Legal Reasoning

Interpretation in Legal Reasoning
The issue in this case study is whether or not palliative sedation could be considered assisted suicide or euthanasia.

Coherence in Legal Reasoning
California law states that mercy killing, assisted suicide, and euthanasia are not permitted (California Probate Code §4653). Also, there are no permissions for acts to end life deliberately or by omission other than when a person (or their surrogate) has decided to withhold or withdraw health care (California Probate Code §4653). To break down this law into its elements, we see that:
(1) mercy killing, assisted suicide, and euthanasia not permitted(
(2) we cannot end life deliberately (except when a person [or surrogate] has decided to withdraw or withhold health care to permit natural process of dying)
(3) we cannot end life by omission (except when a person [or surrogate] has decided to withdraw or withhold health care to permit natural process of dying).

Logic in legal reasoning
The material facts relevant to this case are:
(1) Palliative sedation is not well-defined or readily distinguished as separate from mercy killing, assisted suicide, or euthanasia (2) palliative sedation has the potential to end life
(3) palliative sedation is not equal to withdrawing or withholding health care.

Case law
In the case of Vacco v. Quill (1997), the U.S. Supreme Court upheld that there is an important and logical distinction between withdrawal of life-saving treatments and physician-assisted suicide, explaining that allowing someone to die and causing someone to die are separate entities. Applying this rule to Annie’s case, palliative sedation is an intervention given by a healthcare provider that has the potential to end her life, essentially causing her to die. Assisted suicide is the act of causing someone to die. Therefore, until there is solid legislation differentiating the intervention of palliative sedation to assisted suicide, mercy killing, and euthanasia, it could be argued that it is a form of assisted suicide and thus violates the law.

Legal Analysis
We have laws that solidly identify and quantitate the differences between assisted suicide and withdrawal of life saving treatments, but ambiguity dances around the practice of palliative sedation. Applying the rule to the fact shows that there is a need for a better definition of palliative sedation. Without this definition, the practice could be construed as a violation of the law, causing undo confusion and severe moral distress for nurses.