Direct Democracy and Bioethical Choices : Voting Life and Death at the Ballot Box

Direct democracy, the political process that enables citizens to draft, circulate, and enact laws, has become the refuse for grassroots organizations seeking statutory validation in a legislative arena perceived to be unresponsive or unfriendly to their concerns. One group of citizens, advocates for physician-aid-in-dying, has recently emerged on the national scene, sponsoring state ballot initiatives in three states and pledging to continue their quest for legalization of physician-assisted death throughout the country. This article examines the interplay between direct democracy and end-of-life decision making. This examination reveals that lawmaking by initiative, as seen through the campaigns to gain legalization of physician-aid-in-dying, is no less susceptible to the ravages of political wrangling than is representative democracy. The article argues that direct democracy is best utilized as a spur to legislative action rather than as a replacement for the study and compromise unique to legislating through representative democracy. In addition, the article advocates recognition of a constitutionally protected liberty interest in choices surrounding death, thus providing a threshold level of protection to all citizens, not just those whose lawmakers or citizens are motivated to codify this fundamental right