Death Wish

Larry McAfee was an avid outdoorsman. Growing up in south Georgia, he loved to fish, hunt and play baseball. But all that ended in 1985, when a motorcycle accident left him paralyzed from the neck down. Since then he has lost his zest for living. McAfee, 33, thus petitioned a Georgia court for permission to turn off the ventilator that has been keeping him alive. As the former civil engineer testified in an emotional bedside hearing last month, he woke up every morning "fearful of each new day. There is nothing I have found or can think of that I really enjoy or that has helped my situation."

Last week McAfee got his wish. Superior Court Judge Edward Johnson of Fulton County, Ga., ruled that McAfee's right to refuse life-sustaining treatment outweighed the state's interest in preserving life. "The ventilator to which he is attached is not prolonging his life; it is prolonging his death," said Johnson. With the court's authorization, McAfee plans to move from a nursing home to a friend's apartment and end his life by using a mouth-activated timer to shut off the ventilator after medical personnel have sedated him.

McAfee's situation has revived a smoldering controversy over whether health- care providers should help the disabled commit suicide. In July a paraplegic in Michigan successfully petitioned a court to have his respirator turned off. Some officials denounced that action, saying it set a dangerous example for the handicapped by encouraging them to end their lives rather than strive for a meaningful existence. In McAfee's case, Judge Johnson has exonerated anyone who helps the patient carry out his plan. John Banja, a professor of medical ethics at Emory University, notes that hospitals have no clear mandate for "treatment discontinuance," and the role of doctors and nurses in these affairs remains murky. However, adds Banja, "this is a clear- cut case of a rational adult. The decision lets McAfee decide if his life is meaningful or not."

The McAfee case comes at a time when the right-to-die issue is taking on new urgency in the U.S. Most such cases, unlike McAfee's, involve comatose patients whose families are seeking to withdraw life-support systems. This fall the U.S. Supreme Court will rule on such a situation for the first time when it considers the case of Nancy Cruzan, 32, a Missouri factory worker who has been in an irreversible vegetative state for six years. The court has been asked to decide whether there is a constitutional right of privacy broad enough to allow Cruzan's family to disconnect the feeding tubes that nourish her, and thereby to let her die. An alliance of disability-rights activists and antiabortion groups has already begun to clash with patients' advocates and civil libertarians in what promises to be a bitter battle.