.

             Similarly, throughout its history, the Christian church has condemned suicide as morally wrong. St. Augustine is believed to be the first to actually address this subject in depth (Amundsen), recognizing it as an extension of the fifth commandment of "Thou shalt not kill" and an unrepentable sin. This is especially true since the words "thy neighbor" are not attached as with "Thou shall not bear false witness against they neighbor. St. Thomas Aquinas further elaborated by providing three reasons for the immorality of suicide: 1) It is contrary to natural self-love, whose aim is to preserve humaankind; 2) It harms the individual's community; and 3) It violates duty to God who bestowed the gift of life (Aquinas 1271, part II, Q64, A5.) .

             Overall, until recently, suicide was not a topic that was discussed in the United atees. In the past several years, the subject has been aired because of changes in the laws. According to a review of the laws on the Observer Website, in 1997, in Vacco v. Quill, the Supreme Court upheld New York's prohibition of assisted suicide, but agreed to "aggressive palliative care," in which the physicians are intend only to relieve the patient's pain. Their undisclosed intent, however, may be to kill the patient by "terminal sedation." Palliative care can be morally justified even if it unintentionally shortens life. However, in the absence of exceptional proof of intent, the law cannot effectively determine whether the physician acted with the intent to relieve pain or to cause death.

             Further, a competent adult has the legal right to refuse to take food and water whether administered normally or artificially. Incompetent patients may be denied nutrition and hydration if they had, when competent, expressed their desire to be so denied or, in some states, if such denial is in the best interests of the patient. In cases where the family and the physician agree that the patient should die, the issue never gets to court and the patient can be quietly starved and dehydrated to death.