Of course, the wall of separation in this country is quite permeable, but the public referendum over physician-assisted suicide in Oregon and several other states illustrates how important it is to our sense of community to maintain the boundary. The existing legislative privileges of physicians to remove even food and hydration under appropriate procedures maintains the correct boundaries between religion and law. In law, the person signing a directive or appointing a health care representative does so with his own religious or irreligious convictions in mind. To the degree that religion is important in an individual's death, the institution of the family is a proxy for religion if there are both legal procedures for withdrawing or declining treatment and the presence of criminal law for those who go too far.
Some possibility of criminal prosecution of physicians for "mercy killings" and assisting patient suicide remains an important boundary in maintaining institutional balance among law, medicine, and families. Legislative enactments, such as Measure 16 in Oregon, assume that law can perform a kind of laser surgery between the institutions of law and people's intimate and often conflicted sense of being a part of a unique human family.
Voters and legislatures in every state have the constitutional authority to give physicians a legislative privilege to assist patient deaths. This authority does not mean that legislatures should change the political equilibrium among medicine, law, and families. Legislatures, even in Oregon, have struck that balance by providing procedures for patients or their representatives to decline or withdraw treatment, while maintaining criminal prohibitions against assisting patient suicide. The fact that a popular referendum in Oregon recently disrupted this balance does not negate the fact that the public does not usually vote about individual deaths.
Medical progress can continue without legal authorization of physicians to become the relievers of suffering. Suffering comes from people being connected in positive and negative ways to others--from being born into a particular family that shaped, but does not control, their vision of living and dying. For death to remain personal, legislatures should not exempt physicians from the constraints of law important to everyone as part of the community.