From Cryonics, October 1991
The Donaldson Case:
Appellate Brief
The following is an abbreviated version of of the appellate brief on behalf
of Thomas Donaldson and Alcor, written by attorneys Chistopher Ashwoth and David
B. Epstein.
See also the appellate court decision, case background, and case abstract
I.
ISSUES PRESENTED
Whether or not appellant Donaldson has the right, arising under California's
right to privacy, to procure the assistance of others in the commission of a
suicide, where, as here, a cancerous brain tumor condemns Donaldson to a painful
and degrading end-of-life in the ordinary course.
Whether under California's right to privacy appellant Donaldson has the right
to be cryonically suspended (frozen) premortem where an existing illness promises
to destroy so much brain tissue as to make such cryonic suspension fruitless
if Donaldson is required to await his "natural" death.
Whether appellants (Mondragon and Donaldson) have the Constitutional right
to give and receive advice and encouragement in respect of a suicide under California
Constitution Article I, Section 2 and the United States Constitution, Amendment
I.
II.
STATEMENT OF THE CASE
Procedurally this case is easy to describe. On April 30, 1990, appellant Donaldson
filed an action in the Superior Court in Santa Barbara County seeking declaratory
relief in respect of his right to an assisted suicide/premortem cryonic suspension.
The Attorney General and a number of other public officials were named as party
defendants. Defendant VandeKamp filed a demurrer which was joined by all of
the other defendants. On September 14, 1990, the Honorable Ronald W. Stevens,
Judge of the Superior Court, sustained the Attorney General's demurrer and granted
plaintiff thirty days to amend. Thereafter, Donaldson (now joined by plaintiff
Mondragon) filed a First Amended Complaint for Declaratory Relief on October
15, 1990. In due course, the Attorney General (again joined by all other parties
defendant) demurred to the First Amended Complaint. On December 14, 1990, the
Honorable Ronald Stevens sustained the defendants' demurrer to the First Amended
Complaint without leave to amend.
The underlying facts (as presented in the challenged Complaint and First Amended
Complaint) are straight-forward. In August 1988, plaintiff Thomas Donaldson
("Donaldson") was diagnosed as having a malignant brain tumor. The tumor is
inoperable and, ultimately, will kill him. In the two years since diagnosis,
the tumor has grown and has intruded upon his brain function. It has caused
speech impediment, right-sided weakness and seizures. The tumor is a "space
occupying lesion." As it continues to grow, it will slowly increase the pressure
on all brain tissues within his skull. When this increased pressure reaches
and ultimately exceeds the pressure with which Donaldson's blood is pumped by
his heart, the brain slowly will die from lack of nutrients, especially oxygen
(2). In time, Donaldson will be completely incapacitated and then will die.
Donaldson is a highly educated, mentally competent adult. He does not wish
to suffer through a slow and painful decline while the tumor continues to grow
and literally squeeze all life from his brain. He prefers a timely, albeit earlier,
death, while he is competent and still has some modicum of dignity.
No one disputes that Donaldson lawfully can end his life by his own hand at
any time. All agree that, if Donaldson waits until his brain is sufficiently
destroyed to leave him dependent on medical support (and most likely, incompetent),
he can require then that medical support be removed, permitting him to starve.
Neither of these alternatives is satisfactory to Donaldson because he wishes
also to exercise his right to direct the disposition of his body upon his death.
Specifically, Donaldson has directed that, upon his death, his body be placed
in cryonic suspension. Donaldson cannot place himself in cryonic suspension
without assistance. If he waits until the destruction of his brain cells has
reduced him to incapacity, the objective of cryonic suspension future
reanimation will be impossible and his right to choose the disposition of
his body will have been meaningless.
There is no sound reason, in policy or law, why plaintiff should be forced
to undergo the physical agony and indignity of being reduced to an incapacitated
or vegetative state before he dies. Given the incurable and terminal nature
of his disease, plaintiff is entitled to the assistance necessary to place his
body in cryonic suspension before the destruction of his brain renders the cryonic
suspension absolutely futile.
III.
ARGUMENT
DONALDSON HAS THE RIGHT TO PREMORTEM CRYONIC SUSPENSION OF HIS BODY.
Perhaps nothing is more fundamental to a civilized society than the concept,
described by Justice Cardozo, that "every human being of adult years and sound
mind has a right to determine what shall be done with his own body. . ." As
observed by Justice Rehnquist within the last year:
Before the turn of the century, this Court observed that [no] right is held
more sacred, or is more carefully guarded by the law, than the right of every
individual to the possession and control of his own person, free from all
restraint or interference of others, unless by clear and unquestionable authority
of law.
Defendant here argued before the trial court that this fundamental right is
not available to plaintiff here because "there is no constitutional right to
commit suicide or assist a suicide, nor is there a constitutional right to commit
murder or consent to be murdered." To pose the question in terms of "murder
or suicide" is to begin with a conclusion which begs the questions presented
and contributes nothing to an understanding of the issues.
In fact, there is ample authority for the right of a person who is terminally
ill to put an end to his suffering and to have the assistance of others in doing
so. In California, that right is recognized as "basic and fundamental" to the
right of privacy protected by the state and federal constitutions. Whether the
right is characterized as suicide is immaterial. Under any name, it is an exercise
of liberty which may be exercised and assisted lawfully.
1. A Person Suffering From An Incurable And Terminal Illness Has The Right
To Elect To Die When And As He Chooses.
a. The Case Law In California Concerning The Right To Die
In every reported case, where a competent decision was made, the courts have
affirmed the right to choose an early death with dignity over prolonged suffering
and misery.
The seminal case was decided in 1976 in In Re Quinlan. There, Karen Quinlan,
who had been comatose for years, was permitted to elect (through her conservator
father) to end her life by directing the removal of her respirator. By 1988,
the courts of at least twelve states, including the highest courts of ten, had
upheld the right of a terminally ill patient to discontinue needless suffering
and to end his or her life. [footnote - The only case in which plaintiffs
have been unsuccessful in asserting their right to die are those in which sufficient
proof of a competent decision was lacking.]
The California cases have moved in step with other jurisdictions. In Barber
v. Superior Court, (1983), the Second District Court of Appeal held that
physicians who removed the intravenous feeding tubes from a comatose patient
at the request of his family could not be prosecuted for homicide. One year
later, in Bartling v. Superior Court, (1984), the Second District again
(but a different Division) held that "a competent adult patient, with serious
illnesses which are probably incurable but have not been diagnosed as terminal,
has the right, over the objection of his physicians and the hospital, to have
life support equipment disconnected, despite the fact that withdrawal of such
devices will surely hasten his death."
In Bartling, the court addressed and decided the issue notwithstanding
the fact that the patient had died shortly before the case was argued. Two years
later, the same court that had decided Barber reaffirmed the holding
in Bartling in the case of a live patient, Bouvia v. Superior Court,
(1986). As in Bartling, Bouvia involved a seriously ill patient
who was not terminal and was not comatose. Ms. Bouvia, was an articulate fully
alert and competent young woman who, although seriously ill, had a life expectancy
of fifteen to twenty additional years with sufficient nourishment which was
provided through a nasogastric tube. The court held that Ms. Bouvia's right
to have the tube removed, regardless of any motivation to end her life, was
a "basic and fundamental" part of the right of privacy under the state and federal
constitutions. In 1988, the same principles were reaffirmed in Conservatorship
of Draybick, (1988), where the Sixth District upheld the right of a comatose
patient, through his conservator, to end his life by removal of a respirator.
b. The Characterization Of Plaintiff's Election As Suicide Does Not Diminish
His Right To Die As He Chooses.
Defendant argued, from dicta in Bartling and Bouvia, that those cases do not
apply here because the action by those plaintiffs were not suicide while the
action proposed by plaintiff is. This purported distinction is a fiction.
Bartling and Bouvia held that those plaintiffs had the absolute
right to the removal of life support apparatus notwithstanding that the removal
would kill them. Having established the plaintiffs' right at the constitutional
level, the question of whether or not the act permitted was suicide was not
an issue. In this context, the references to suicide in both cases is seen as
an explicit statement of what the court did not decide. Thus, Bartling
emphasized that "this is not a case, however, where real parties would have
brought about Mr. Bartling's death by unnatural means. . ." Similarly, Bouvia
emphasized that "it is not necessary here to define or dwell at length upon
what constitutes suicide."
To the extent that either case appears to characterize those plaintiffs' decisions
to end their lives as other than suicide, it is now recognized that this was
more a matter of circumspection than an issue of substance. In truth, it is
romanticized nonsense. The point is made by Professor Alexander:
As is often true in times of social transition, case law has created fictions
to avoid affronting previously accepted norms. In life-support termination,
there is a fiction of medical determinism. Patients are seen as passive victims
of their illness. They do not choose to die; death overtakes them. Their physicians
do nothing to help them die. Death overwhelms them, too.
The fiction requires that any action taken which will lead to death be described
as, at worst, surrender to the futility of further treatment.
Blaming the underlying disease rather than the act of life- support removal
is romantic but illogical. A person who removed a feeding tube from a recovering
patient temporarily dependent on it, would have a difficult time persuading
anyone that the resulting death was caused by the underlying illness, not
by the removal of the tube.
The fiction was acknowledged and criticized by Justice Compton in his concurring
opinion in Bouvia:
In order to seek the assistance which she [Bouvia] needs in ending her life
by the only means she sees available starvation she has had to stultify
her position before this court by disavowing her desire to end her life in
such a fashion and proclaiming that she will eat all that she can physically
tolerate. Even the majority opinion here must necessarily "dance" around the
issue.
Elizabeth apparently has made a conscious and informed choice that she prefers
death to continued existence in her helpless and, to her, intolerable condition.
I believe she has an absolute right to effectuate that decision . . . . The
fact that she is forced to suffer the ordeal of self-starvation to achieve
her objective is in itself inhumane.
Ironically, the very authorities cited by defendant would agree that the characterization
of Bartling's and Bouvia's actions as anything other than suicide is pure fiction.
Suicide may be defined as doing something which results in one's death,
either from the intention of ending one's life or the intention to bring about
some other state of affairs (such as relief from pain) which one thinks is
certain or highly probably can be achieved only by means of death or will
produce death.
Now, in 1991, one would hope we would no longer need to engage in fictions
or euphemisms to make a fundamental right more palatable. The plaintiffs in
Bartling, Bouvia (and every other reported case) demanded the right to choose
a dignified death over a painful and miserable life. The court acknowledged
that right not because the method employed was or was not suicide, but because
the constitutional right to privacy guarantees that the choice is theirs to
make. Plaintiff Donaldson here demands and is entitled to the right to make
the same choice.
c. The Right To Die Includes The Assistance of Others.
In Bouvia, Justice Compton commented on the fact that Bouvia needed
the assistance of others to implement her choice.
The right to die is an integral part of our right to control our own destiny
so long as the rights of others are not affected. That right should, in my
opinion, include the ability to enlist the assistance from others, including
the medical profession, in making death as painless and quick as possible.
A necessary corollary to the terminally ill patient's right to end his or
her life is the right to secure the assistance of others where necessary to
carry out such a direction. Barber v. Superior Court (1983) Whether it
is carried out by the "passive" removal of the nasogastric tube as in Bouvia
or the "active" sedation and lowering of body temperature for cryonic suspension
here, the only material distinction between lawful assistance and murder is
plaintiff's consent. Absent such consent, neither would be any more or less
a crime because it is was either "passive" or "active."
2. In This Case, Plaintiff's Interests In Exercising His Right To Die As
He Chooses Are Paramount To Any Interests Of The State.
Defendant acknowledges that plaintiff's right to end his suffering in the matter
he has chosen "centers around a balancing of the asserted constitutional right
against the pertinent interest of the State." Defendants then argued that "when
that balance is struck, . . . plaintiff's asserted claim to a right to enlist
others to take his life in an assaultive manner must be rejected." While defendants'
argument recited the abstract interest of the State in preserving life, it failed
entirely to address any of Donaldson's interest in ending his. Defendants' one-
sided analysis, therefore, presented no balancing of interest at all. [footnote
- Certainly the state has an interest in preventing the involuntary termination
of life as a necessary element of social order. Stated in the abstract, however,
the state's interest "in preserving life" or "in preventing suicide" is devoid
of sufficient content to overcome a constitutionally protected right to privacy.
Indeed, merely defending the state's abstract interest to "life" is a throwback
to the view articulated by Blackstone that suicide is criminal behavior because
the suicide is seen "rushing into [God's] immediate presence uncalled for .
. ." Blackstone, Commentaries on the Laws of England, Book IV, ch. 14,
sec. III.]
a. Donaldson's Interests Are No Less Compelling Than Bartling's Or Bouvia's.
A comparison of Donaldson's condition with Bouvia's leaves one hard pressed
to identify a material difference in the interest of either in ending his and
her suffering. While Bouvia's condition had reached a more debilitating state,
the difference is only one of time and provides us with a glimpse of what lies
ahead for Donaldson. . . . . Donaldson's condition is terminal while Bouvia's
condition was not. Bouvia had a life expectancy of 15-20 years, which is substantially
longer than Donaldson's.
Notwithstanding these differences, the compelling comparison is that Donaldson,
as did Bouvia, faces a certain future of pain and humiliation. While Donaldson
may have fewer years left than Bouvia, the message from Bouvia is that it is
not so much the amount of life left as it is the quality of the life remaining
that counts.
Who shall say what the minimum amount of available life must be? . . . As
in all matters, lines must be drawn at some point, somewhere, but that decision
must ultimately belong to the one whose life is an issue.
b. The State Has No Greater Interest Here Than It Had In Bartling Or Bouvia.
Defendants asserted a greater state interest here than in Bartling and
Bouvia based on the State's interest in preventing suicide and murder.
As discussed at [I.A.1.b.], supra, the characterization of Bartling's
and Bouvia's decisions as other than suicidal are pure fiction. Nor is there
any material distinction in the characterization of the means used as "passive"
in one case and "active" in another. As Justice Scalia observed:
It would not make much sense to say that one may not kill oneself by walking
into the sea, but may sit on the beach until submerged by the incoming tide;
or that one may not intentionally lock oneself into a cold storage locker,
but may refrain from coming indoors when the temperature drops below freezing.
In fact, one is hard pressed to identify any compelling interest of the state
in depriving an incurably and terminally ill person the right to end his suffering
sooner rather than later.
The compelling State interest to prevent assisted suicide is quite weak when
the act is undertaken because of a terminal or severely handicapped illness,
. . . [footnote - Smith, "All's Well That Ends Well: Toward a Policy
of Assisted Rational Suicide Or Merely Enlightened Self-Determination." 22
UC Davis L. Review 275, 312 (1989), cited by defendant at Demurrer, p. 13.]
It is worthwhile at this juncture to examine some of the rationales advanced
against assisted suicide and note their constitutional fragility in the contemporary
world.
Prevention of crime. There is no doubt that every state has a legitimate
and compelling interest in preventing one person from imposing death upon an
unwilling victim. No organized society can long endure unless it can ensure
the lives of its citizens. The nugget in the prevention of this kind of activity,
however, only makes sense if it is geared toward the prevention of involuntarily
imposed results. The chaos implicit in a society that permitted unconsented
killings is largely absent when the concept of involuntariness is taken out
of the equation. Despite the occasional flat earth utterance that a state has
a compelling interest in protecting "undifferentiated" life, the intellectually
defensible position appears to be that civil society only has a legitimate interest
in protecting against unwanted bodily intrusion.
. . . . The state has an obvious interest in preventing murders that are disguised
as suicides. It does not require very much imagination to conjure up scenarios
whereby interested parties would be very unreliable assistants to a prospective
suicide. We are reluctant to accept the word of the sole heir of a suicide that
his or her "assistance" was solicited by the deceased. The state could, therefore,
require some reasonable scheme of vetting the bona fides of those who would
assist another in committing suicide in order to assure that the prospective
suicide is being done voluntarily and not as the result of undue influence,
fraud or duress.
One court system has worked through this problem already. The Supreme Court
of Holland, in a relatively recent decision, has outlined what it considers
to be the necessary ingredients of a process to subject a prospective assisted
suicide to a "disinterested" outsider's view. The Dutch Supreme Court's resolution,
if not perfect, is workable. It simply anticipates a review by a disinterested
party (a medical doctor) prior to the assistance being rendered to the suicide.
It is difficult to imagine a legitimate crime prevention interest that the
state might have that would not be served by the Dutch model as outlined above.
Similarly, constitutional liberty is not unduly compromised. By ordinary constitutional
standards, a society can legitimately require some dispassionate demonstration
of voluntariness before permitting a person to assist at a suicide. In simple
words, the intrusion of government contemplated by the Dutch model would appear
to be minimal and no broader than required to subserve legitimate governmental
ends. It is the province of courts to fashion just such appropriate orders to
serve the needs of the case at hand.
Civil duty. Some cases that discuss suicide tell us that suicide ought
to be against public policy because it destroys the ability of the actor to
perform his civic duties to his dependents and to other persons. Whatever theoretical
merit that position may have in respect of the "ordinary" suicide, it has no
pertinence to the assisted suicides which are the focus of this case. Our case
involves someone who is or will be helpless at the time of his death. It follows
that people who, because of physical or mental infirmity, are unable to effectuate
their own suicide are not persons who are likely to be able to discharge civil
duties in any event. They constitute a relatively small class of impaired persons
from whom society cannot legitimately expect extensive and socially useful performance.
As applied to assisted suicide the logic behind the "civil duty" prohibition
is tenuous, bordering upon non sequitur. (One also shrinks from the notion
that a person ought to be kept alive and in traces like a draft horse until
he dies from natural causes.) Proceeding from the assumption that suicide is
a fundamental constitutional right, then the state is required to demonstrate
a compelling state interest to outlaw or unduly interfere with the right. In
the arena of civil duty, it is unlikely that the state could demonstrate that
the class of persons who are the focus of this case persons who are helpless
to effectuate their own suicide would be sufficiently likely to form a critical
block of civil accomplishment so as to proscribe assistance at their suicides.
Citizens are hardly civic chattel. See, generally, U.S. Constitution, Amendment
XIII. A "civil duty" proscription against suicide (and particularly assisted
suicide) would seem to violate the unbroken line of cases which suggest that
the existence of civil duties and the threatened breach thereof cannot
otherwise curtail fundamental liberty rights.
The miasmal dread of unperformed civil duties is not an appropriate basis to
prohibit assisted suicide.
Religious and philosophical. If nothing else, law is one of many ways
in which a society expresses its cultural or philosophical prejudices and preferences.
There is nothing intrinsically the matter with that state of affairs. However,
legal conflict is inevitable where, as here, philosophical values are in sharp
conflict or so in need of reconciliation as to require the intervention of constitutional
jurisprudence.
The philosophical and religious objections to suicide (perforce, assisted suicide)
seem to fall into three broad categories: first, a residual holdover of Christian
distaste for suicide; second, a somewhat undifferentiated and confused bias
in favor of the "life force"; and third, the numbingly familiar "slippery slope"
argument.
At common law, the courts accepted the religious proscription of the Church
as a basis of decision. The common law text writers of course followed suit.
Typical is Blackstone who informs us that suicide ("self murder") is
criminal in part because the suicide is seen as "rushing into [God's] immediate
presence uncalled for . . . ." Obviously, no court could get away with interfering
with a suicide on the basis that it puts the suicide in the presence of God
"uncalled for." The establishment clause of the First Amendment scotches that
notion. However, the generalized notion that suicide is "wrong" or somehow violative
of public policy has endured. One still finds cases that, with absolutely no
underlying explanation, declare that the state's interest in "preventing suicide"
and "preserving life" were self-evident propositions. This class of cases, being
uncritical and unanalytical in the extreme, resist contrary argument. They are
simply the residual effects cast into judicial utterances of a belief
system which no longer is entitled to the enforcement of law. For the purpose
of this brief it is simply appropriate to note that these cases exist and that
their genesis defies both logic and analysis. It must be remembered that in
California at least, a prohibitory statute must have a secular purpose. Wollersheim
v. Church of Scientology, (1989).
The next subcategory is the generalized perception that the law should favor
human "life" and pit itself against "death." One finds statements such as that
of Justice Rehnquist in declaring that a state has a legitimate interest in
the "undifferentiated" preservation of life. A number of things are the matter
with that philosophical proposition. The most glaring of the defects is that
the a priori consignment of death to a "bad" category as opposed to the
"good" category of life makes no objective sense. Barring the demonstrable advent
of an afterlife (to which the mode of death in this mortal existence would have
no pertinence) death is simply the inevitable end-point of the life processes
enjoyed (or endured) by all living things including humans.
In the specific context of California constitutional jurisprudence, it is impossible
to conjure up a defensible state interest that would compel an individual to
treat his or her life as worth living even after the individual manifestly concludes
that that is not so. The state is in no position to answer the ultimate "because"
question: "We are forcing you to stay alive because _______________." That blank
space stares back at us accusingly. Just what is it about a person's involuntarily
continued mortal existence that advantages the state? Aside from the possibility
of some merit in the "slippery slope" arguments discussed infra, Donaldson's
counsel have found no philosophically cogent arguments posited by any writer
which would justify imposing an unwanted continuation of mortal existence on
a Californian, protected as he is by the right to privacy. That is, the price
which someone might pay with their body in terms of pain or degradation has
never been demonstrated to advance an objective and secular interest of the
state. The best that the cases have done is to advance the tautological proposition
that life is good because life is good. In that context it is impossible to
justify a policy of miasmal life enhancement which may and very, very frequently
does visit upon a citizen a level of torment and pain which would not be
tolerated as punishment for the most heinous and revolting criminal behavior.
It would seem to be a strange society indeed that required innocent citizens
to live in torment and evil ones to be largely free of physical discomfort.
The last category of philosophical objection to assisted suicide can be generally
lumped under the heading of "slippery slope." The central theme of all of the
"slippery slope" arguments with no exceptions Donaldson's counsel have been
able to uncover is that any step along the path of euthanasia creates an
unreasonable risk that the permissive society will ultimately condone involuntary
euthanasia. But there is no evidence that any society has developed aberrant
homicidal offshoots such as involuntary euthanasia because of a progressive
deterioration in the society's appreciation of the value of human life. The
only historical precedents involve phenomena such as human sacrifices to propitiate
the gods (ancient Aztecs) or the abandonment of the elderly because there is
not enough food to go around (Eskimos).
If the underlying premise of Donaldson's complaint is correct, i.e., that the
right to suicide is a fundamental one, then it is respectfully submitted that
the trial court was wrong in staying its hand: Making the "great leap" from
the recognition of a fundamental right to decisions that implement that right
is precisely what judges are supposed to do. It is inappropriate for a trial
court to avoid deciding a case in the hopes (or dread) that a legislature will
act. California judges have a duty to exercise their jurisdiction and to decide
all cases properly before them. This is especially true of cases involving interference
with constitutional rights. Even in the absence of recognized procedure, constitutional
jurisdiction must be exercised even if it has to "make up" a procedure.
The issue raised by Donaldson's case is now ripe for a reasoned decision. The
pirouettes of "preservation of life," "prevention of suicide" and avoidance
of the "slippery slope" are no longer acceptable substitutes for a rational
confrontation between compelling state interests of the secular variety and
Donaldson's fundamental constitutional rights.
c. The Commentators Cited By Defendant Would Each Support Plaintiff's Right
To Die.
Ironically, each of the commentators cited by defendants in their demurrer
supports plaintiff's right to carry out his plan.
In the note "Criminal Liability For Assisting Suicide," the author proposes
a model statute which would decriminalize assisting a suicide where the person
ending his or her life was a competent adult who was suffering from a terminal
or chronic illness or a permanent, serious physical handicap. As Donaldson's
condition is terminal, he could enlist the assistance of others under this standard.
In "Suicidal Competence and the Patient's Right to Refuse Life Saving Treatment,"
the author argues that the State has an interest only in preventing "irrational"
suicides or those in which the decision to terminate life is not competently
made. The author proposes a two-prong test . . . . Applying this test, the record
would compel that Donaldson be entitled to carry out his plan.
Finally, in "All's Well That Ends Well, etc." , the author argues for an "enlightened
self-determination" of an individual's life plan as the fulfillment of liberty.
Again, given the dismal future in store for plaintiff, who could say that his
decision to end his life with dignity at this stage is anything other but an
exercise of "enlightened self-determination." Certainly not the state.
3. Plaintiff Has The Right To Direct That His Body Be Cryonically Suspended.
a. California Recognizes One's Right To Determine The Disposition Of His
Body.
The right to determine the disposition of one's own body attaches to the most
fundamental values of a civilized society. It carries with it religious, moral,
ethical, social and even environmental considerations which, instinct tells
us, attach to basic human rights. While there are no reported appellate opinions
focusing specifically on this issue, there is a substantial legal foundation
for the concept of freedom of choice in directing the disposition of one's own
body.
The legislature has acknowledged this concept of liberty in Health & Safety
Code sec. 7100 which provides, in pertinent part:
Sec. 7100. Right to control disposition of remains; duty and liability
for interment; devolution; prior directions of decedent. Order of Devolution.
The right to control the disposition of the remains of a deceased person,
unless other directions have been given by the decedent, vests in .
. . the following in the order named: [surviving spouse, children, etc. ]
[Emphasis added. ] . . .
Directions of Decedent. A decedent, prior to his death, may direct
the preparation for type or place of interment of his remains, either by oral
or written instructions, . . . The person or persons otherwise entitled to
control the disposition of the remains under the provisions of this section
shall faithfully carry out the directions of the decedent subject only to
the provisions of this chapter with respect to the duties of the coroner."
While the last section of the statute uses the word "interment," it is evident
that that term was not intended as one of limitation on the types of dispositions.
The first sentence of the section provides for the order of devolution of the
right to control the "disposition" of remains, predicated upon the condition
"unless other directions have been given by the decedent." From this, it would
appear that the legislature utilized the terms "disposition" and "interment"
interchangeably. It would make no sense to confer upon family members the right
to control the "disposition" of the remains subject to other directions by the
decedent and, at the same time, confer a more limited right upon the decedent
himself. The only logical interpretation of Sec. 7100 which would reconcile
all of the provisions of that section is that the legislature intended to vest
in each of us the right to determine the disposition of our bodies.
b. Plaintiff's Right To Direct The Disposition Of His Body Includes The
Right To Premortem Cryonic Suspension.
On at least three occasions, trial courts have addressed the issue of cryonic
suspension and, in various contexts, have acknowledged, both implicitly and
explicitly, the right of the individual to direct the cryonic suspension of
his or her body.
In Kent, et al. v. Carrillo, et al., Riverside Superior Court Case
No. R 191277, the Riverside Coroner threatened to thaw the remains of decedents
in cryonic suspension at the facility of the Alcor Foundation. The focus of
the coroner's threat was the remains of Dora Kent who had recently died and
had been placed in cryonic suspension. The plaintiff, who was the decedent's
son, sought to enjoin the actions threatened by the coroner.
In granting Kent's application, on February 1, 1988, Judge Miceli specifically
found that the action threatened by the coroner "would be in violation of the
rights of the decedents" and that thawing the remains of the decedents at the
Alcor Foundation "would produce irreparable injury."
The second instance in which these issues were presented to a trial court occurred
nine months later in Roe v. Mitchell, Los Angeles Superior Court Case
No. C 697 147. Initially, the defendants in the case were a hospital and various
employees of the state of California. The context was the advice by the hospital
caring for a terminal patient that it would not honor his request to release
his body to a cryonics organization at the time of his anticipated death. On
October 14, 1988, Judge Mu¤oz issued a Temporary Restraining Order and Order
to Show Cause Re Preliminary Injunction(25) restraining the hospital from interfering
with the application of the initial cryonic procedures (use of a portable resuscitator)
at the hospital after pronouncement of Jones' "legal death." [footnote
- The hospital later stipulated to make Judge Munoz' restraining order the terms
of a preliminary injunction, which remained in effect until Jones died. The
hospital was dismissed from the litigation.]
In October, 1990, Judge Mu¤oz granted summary judgment in favor of Jones and
issued a sweeping, comprehensive injunction prohibiting the state from interfering
with cryonic suspensions in any way.
[The] farthest reaching, Superior Court action, occurred in December 1989,
again in Riverside County, in the matter of Saul Kent, et al. v. Grover C.
Trask, II, Riverside Superior Court Case No. 201022. That action involved
a threatened prosecution of certain Alcor members who had participated in the
cryonic suspension of Dora Kent for violation of the Business and Profession
Code prohibitions against the unlicensed practice of medicine. The Alcor member
defendants sought injunctive relief on the claim that the threatened prosecution
created an impermissible "chilling" of the constitutional right of each Alcor
member to direct the disposition of his body by cryonic suspension. In a lengthy
opinion, Judge (now Justice) Timlin(26) concluded:
This court concludes that the Adherents, including Dora Kent, under Article
I, Section 1 of the California Constitution and the Fifth and Ninth Amendments
to the United States Constitution have a right to privacy, which includes
the right to exercise control over his/her own body and to determine whether
to submit his/her body, or any portion thereof, including the brain, to premortem
cryonic suspension. (In ruling on the application, this court in no way comments
directly or indirectly on the wisdom of such a choice.)
The moving papers submitted to Judge Timlin in the Kent v. Trask matter
relied extensively on the "right to die" cases which consistently have conferred
upon the individual the right to direct the discontinuance of life-support measures.
While Judge Timlin distinguished those cases from the issues before him, the
rationale of the "right to die" cases certainly provides an instructive insight
into the direction the law has taken.
While it is not common in constitutional litigation for a plaintiff to take
refuge in the technical rules of pleading, the court should be reminded that
(1) the proceeding below was a hearing on a demurrer and that (2) one of the
allegations of Donaldson's complaint that the trial court must have accepted
as true for the purposes of ruling on the demurrer is as follows:
17. As noted above, Donaldson's progressive brain tumor will, unless checked,
destroy a large part of his brain long before his heart stops beating and
Donaldson could be declared legally "dead." As a consequence, much or all
of the physical structure of Donaldson's brain which encodes memories (personality)
will be lost unless he is cryonically suspended prior to that time. In the
opinion of established scientists, [a representative list of such scientists
and their curricula vitae was attached to the First Amended Complaint as Exhibit
"A"] cryonic suspension portends a ponderable likelihood of ultimate
success in being able to revive and treat and cure a person whose illness,
in contemporary terms, would otherwise be deemed terminal. Further, it is
a factual certainty that Donaldson's post cryonic suspension prognosis would
be markedly better and the chances for his revival and survival would be
also be markedly better if he is placed in cryonic suspension well in advance
of the time when his "natural" death would occur.
The development of the technology necessary to effect the repairs described
in the subparagraph next above and to restore cryonic suspension patients
such as Donaldson to health and vigor is viewed by the scientists (and others)
identified in Exhibit "A" as highly probable. As a consequence, interfering
with Donaldson's cryonic suspension will, as a matter of probability, shorten
his life span particularly in view of the certain fact that his life expectancy,
absent cryonic suspension, is zero.
Factually, Donaldson's long-term prognosis is, beyond any statistical doubt,
better with cryonic suspension than without it. It is anomalous to suggest that
a process that augurs some measure of success is unlawful where the only alternative
is a process that augurs no chance of success. More to the point, the demurrer
ought not have been sustained unless the trial court was willing to say that
cryonic suspension has no chance of working in the future or that there is no
constitutionally protected right to suicide under any circumstance. It is unlikely
that this court is willing to do either of those things.
B. PLAINTIFFS HAVE THE CONSTITUTIONAL RIGHT TO GIVE AND RECEIVE ADVICE AND
ENCOURAGEMENT IN RESPECT OF A SUICIDE.
The salient portions of the first amended complaint are as follows:
29. Assuming arguendo that plaintiffs are not afforded judicial protection
arising from their intention to tangibly (physically) aid Donaldson in achieving
a "dead" state by cryonically suspending him pre-mortem, Donaldson,
Mondragon and Roes 1-10 intend to do the things described in paragraph 30,
infra.
30. Without the tangible (physical) assistance of any other person, Donaldson
intends to procure sufficient appropriate drugs and intravenous injection
equipment to permit him to administer to himself a lethal dose of some substance
in order to rapidly bring about his death. Donaldson further intends to bring
about his death in the presence of Mondragon and Roes 1 through 10 in order
to minimize the time between his legal death and the onset of the cryonic
suspension process.
For their part, Mondragon and Roes 1 through 10 (although disavowing any
intention to render any tangible, "physical" aid to Donaldson) intend to "talk"
Donaldson through the suicide procedure and intend to advise and encourage
him in such ways as will assist him in achieving a state of "dead" by the
means described above.
31. California Penal Code sec. 401 declares as follows:
"Every person who deliberately aids, or advises, or encourages
another to commit suicide is guilty of a felony." [Emphasis added].
32. Suicide is not listed as a crime or public offense in the California
Penal Code nor in any other statutory scheme in this State. Moreover, suicide
is not treated as a "common law" crime in this State, inter alia, because
Penal Code sec. 6 declares as follows: "No act or omission, commenced after
12: 00 noon of the day on which this code takes affect as a law is criminal
. . . except as prescribed . . . by this code . . . ."
33. Plaintiffs intend to advise and encourage Donaldson to effectuate his
suicide in the way described in paragraph 30 above and by so doing will (definitionally)
aid Donaldson in bringing about his own death.
34. Plaintiffs are informed and believe and on that basis allege that defendants
Van de Kamp and Sneddon presently intend to prosecute any persons, such as
the cryonic suspension team members, who would aid (even if such aid only
consists of advising and encouraging) a fellow human being in moving from
a state of "alive" to a state of "dead" within the meaning of Health and Safety
Code sec. 7180.
Because suicide is not a crime or a public offense, plaintiffs Mondragon
and Does 1 through 10 and Donaldson (as a recipient of any advice or encouragement),
are protected by the First Amendment of the United States Constitution, and
Article I, Section 2 of the California Constitution from any act or threatened
act including a threatened prosecution under Penal Code secs. 401 and 187
et seq. which would interfere with their right to free speech and expression.
At issue here is whether and to what extent the plaintiffs' right to give
and receive suicide advice (speech by any other name) can be curtailed by
government fiat. We might also keep in mind that California Constitution Article
I, section 2 constitutes a "protective provision more definitive and inclusive
than the First Amendment [of the U.S. Constitution]." Wilson v. Superior
Court, (1975). State action violative of the First Amendment is, a fortiori,
violative of the California Constitution. Bill v. Superior Court, (1982).
Under the First Amendment, there is a two pronged test which must be utilized
in order to justify imposing either a civil or criminal penalty upon speech:
The court must be satisfied that the speech in question (1) is directed at the
goal of producing imminent lawless conduct and (2) the speech
is likely to produce such conduct. Hess v. Indiana, (1973). Suicide is
not "lawless" in California. Suicide is not a crime. Suicide is not a
tort. Suicide is not a breach of contract. It necessarily follows that speech
which is intended to lead to an imminent suicide (and that is the case here)
may not constitutionally be prohibited. Counsel for Donaldson have made a comprehensive
review of the cases and have been absolutely unable to find a single case wherein
the advocacy of lawful activity could be constitutionally proscribed.
Because of the foregoing analysis, Penal Code sections 401 and 187 et. seq.
are unconstitutional as applied to the facts of this case. Further, section
401 is unconstitutional on its face precisely because it attacks expression
rather than any underlying unlawful conduct. The cases cited below by the Attorney
General are beside the point. Statutes prohibiting solicitation of crimes are
simply not comparable to statutes (such as section 401) which proscribe the
advocacy of lawful behavior. Solicitation statutes are constitutional; section
401 is not. The demurrer ought to have been overruled on this point.
C. THE COURT HAS THE POWER TO ENJOIN THE UNLAWFUL ENFORCEMENT OF A STATUTE
Defendant argued that the trial court does not have the power to enjoin actions
taken by a public official pursuant to statutory authority. This is a correct
statement of the law only so long as the statute or its enforcement does not
contravene constitutional rights.
Plaintiffs' complaint alleges that, if he exercises his right to die and to
direct the disposition of his body in the manner he has chosen, defendants will
prosecute those assisting plaintiff and will autopsy Donaldson's body. As demonstrated
in plaintiff's argument, supra, such actions by the defendants would
be unconstitutional and therefore can be enjoined.
D. PLAINTIFFS HAVE NO ADEQUATE REMEDY AT LAW
Defendants lastly argues that plaintiffs have an adequate remedy at law because
they can defend themselves against criminal charges. The simple answer is that
so long as the chilling effect of the prospect of criminal prosecution is present,
all plaintiffs will be denied the opportunity to exercise their constitutional
rights. Moreover, even if an assistant were willing to take the risk, by the
time charges are brought, damage already would have been done.
IV.
CONCLUSION
For all of the foregoing reasons, it is manifestly clear that the trial court
erred in failing to recognize that both Donaldson has the right to an assisted
suicide under the facts of this case (whether or not in the context of a cryonic
suspension) and that Mondragon and those similarly [situated] have an absolutely
protected Constitutional right to advise and encourage Donaldson in his efforts
at suicide. For these reasons the trial court must be reversed and this case
returned to the trial court with directions consistent with the positions of
plaintiffs set forth hereinabove.
DATED: May 28, 1991
Respectfully submitted,
GARFIELD, TEPPER, ASHWORTH & EPSTEIN
A Professional Corporation
See also the appellate court decision, case background, and case abstract
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