WASHINGTON (BP)–In a major victory for supporters of physician-assisted suicide, the U.S. Supreme Court Jan. 17 said the federal government cannot prohibit Oregon doctors from prescribing lethal amounts of medicine to patients who want to kill themselves.
The 6-3 ruling was the first high-profile decision under new Chief Justice John Roberts, who joined Justices Clarence Thomas and Antonin Scalia in the dissent. Justice Anthony Kennedy wrote the majority opinion.
The case pitted a federal law, the 1970 Controlled Substances Act, against Oregon’s Death with Dignity Act, passed by voters in 1994. Congress passed the Controlled Substance Act to help combat drug abuse and to assist in the control of both legal and illegal drugs. The Oregon law allows someone who has been diagnosed with a terminal illness and given six months or less to live to request a lethal dose of medicine from their doctor. A second physician also must agree with the diagnosis. The doctor prescribes the drug but does not administer it.
In 2001, then-Attorney General John Ashcroft, citing the Controlled Substances Act, issued an order that basically barred physicians from giving lethal amounts of drugs to patients. Ashcroft argued that assisted suicide “is not a ‘legitimate medical purpose'” under the federal law. His order made it a crime for physicians to prescribe lethal amounts of drugs. Oregon then sued Ashcroft; Attorney General Alberto Gonzales took over the case when Ashcroft left the administration. Oregon also won at the trial court and appeals court levels.
Writing for the majority, Kennedy said that under the Controlled Substances Act, Oregon has the leeway to legalize assisted suicide. Kennedy further said that the federal law is silent on the issue of assisted suicide and that Ashcroft did not have the power under the law to issue his order.
“If the attorney general’s argument were correct,” Kennedy wrote, “his power to deregister [doctors] necessarily would include the greater power to criminalize even the actions of registered physicians, whenever they engage in conduct he deems illegitimate. This power to criminalize … would be unrestrained.”
Ashcroft’s order, the majority argued, “goes well beyond the attorney general’s statutory power” as defined by the Controlled Substances Act.
Scalia, in dissent, wrote, “Congress implicitly (but clearly) gave the attorney general authority” to regulate physician assisted suicide. Scalia also took exception with the majority’s interpretation of “legitimate medical purpose.”
“If the term ‘legitimate medical purpose’ has any meaning, it surely excludes the prescription of drugs to produce death,” Scalia wrote.
Scalia further wrote: “Virtually every relevant source of authoritative meaning confirms that the phrase ‘legitimate medical purpose’ does not include intentionally assisting suicide. ‘Medicine’ refers to ‘the science and art dealing with the prevention, cure, or alleviation of disease.’
“… [V]irtually every medical authority from Hippocrates to the current American Medical Association (AMA) confirms that assisting suicide has seldom or never been viewed as a form of ‘prevention, cure, or alleviation of disease,’ and (even more so) that assisting suicide is not a ‘legitimate’ branch of that ‘science and art.'”
Thomas wrote a separate dissenting opinion.
Conservatives warned that the decision leaves the door open for other states to adopt similar, and even more far-reaching, laws.
“This is one more example of American society flirting with the idea of skiing down a steep and slippery slope to a dark and dangerous place where physicians become administrators of death and not healing,” Richard Land, president of the Southern Baptist Ethics & Religious Liberty Commission, told Baptist Press. “It is sad that a majority of the current court prefers to see this issue in purely federal vs. state terms as opposed to the profound moral issue of involving the healing arts in death therapy — the therapy or treatment for an illness being death by a doctor’s prescription.”
Pro-assisted suicide organization praised the ruling.
“This is a watershed decision for freedom and democracy in the U.S.,” Barbara Coombs Lee, president of Compassion & Choices, which supports assisted suicide, said in a statement. “It reaffirms the liberty, dignity and privacy Americans cherish at the end of life. No government should threaten these rights nor usurp a state’s power to meet the needs of its dying citizens.”
But David Stevens, executive director of the 17,000-member Christian Medical and Dental Association, said the court’s ruling “severely undermines the rightful and crucial ability of the federal government to govern the use of lethal and dangerous drugs.”
“This lethal violation of medical ethics erases a prohibition that has protected patients since the time of Hippocrates,” Stevens said in a statement. “Before Hippocrates, patients couldn’t know for sure if their doctor would heal them or kill them. This decision moves the practice of medicine one step closer to ethical mayhem. The ethical foundation of medicine is crumbling under the Court’s jackhammer.
“… Killing is not a legitimate medical purpose,” Stevens added. “Legalized assisted suicide gives doctors the right to help kill, and in our money-driven healthcare system, that’s dangerous. The cheapest form of medical care is always a handful of lethal drugs.”
The 6-3 decision means that Samuel Alito would not have made a difference in the ruling even if he had been on the court. If confirmed, he will replace Justice Sandra Day O’Connor, who voted with the majority. But conservatives were heartened that Roberts joined the court’s other two conservative members in the dissent.