Vacco v. Quill

In New York, as in most States, it is a crime to aid another to commit or attempt suicide, but patients may refuse even lifesaving medical treatment. Respondent New York physicians assert that, although it would be consistent with the standards of their medical practices to prescribe lethal medication for mentally competent, terminally ill patients who are suffering great pain and desire a doctor’s help in taking their own lives, they are deterred from doing so by New York’s assisted-suicide ban. They, and three gravely ill patients who have since died, sued the State’s Attorney General, claiming that the ban violates the Fourteenth Amendment’s Equal Protection Clause. The Federal District Court disagreed, but the Second Circuit reversed, holding (1) that New York accords different treatment to those competent, terminally ill persons who wish to hasten their deaths by self-administering prescribed drugs than it does to those who wish to do so by directing the removal of life-support systems, and (2) that this supposed unequal treatment is not rationally related to any legitimate state interests.

Held: New York’s prohibition on assisting suicide does not violate the Equal Protection Clause. Pp. 799-809.

(a) The Equal Protection Clause embodies a general rule that States must treat like cases alike but may treat unlike cases accordingly. E. g., Plyler v. Doe, 457 U. S. 202, 216. The New York statutes outlawing assisted suicide neither infringe fundamental rights nor involve suspect classifications, e. g., Washington v. Glucksberg, ante, at 719-728, and are therefore entitled to a strong presumption of validity, Heller v. Doe, 509 U. S. 312, 319. On their faces, neither the assisted-suicide ban nor the law permitting patients to refuse medical treatment treats anyone differently from anyone else or draws any distinctions between persons. Everyone, regardless of physical condition, is entitled, if competent, to refuse unwanted lifesaving medical treatment; no one is permitted to assist a suicide. Generally, laws that apply evenhandedly to all unquestionably comply with equal protection. E. g., New York City Transit Authority v. Beazer, 440 U. S. 568, 587. This Court disagrees with the Second Circuit’s submission that ending or refusing lifesaving medical treatment “is nothing more nor less than assisted suicide.