Elder Law

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Considering Competency: The Need for States’ Death with Dignity Statutes to Establish Competency Committees

By Andrew J. Older

Nine states and the District of Columbia have statutes which legalize physician-assisted death (PAD), the process by which a “physician provid[es], at the patient’s request, a prescription for a lethal dose of medication that the patient can self-administer by ingestion, with the explicit intention of ending life.” In the United States, this practice is confined to patients suffering from terminal illnesses who are “mentally competent.” Despite some guidance on what the word “competent” means, however, the term has proved incredibly difficult to understand in practice.

This Note argues that states’ PAD laws should statutorily create medical committees which research and, from time to time, promulgate clinical criteria in order to guide physicians who choose to participate in PAD. Part I will trace PAD’s historical background in the United States; Part II will offer some insight into the current problem that a patient competency evaluation might entail; and Part III will outline how and why medical committees could help physicians administer aid in an environment rife with uncertainty. Although this Note takes no side in the moral debates over PAD, it recognizes that states either have PAD statutes on the books or are considering such statutes in the future. As such, this Note serves to suggest necessary safeguards for a burgeoning medical-legal landscape.

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