DEATH'S DOOR LEFT AJAR

By DAVID VAN BIEMA

Linda Jewell was just waking up on Thursday in Edmonds, Wash., when she heard the news. The radio announced that the Supreme Court had sustained a Washington State law forbidding the terminally ill from enlisting doctors' help in committing suicide. Jewell, 58, who has advanced ovarian cancer and an aversion to a bedridden, IV-tubed future, was bitterly dismayed. "I felt a heaviness in my heart," she says. "I've always been a law-abiding citizen, but I think this is a moral right."

At first hearing, the court's dual, unanimous decisions on assisted suicide (the second addressed a New York case) constituted a heavy weight indeed for the practice's advocates. Led by Chief Justice William Rehnquist, whose wife died in 1991 after fighting ovarian cancer, the court delivered a much anticipated judgment on one of the era's most wrenching dilemmas. "The history of the law's treatment of assisted suicide in this country [is]...rejection of nearly all efforts to permit it," Rehnquist wrote. "The asserted 'right' to assistance in committing suicide is not a fundamental liberty interest..." The Justices also rejected the parallel between the practice and the request of someone on life support to have the plug pulled, a right upheld by the court in the past.

In reality the decisions were more nuanced. Although the 35 states with outright bans on doctor-assisted suicide may now enforce them with greater assurance, the court rulings did not preclude states from voting to allow assisted suicide, as Oregon did in 1994. The right Rehnquist denied was so broadly stated that more modest constitutional claims may someday be affirmed. And five Justices, a majority, wrote concurring opinions that further qualified his meaning. The court's fondest hope appeared to be that its judgment, as Rehnquist wrote, "permits this debate to continue, as it should in a democratic society." The court also seemed to encourage further work with pain-managing drugs.

Several of those searching for the decision's center focused on Sandra Day O'Connor, arguably the most conservative of the concurring Justices. Although agreeing that there is no broad-brush constitutional right to assisted suicide, O'Connor defined a "narrower question" of "whether a mentally competent person who is experiencing great suffering has a constitutionally cognizable interest in controlling the circumstances of his or her imminent death." She left the question open, but advocates like Laurence Tribe, who argued the New York case, read her words as suggesting possible constitutional exceptions to state bans. Several of the remaining concurring Justices--Stephen Breyer, Ruth Bader Ginsburg, John Paul Stevens and David Souter--seemed still more receptive. Even Rehnquist, in a footnote, declined to "foreclose" consideration of a "more particularized challenge" by a suffering individual.

The court would rather not see such an explosive issue redeposited in its lap. The Justices palpably yearn for a probing debate in the statehouses. This will commence in Oregon, where a more conservative state legislature has managed to return the earlier referendum to the voters for a second look. Partisans now view the November vote as a "national campaign," fueled with millions of out-of-state dollars.

Meanwhile, there is the reality of hospital wards and hospice rooms. Timothy Quill, an M.D. who has assisted suicides and helped bring one of the high court challenges, and New York Attorney General Dennis Vacco, who argued against Quill's position before the court, both talk of a clinical "middle ground," and their conceptions are related. Vacco, advising legislatures to reject the suicide option, hopes the ruling will inspire more "common-sense" distribution of pain-killing medication for the terminally ill. Quill guarantees that assisted suicide will continue, mostly unadvertised and mostly unprosecuted. But he thinks the court's kind words for sedation will create quasi-official situations where patients can request sufficient medication to provide a final escape. "So at least," Quill says, "they are in some sense consciously freed from their suffering."

Jewell has settled the issue for herself, regardless of the news on the radio. Over time, she says, she has collected enough barbiturates to cause death, should she so desire. "I guessed right in picking the right doctor," she says. "I was fortunate."

--Reported by Charlotte Faltermayer/New York and Ellis Conklin/Seattle

With reporting by CHARLOTTE FALTERMAYER/NEW YORK AND ELLIS CONKLIN/SEATTLE