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Scholarly discussion of physician aid in dying – physicians actively aiding patients in ending their lives – has noticeably increased in recent years. While conversations and examinations of end-of-life treatment have been ongoing for decades, the antecedent law and ethics of aid in dying that have developed in the United States have recently moved into the spotlight. In this essay, written for a symposium at Quinnipiac School of Law, the author takes his audience on a brief journey through the history of end-of-life decision-making in the U.S., beginning with the early days of the Karen Quinlan case in 1976 and ending in the present day – from the acceptance of allowing terminally ill patients to die without medical intervention to the (very gradual) move toward varying degrees of physician assistance in carrying out patients’ decisions to hasten death. The author addresses some of the most difficult legal questions in this area, such as:

• Who has the authority to make decisions about forgoing or continuing treatment when patients lack the capacity to do so?

• What standards are decision-makers supposed to use to guide these decisions?

• What role do courts play in resolving conflicts over end-of-life decision-making?

By revisiting the history of physician aid in dying, researchers and others interested in the subject can gain a better understanding not only of where the law stands today, but also how it got there.