he did kill himself. That's assisted suicide. The question is what short of that is assisted suicide?

I mean, for example doctors write prescriptions sometimes for drugs that help you sleep or can alleviate pain. Knowing, and even telling you if you take 30 of these you're going to die, don't take 30 of these because you're going to kill yourself, right, is that assisted suicide? I've always said the answer is of course now. And this case agrees with that, that of course that's not assisted suicide.

PFEIFFER: Do you think this Minnesota ruling will have more wide-reaching implications for the legality of assisted suicide in general?

ANNAS: I think that the next case is going to be about how far organizations like Final Exit can go.

PFEIFFER: That's a national right to die group.

ANNAS: Yeah, a national right to die group, is how far you can go in helping someone who you're not related to, who's not a family member, I think family members can go further than non-family members, in helping strangers to commit suicide.

PFEIFFER: Very fraught, very complicated.

ANNAS: It is complicated both because mental illness is often involved here, and when it's not, when people have terminal illnesses and have no good medical options, this is really a failure of the medical profession to properly help people during the dying process.

PFEIFFER: George Annas is chair of the Department of Health Law, Bioethics & Human Rights at Boston University. George, thank you.

ANNAS: Thank you.

ROBIN YOUNG, HOST:

Fascinating, and other stories we're following, tonight the big screens in Times Square will show that photo of desperate Syrians waiting in line for food on a ruined city street. Some people thought it was photoshopped. It's gone viral. And the U.N. hopes it will focus attention back on the war in Syria. But can it?

Also, after decades of development pressure and poaching, Florida's native orchids are rarely found in the wild. So Fairchild Tropical Garden in Miami is trying to re-establish a million of them. These and other stories later today on ALL THINGS CONSIDERED. Right now you're listening to HERE AND NOW. Transcript provided by NPR, Copyright NPR.


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  • it_disqus

    Sacha is not impartial in this story. Around 2:15 she sides with the person who actually kills rather than the the person who just talked about it. Her definition of suicide and all that encompasses it is obviously prejudiced.

  • Confused by George Annas

    I also teach bioethics and I am very confused. We ask judges to use their discernment precisely in cases like this. I have a couple of relatives who are mentally ill. Their lives are not threatened by Final Exit, who only seek to manage the end of people’s lives (albeit controversially). Someone like Melchert-Dinkel threatens their lives. “He’s a nasty person” just doesn’t cut it. He has convincingly shown he is dangerous.

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