Assisted suicide in the US has a long and somewhat tortured history, beginning in modern times with Dr Jack Kevorkian, the Michigan pathologist who hit the news in the early 1990s with his so-called "suicide machine".
Dr Kevorkian, by any standards an eccentric man whose hobby of painting the eyes of dead people did little to inspire confidence among the general public, assisted in the suicides of 130 people. He was acquitted three times in jury trials before finally being convicted in 1999, not of assisted suicide, but of second degree murder.
Dr Kevorkian began his advocacy of assisted suicide with two different methods and two different so-called "suicide machines".
The first, which caused death through a combination of drugs, was the lethal injection method. An aide would begin the flow of drugs through an IV, and the person who wished to die would then have to deliver the drugs themselves, pulling a switch or lever. Death usually occurred within about two minutes after the patient fell asleep.
The second method was carbon monoxide, where the patient breathed in gas.
This method could take over 10 minutes.
Rather than portray a picture of the dignified death he was advocating, Dr Kevorkian's assisted suicides often seemed to take place in less than serene conditions; patients died in cheap motel rooms or in the rear of Dr Kevorkian's van. But the doctor succeeded in helping to bring the issue to the media and the medical establishment's attention.
Four years ago, Oregon became the first and only US state to permit assisted suicide. Since then, some 96 patients have used it to obtain prescriptions for lethal drugs to end their lives, and 70 people then used the drugs.
The law, however, is stringent about who is allowed to make use of it; any Oregon resident who requested permission for lethal medication must be certified by two doctors as terminally ill with less than six months of life expectancy.
A written request by the patient must be witnessed by two people who are not family members and who have no involvement in their health care.
Finally, if a doctor suspects the patient is suffering from depression or other mental impairment, the patient must be evaluated by a psychiatrist or psychologist.
Depression is not permitted as a reason to commit suicide and it is generally understood that the presence of depression eliminates one as a candidate for assisted suicide.
Even opponents of the law agree that it has generally worked well and has not resulted in the kinds of abuses they predicted.
Nonetheless, last month the US Attorney General, Mr John Ashcroft, moved to block the law in court. An Oregon judge issued a four-month restraining order on Mr Ashcroft's Justice Department. Several terminally ill patients have issued a challenge to Mr Ashcroft and are seeking to keep the law intact.
For now, the Oregon law is still in effect. But the real point is that in the rest of the US, many doctors and hospitals now routinely, albeit quietly and discreetly and only when requested by the patient and their families, give lethal doses of morphine to terminally ill patients in their last weeks, thus speeding up death.
It is an issue in the US where practice has moved ahead of legislation. But the matter of obtaining help to die when one is not terminally ill, or is simply depressed, remains way beyond the bounds of policy and medical discourse.