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The right to die continues to spark controversies around the world, and a lot of debate about it in the United States and worldwide results from disparate treatment of different forms of the right to die. For example, all U.S. states permit withdrawal of life-sustaining medical treatment, while only a handful of them have legalized physician-assisted suicide, and all of them prohibit lethal injection. This article argues that the disparities in how the right to die is regulated in the United States are attributable to legal fictions about intention and causation and that those fictions have outlived their utility and should be abandoned, especially in light of the Obergefell v. Hodges decision of the Supreme Court. The paper also looks into the experience of Canada and China to see how a legal regime of the right to die without legal fictions might look. Finally, the paper proposes a framework for future development of the right to die regulations in the United States.

The Right to Die in the United States, Canada, and China: Legal Fictions and Their Utility in a Comparative Perspective