WASHINGTON (ABP) — By a 6-3 majority Jan. 17, the Supreme Court rebuffed the Bush administration's efforts to punish doctors who participate in physician-assisted suicides under an Oregon law.
The ruling does not establish a constitutional “right to die.” But in deciding Gonzales v. Oregon (No. 04-623), the court said the attorney general cannot interpret a federal drug-control law to effectively override the Oregon Death With Dignity Act. That legislation, which Oregon voters passed in 1994 and reaffirmed in 1997, is the nation's first and only law allowing physician-assisted suicide.
The case represents the first contentious social issue to come before the court since Chief Justice John Roberts took its helm Oct. 3. Roberts joined the court's two most conservative members — Antonin Scalia and Clarence Thomas — in the minority.
Not at issue in the decision was whether the Constitution provides individuals with a “right to die.” Rather, the case turned on the question of whether a federal administration that is opposed to a state's policy allowing physician-assisted suicide can effectively undermine it, even though the legal system historically has given states the authority to regulate the medical professions.
“The question before us is whether the Controlled Substances Act allows the United States attorney general to prohibit doctors from prescribing regulated drugs for use in physician-assisted suicide, notwithstanding a state law permitting the procedure,” wrote Justice Anthony Kennedy, who penned the majority opinion.
The Oregon law allows doctors to prescribe oral medications to hasten death for terminally ill patients who are mentally competent and meet other strict criteria. Since the law was enacted, according to court documents, approximately 200 patients have used it to end their lives.
The drugs prescribed to patients to end their lives under the law, however, are controlled by federal law. That means physicians must have a federal license to prescribe them.
In 1997, several members of Congress who oppose assisted suicide inquired if the federal Controlled Substances Act, or CSA, would allow the Justice Department to punish Oregon physicians for prescribing suicide drugs. Then-Attorney General Janet Reno determined in 1998 that her Justice Department would not pursue such sanctions.
However, with the advent of President Bush's administration in 2001, then-Attorney General John Ashcroft reversed the Justice Department's position. Ashcroft determined that prescribing drugs to hasten death violates a provision in the federal law that says “a prescription for a controlled substance to be effective must be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice.”
After Ashcroft resigned, his successor, Alberto Gonzales, maintained that stance. Lawyers for the government argued that physician-assisted suicide violates the public interest and thus is not a legitimate medical purpose.
But the high court's majority disagreed, upholding two lower federal courts that ruled against Ashcroft and Gonzales.
“The statutory terms 'public interest' and 'public health' do not call on the attorney general, or any other executive [branch] official, to make an independent assessment of the meaning of federal law,” Kennedy wrote.
He also said the text and history of the Controlled Substances Act do not authorize such an interpretation.
“The statute and our case law amply support the conclusion that Congress regulates medical practice insofar as it bars doctors from using their prescription-writing powers as a means to engage in illicit drug dealing and trafficking as conventionally understood,” Kennedy said. “Beyond this, however, the statute manifests no intent to regulate the practice of medicine generally.”
He concluded: “The government, in the end, maintains that the prescription requirement delegates to a single executive officer the power to effect a radical shift of authority from the states to the federal government to define general standards of medical practice in every locality. The text and structure of the CSA show that Congress did not have this far-reaching intent to alter the federal-state balance and the congressional role in maintaining it.”
But Scalia said the text of the statute clearly allows such an interpretation. “Virtually every relevant source of authoritative meaning confirms that the phrase 'legitimate medical purpose' does not include intentionally assisting suicide,” he wrote, in a dissenting opinion joined by Thomas and Roberts. “If the term 'legitimate medical purpose' has any meaning, it surely excludes the prescription of drugs to produce death.”
The conservative Family Research Council was among the first of several anti-euthanasia groups to release statements condemning the ruling. While noting that the opinion does not directly endorse physician-assisted suicide, the group's president, Tony Perkins, said it nonetheless places the court on a slippery bioethical slope.
“It is important that the traditional understanding of the medical role as one of healing not be confused by licensing doctors to kill,” Perkins' statement read. “Assisted suicide is a perversion of the medical profession because it violates a fundamental ethical principle of medicine, 'First, Do No Harm.'”
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