(CN) - The Montana Supreme Court ruled that nothing in state law bars doctors from prescribing lethal drugs to terminally ill patients who want to end their lives. Montana is now the third state, along with Oregon and Washington, to allow physician-assisted suicide.
The justices sidestepped the constitutional issue, focusing instead on whether physician-assisted suicide is a crime under state law.
"We find nothing in Montana Supreme Court precedent or Montana statutes indicating that physician aid in dying is against public policy," Justice W. William Leaphart wrote for the 5-2 opinion.
Doctors for Robert Baxter, a retired truck driver from Billings, were worried that fulfilling his request to let him die with dignity would expose them to criminal liability.
Baxter underwent multiple rounds of chemotherapy to treat leukemia. The disease and treatment left him with several debilitating symptoms, including infections, chronic fatigue, anemia, night sweats, nausea, swollen glands, digestive problems and general pain.
Baxter, four doctors and a patient-rights group called Compassion & Choices filed suit, claiming it was unconstitutional to apply Montana's homicide laws to doctors who helped terminally ill patients like Baxter commit suicide.
Doctors' liability hinged on whether the "consent defense" applies to them, the justices said. But under Montana law, consent is "ineffective" if it's given in response to an act that's considered "against public policy."
"The 'against public policy' exception to consent has been interpreted by this court as applicable to violent breaches of the public peace," Leaphart wrote. "Physician aid in dying does not satisfy that definition. We also find nothing in the plain language of Montana statutes indicating that physician aid in dying is against public policy. In physician aid in dying, the patient - not the physician - commits the final death-causing act by self-administering a lethal dose of medicine.
"In light of the long-standing, evolving and unequivocal recognition of the terminally ill patient's right to self-determination at the end of life ... it would be incongruous to conclude that a physician's indirect aid is contrary to public policy," Leaphart concluded.
The majority reversed an award of attorneys' fees to Baxter, explaining that there had been no "vindication of constitutional interests."
In a concurring opinion, Justice John Warner agreed that the state Legislature "has not plainly stated that assisting a suicide is against public policy," but urged lawmakers to change that.
"In my view, the citizens of Montana have the right to have their Legislature step up to the plate and squarely face the question presented by this case, do their job, and decide just what is the policy of Montana on this issue," Warner wrote.
The state applauded the narrow ruling as a rejection of the broader constitutional challenge.
"[T]he Montana Supreme Court recognized that physician-assisted suicide is a policy question for the people of Montana and their Legislature," State Solicitor Anthony Johnstone said in a statement. "As we have argued, that is where the resolution of this important issue belongs."
Justice James C. Nelson agreed with the majority's reasoning, but said he would have upheld the lower court's ruling for Baxter on the constitutional issues.
"Society does not have the right to strip a mentally competent, incurably ill individual of her inviolable human dignity when she seeks aid in dying from her physician," he wrote in a specially concurring opinion.
Dissenting Justice Jim Rice argued that preventing murder is the "ultimate recognition of human dignity," and that physician-assisted suicide clearly violates public policy.
He said the majority "has badly misinterpreted our public policy: assisting suicide has been explicitly and expressly prohibited by Montana law for the past 114 years."
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