Donald Trump’s surprisingly decisive electoral victory was a serious blow to those who value freedom and human dignity.
His version of freedom does not include respecting the choices that individuals make about their own bodies. That was made perfectly clear in a campaign that invoked the rhetoric of states’ rights in response to demands for reproductive freedom. And if that wasn’t enough, Trump targeted transgender Americans and mocked gender-affirming medical care.
As USA Today notes, “Trump made gender identity issues a focal point of his campaign, targeting transgender rights in a barrage of TV advertising, speeches and campaign rallies and indicating that elimination of those rights would be among the initial priorities of his term.”
And while our attention was focused on those assaults on bodily autonomy, voters in West Virginia, where the MAGA ethos reigns supreme, passed a ballot measure amending their state constitution to prohibit people from participating in “the practice of medically assisted suicide, euthanasia, or mercy killing of a person.”
Physician-assisted suicide is legal only in nine states (California, Colorado, Hawaii, Maine, New Jersey, New Mexico, Oregon, Vermont and Washington, as well as the District of Columbia). Forty other states “affirmatively prohibit assisted suicide and impose criminal penalties on anyone who helps another person end his or her life.”
The remaining state, Montana, has decriminalized physician-assisted suicide. And according to the Associated Press, “At least 12 states currently have bills that would legalize physician-assisted death.”
But what just happened in West Virginia is unprecedented. It is the first state to put a ban on assisted suicide in its constitution.
In the context of assisted suicide, what West Virginia voters just did might seem redundant. As an article in The Review explains, medically assisted suicide was “already illegal in the state.”
Of course it is much easier to change an ordinary law than to pass a constitutional amendment. Proponents of the new amendment explained that their purpose was to “make it harder for lawmakers to — at some later time — legalize physician-assisted suicide in the state.”
Unlike ordinary legislation, the state legislature can only place a constitutional amendment on the ballot if two-thirds of the members of each house vote to do so during a single legislative session.
Supporters of the proposal to add language about assisted suicide to the state constitution argued that it would prevent doctors and others from “cold-heartedly encouraging elderly and sick people to commit suicide” and pressuring people with disabilities to do likewise. Leaders of the Catholic Church in West Virgina who worked hard to get voters to endorse the constitutional change offered other arguments.
For example, Bishop Mark Brennan of the Diocese of Wheeling-Charleston wrote in a statement that “suicide, even if done for altruistic reasons, is a rejection of our place in the human community, because we choose to leave it before we have to.” In his statement, Bishop Brennan pointed out that medically assisted suicide “corrupts the medical profession” and that “many of the reasons that lead people to choose the help of medical personnel to end their lives can be met by nonlethal means.”
As for personal autonomy, the bishop said that it “is exercised more clearly by holding firmly to the value of one’s life until it must be relinquished than by rushing into death’s embrace.”
Opponents of the West Virginia ballot measure also invoked autonomy but had a very different understanding of it. As the ACLU pointed out, “The right to avoid excruciating, end-of-life pain is essential to bodily autonomy and basic freedom … This is particularly cruel in West Virginia. We already boast one of the oldest and sickest populations in the nation.”
In their effort to block passage of the ballot measure, they drew on arguments made by former Supreme Court Justice David Souter. As Souter observed almost 30 years ago, those who support legal assisted suicide “base their claim on the traditional right to medical care and counsel, subject to the limiting conditions of informed, responsible choice when death is imminent, conditions that support a strong analogy to rights of care in other situations in which medical counsel and assistance have been available as a matter of course.”
“There can be no stronger claim to a physician’s assistance,” Souter added, “than at the time when death is imminent, a moral judgment implied by the State’s own recognition of the legitimacy of medical procedures necessarily hastening the moment of impending death.”
Finally, opponents of the ballot measure rightly noted that the amendment banning assisted suicide “follows a disturbing trend of more and more legislators inserting their personal beliefs into the patient-physician relationship.”
But more was a stake in what West Virginia just did; adding the ban of physician-assisted suicide to the state constitution was also an important symbolic victory for MAGA people who think the government ought to be able to tell citizens how to live and how to die.
As Republican state Sen. Eric Tarr said, “I believe that West Virginia adopted the amendment because of Mountaineers’ commitment to choosing life.”
Signaling the broader ambition of Tarr and people like him, the senator crowed, “Today is a good day for West Virginia and our country.”
While some other red states have passed ballot measures to protect abortion, don’t be surprised if Trump supporters elsewhere try to follow the Mountaineer State by enshrining bans on death with dignity in their state constitutions.
If they do so, they will be running against the tide of public opinion. That is reflected in the fact that, even deep in MAGA country, the West Virginia ballot measure barely scraped by, passing by a margin of around 6,000 votes out of around 660,000 votes cast.
Moreover, an August 2024 Gallup Poll found that 66 percent “believe doctors should ‘be allowed by law to assist the patient to commit suicide’ for terminal patients living in severe pain who request it.”
In the wake of the presidential election, some people may be tempted to think that Trump and his cronies’ desire to tell people what they can and cannot do with their bodies is just a problem for women seeking abortions or transgendered citizens. They should think again.
Recall that during his first term, Trump appointed Neil Gorsuch, a vehement opponent of medically assisted suicide, to the Supreme Court.
All of us, sooner or later, will die, and all of us have an interest in making sure that our death is not slow and agonizing. And what happened in West Virginia may be a harbinger of things to come that will touch everyone’s life.
Austin Sarat is the William Nelson Cromwell Professor of Jurisprudence and Political Science at Amherst College. His views do not necessarily reflect those of Amherst College.
