U.S. Supreme Court Says Federal Government Cannot Block Oregon Law

The Supreme Court on Tuesday voted 6-3 to uphold an Oregon physician-assisted suicide law in the case Gonzales v. Oregon, ruling that former Attorney General John Ashcroft overstepped his authority in seeking to punish doctors who prescribed drugs to help terminally ill patients end their lives, USA Today reports (Biskupic [1], USA Today, 1/18).

The Oregon Death With Dignity Act, which became law in 1997, allows physicians to prescribe, but not administer, a lethal dose of prescription drugs to a terminally ill patient after two physicians agree that the patient has less than six months to live, has decided to die voluntarily and can make health care decisions.

In 2001, Attorney General John Ashcroft issued a directive that said assisted suicide serves "no legitimate medical purpose" and warned physicians who prescribe controlled narcotics to assist in patient suicides under the Oregon law that they could face criminal penalties and license suspension or revocation.

U.S. District Judge Robert Jones in 2003 ruled that the federal government did not have the authority to overturn the Oregon law -- a decision upheld in May 2004 by a three-judge panel of the 9th U.S. Circuit Court of Appeals. In November 2004, Ashcroft asked the Supreme Court to reverse the decision. Attorneys for the Bush administration argued that the federal Controlled Substances Act supersedes the Oregon law (California Healthline, 1/17).

In the decision on Tuesday, the Supreme Court said that the Oregon law supersedes federal authority to regulate physicians and that the Bush administration improperly attempted to use the CSA to prosecute Oregon physicians who assist in patient suicides. In the majority opinion -- also supported by Justices Sandra Day O'Connor, John Paul Stevens, David Souter, Ruth Bader Ginsburg and Stephen Breyer -- Justice Anthony Kennedy wrote that the federal government can regulate prescriptions through CSA but only in relation to prohibiting doctors from engaging in illegal drug dealing.

"Beyond this, the statute manifests no intent to regulate the practice of medicine generally," Kennedy wrote (Taylor, Washington Times, 1/18). Kennedy wrote that the "authority claimed by [Ashcroft] is both beyond his expertise and incongruous with the statutory purposes and design" (Greenhouse, New York Times, 1/18).

He wrote that had the Bush administration's position been upheld, it would have "delegate[d] to a single Executive officer the power to effect a radical shift of authority from the states to the federal government to define the medical practice in every locality." He added that when Congress passed CSA, it "did not have this far-reaching intent to alter the federal-state balance" (Savage, Los Angeles Times, 1/18).

Justice Antonin Scalia in a dissenting opinion wrote that the court should defer to Ashcroft's decision that physician assisted suicide is not a "legitimate medical purpose" for doctors to prescribe drugs, adding that "virtually every medical authority from Hippocrates to the current American Medical Association confirms that assisting suicide has seldom or never been viewed" as legitimate. He added, "The fact that many in Oregon believe that the boundaries of 'legitimate medicine' should be extended to include assisted suicide does not change the fact that the overwhelming weight of authority" says it should not (Bravin, Wall Street Journal, 1/18).

Scalia was joined in his dissent by Chief Justice John Roberts and Justice Clarence Thomas (Washington Times, 1/18).

In his dissenting opinion, Thomas said the ruling contradicted a previous Supreme Court ruling in which the justices said the federal government had the right to use federal law to regulate medical marijuana (Henderson, Philadelphia Inquirer, 1/18). He noted that with respect to doctrine, "I agree with limiting the applications" of federal drug laws "consistent with the principles of federalism and our constitutional structure. But that is now water under the dam" (Wall Street Journal, 1/18).

Sen. Ron Wyden (D-Ore.) said the ruling was "a significant victory," adding that it stops the Bush administration's efforts to "wrest control of decisions rightfully left to the states and individuals" (Washington Times, 1/18).

Barbara Coombs Lee, president of Compassion in Dying -- which sponsored the Oregon law -- said, "This is a watershed decision (that) reaffirms the liberty, dignity and privacy Americans cherish at the end of life" (Savage, Los Angeles Times, 1/18).

Peg Sandeen, executive director of the Death with Dignity National Center, said, "The favorable ruling by the Supreme Court now permits other states to move forward in replicating Oregon's landmark law" (McCall, AP/San Francisco Chronicle, 1/18).

White House spokesperson Scott McClellan said the Bush administration is "disappointed at the decision," adding, "The president remains fully committed to building a culture of life, a culture of life that is built on valuing life at all stages" (New York Times, 1/18).

Sen. Tom Coburn (R-Okla.) said, "Nowhere does our Constitution give doctors the right to take the lives of their patients. Deliberately causing death is never a legitimate medical purpose. By creating another class of human beings whose lives have no value, the Supreme Court has put all vulnerable persons at risk" (Perine, CQ Today, 1/17).

Sen. Orrin Hatch (R-Utah) said he was "deeply troubled" by the decision, adding, "I anticipate Congress will now take steps to solve the problems created by this decision" (Wall Street Journal, 1/18).

Jay Sekulow, chief counsel of the American Center for Law and Justice, said, "This is a disappointing decision that is likely to result in a troubling movement by states to pass their own assisted-suicide laws."

Ron Sunseri, a former Oregon state representative who opposes physician-assisted suicide, said, "What they addressed was the Controlled Substances Act and whether or not the attorney general could prohibit doctors from prescribing lethal drugs. A doctor's sworn oath is to 'first do no harm.' That should be paramount in their decision-making" (Grossman/Nichols, USA Today, 1/18).

According to the Los Angeles Times, the ruling "leaves open the possibility that the Republican-controlled Congress could amend the federal drug control laws and forbid physicians from prescribing lethal medications. Congress could also pass laws explicitly banning doctor-assisted suicide." The decision also "clears the way for other states, notably California, to at least consider adopting similar measures," the Los Angeles Times reports (Savage, Los Angeles Times, 1/18).

At least six other states have proposed or are considering physician-assisted suicide laws. Currently, California and Vermont have bills related to the issue in their state Legislatures (AP/San Francisco Chronicle, 1/18).

Polls in Vermont also show support for a law based on Oregon's, according to Michael Sirotkin, a spokesperson for Death with Dignity Vermont and End of Life Choices Vermont.

However, Eli Stutsman, an Oregon attorney who has defended the state's law, said political opposition to the issue remains high in many states (AP/San Francisco Chronicle, 1/18).

According to USA Today, 44 states have enacted specific bans on physician-assisted suicide or "consider it akin to homicide" (Biskupic [1], USA Today, 1/18).

• "Requests for Assisted Suicide Uncommon, Local Doctors Say" (Kohn, Baltimore Sun, 1/18).
  


• "Doctor-Assisted Suicide Gains Ground" (Savage, Boston Globe, 1/18).
  


• "More Vital Issue is Care of the Dying, Doctors Say" (Graham/Schodolski, Chicago Tribune, 1/18).
  


• "High Court Allows Physician-Assisted Suicide" (Richey/Feldmann, Christian Science Monitor, 1/18).
  


• "Justices Uphold Right-To-Die Law" (Tizon/Marshall, Los Angeles Times, 1/18).
  


• "Fraught Issue, But Narrow Ruling in Oregon Suicide Case" (Egan/Liptak, New York Times, 1/18).
  


• "Suicide Ruling: End or a Start?" (Vitez, Philadelphia Inquirer, 1/18).
  


• "California Lawmakers Renew Effort, Backers Hope Ruling Will Boost Support for Assisted Death" (Gledhill, San Francisco Chronicle, 1/18).
  


• "State Suicide Bill Back in Play" (Puzzanghera, San Jose Mercury News, 1/18).
  


• "Opinion Accuses Feds of Power Grab" (Biskupic [2], USA Today, 1/18).

Several broadcast programs reported on the ruling:

• ABCNews' "World News Tonight": The segment includes comments from California state Rep. Patty Berg (D); Nick Gideonse, family physician in Oregon; Sekulow; Scott Swenson, executive director of the Death with Dignity National Center; and an Oregon resident who supports the law (Stark, "World News Tonight," ABCNews, 1/17). The complete segment is available online.
  


• CBS' "Evening News": The segment includes comments from James Bopp, president of the National Legal Center for the Medically Dependent and Disabled, and an Oregon resident who supported the law before his death (Andrews, "Evening News," CBS, 1/17). The complete segment is available online in RealPlayer.
  


• NBC's "Nightly News": The segment includes comments from Sekulow and Oregon residents who support the law (Williams, "Nightly News," NBC, 1/17). The complete segment is available online in Windows Media.
  


• NPR's "All Things Considered": The segment includes comments from Howard Brody, former chair of Michigan's Commission on Death and Dying; Matthew Staver, president of the Liberty Council; and Stutsman (Totenberg, "All Things Considered," NPR, 1/17). The complete segment is available online in RealPlayer.
  


• NPR's "All Things Considered": The segment includes comments from Peter Rasmussen, a physician of medical oncology, hospice and palliative medicine in Oregon (Siegel, "All Things Considered," NPR, 1/17). The complete segment is available online in RealPlayer.
  


• NPR's "Day to Day": The segment includes comments from Slate legal analyst Dahlia Lithwick (Chadwick, "Day to Day," NPR, 1/17). The complete segment is available online in RealPlayer.
  


• NPR's "Morning Edition": The segment includes comments from Bopp; Brody; Diane Meier, director of the Center to Advance Palliative Care; and an Oregon resident who supported the law before his death (Totenberg, "Morning Edition," NPR, 1/18). The complete segment is available online in RealPlayer.
  


• NPR's "Morning Edition": The segment includes comments from Gideonse; Ken Stevens, president of Physicians for Compassionate Care; Wyden; and Oregon residents who support the law (Fogarty, "Morning Edition," NPR, 1/18). The complete segment is available online in RealPlayer.
  


• NPR's "Talk of the Nation": The segment includes comments from Julie Rovner, NPR health policy correspondent; Sandeen; David Savage, legal correspondent for the Los Angeles Times; Sekulow; and Stutsman (Conan, "Talk of the Nation," NPR, 1/17). The complete segment is available online in RealPlayer.
  


• PBS' "NewsHour with Jim Lehrer": The segment includes comments from Bopp; Marcia Coyle, Washington, D.C., bureau chief and Supreme Court correspondent for the National Law Journal; and Kathryn Tucker, director of legal affairs for Compassion and Choices (Suarez, "NewsHour with Jim Lehrer," PBS, 1/17). The complete transcript is available online. The complete segment is available online in RealPlayer.