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Ashcroft restores federal threat to doctors assisting in suicide

WASHINGTON (BP)–U.S. Attorney General John Ashcroft has acted to reverse a ruling by his predecessor, Janet Reno, that allowed the use of federally regulated drugs by doctors assisting patients in committing suicide.

The Nov. 6 decision by Ashcroft immediately affects the state of Oregon, which has permitted physician-assisted suicide since a 1997 vote. While Ashcroft’s ruling does not overturn Oregon law, it means physicians who prescribe or pharmacists who distribute federally controlled substances to aid in suicide may have their licenses to prescribe and dispense such drugs rescinded.

Oregon Attorney General Hardy Myers filed suit Nov. 7 to block implementation by the U.S. Drug Enforcement Agency of Ashcroft’s ruling, according to The Oregonian newspaper. The suit in federal court in Portland contends action by the DEA against Oregon doctors would violate the state’s right to control medical practice, The Oregonian reported.

Opponents of assisted suicide hailed Ashcroft’s decision as a correction of a harmful and erroneous ruling by Reno, the previous attorney general.

“The attorney general has taken responsible action on a matter of profound medical, ethical and legal importance,” said Ben Mitchell, biomedical consultant for the Southern Baptist Ethics & Religious Liberty Commission. “Oregon physicians are using drugs illegally. Assisted suicide may be legal in Oregon, but using federally controlled substances for that purpose is not.

“Pharmaceuticals ought not be captive to political agendas. No drug in the Physician’s Desk Reference or hospital formulary has been approved for use by physicians as a killing agent,” said Mitchell, associate professor of bioethics at Trinity Evangelical Divinity School in suburban Chicago.

Rep. Christopher Smith, R.-N.J., commended Ashcroft and President Bush “for correcting a seriously flawed” ruling by Reno.

“Euthanasia should never be considered medicine, and a decision by a state to rescind its own penalties for assisting a suicide cannot supersede federal laws or remove federal responsibility to uniformly enforce laws passed by Congress and approved by the president,” Smith said in a written release. “Our focus should be on killing pain instead of making it easier to kill people.”

The controversy over the use of federally controlled drugs in assisted suicides in Oregon began in 1997 when the voters of that state reaffirmed an earlier approved initiative that had been blocked in the courts. The Death With Dignity Act made it legal for a person to request a prescription for drugs to take his life when he is judged by two doctors to have less than six months to live.

Shortly thereafter, Thomas Constantine, DEA administrator at the time, announced the prescription of federally regulated drugs for suicide would be considered a violation of the Controlled Substances Act.

In June 1998, however, Reno overruled Constantine, saying the law does not permit the federal government to take action against physicians who prescribe medication for terminally ill patients in order for them to commit suicide. Opponents of assisted suicide inside and outside Congress highly criticized Reno’s decision at the time.

Ashcroft revealed his reversal of Reno’s ruling in a memorandum to DEA administrator Asa Hutchinson.

The American Medical Association supported the Ashcroft ruling but expressed concern it may inhibit doctors in providing medication to alleviate pain in terminally ill patients, The Washington Post reported.

Other supporters of the action, however, contended it actually would increase palliative care.

The memorandum “protects doctors who aggressively treat pain,” the Oregon-based Physicians for Compassionate Care said in a written statement. “The ruling clarifies that aggressive pain management is legitimate medical care even if it may increase the likelihood of death in rare instances.”

On the same day he sent his memo, Ashcroft sought to assure doctors the ruling would not threaten their efforts to care for terminally ill patients. In a letter to the Oregon Medical Association, the attorney general said the state’s physicians “will have no reason to fear that prescription of controlled substances to control pain will lead to increased scrutiny by the DEA, even when high doses of painkilling drugs are necessary and even when dosages needed to control pain may increase the risk of death.”