Mr. Smith is 85 years old and has several medical problems. He has spent the past several months in and out of hospitals and rehab.

Mr. Smith is 85 years old and has several medical problems. He has spent the past several months in and out of hospitals and rehab. He tells his doctors: “My body is all worn out. I’m worn out. Don’t want to do this anymore, Doc. They say I can’t go home and be safe. And I’m NOT going to a nursing home. No way! Just stop that little gadget that shocks me and the part that keeps my heart going. I want them stopped. Yes, the pacemaker, too. A magnet will stop it, right? Just do it. Please. I’m tired of fighting.”

Mr. Smith had received cardiac resynchronization therapy a few years ago, with included a pacemaker for heart rhythms on which he was 100% dependent, and an internal defibrillator which had shocked him more than once. His doctors concluded they didn’t need an ethics consultation for the decision to deactivate the defibrillator and a “Do Not Attempt Resuscitation” order was placed in the medical chart. They reasoned “If he doesn’t want to be shocked again, that’s his decision. And if it went off again after he’d requested it stopped, that could be a kind of torture.” However, they were unsure about the pacemaker, as Mr. Smith would die within a few minutes if it was stopped.

1) What laws are in place to ensure that Mr Smith’s decision about deactivating his internal defibrillator are respected? Provide both the name of the Act and at least one court case on point.

2) What is the current state (legal status) of physician assisted suicide in the United States?