A federal appeals court ordered the Bush administration not to meddle with a state's assisted suicide law, ruling Wednesday that doctors in Oregon may prescribe lethal doses of medication to terminally ill patients.
Ruling on the nation's only law that allows doctors to assist in
hastening the death of a patient, the court said U.S. Attorney
General John Ashcroft cannot sanction or hold Oregon doctors
criminally liable for prescribing overdoses, as the state's
voter-approved Death With Dignity Act allows.
"The attorney general's unilateral attempt to regulate general medical practices historically entrusted to state lawmakers interferes with the democratic debate about physician assisted suicide and far exceeds the scope of his authority under federal law," wrote Judge Richard Tallman in the 2-1 opinion by the 9th U.S. Circuit Court of Appeals.
The case is a classic states' rights battle. Oregon has defended its assisted suicide law against attacks from the Justice Department, which concluded that suicide is not a "legitimate medical purpose."
Oregon maintained it had the power to declare for itself what types of medical procedures are allowed.
In dissent, Judge J. Clifford Wallace said the courts should give "substantial deference" to the attorney general's findings in the absence of a clear congressional policy.
"Certainly, Congress is free to enact legislation limiting or counteracting the Ashcroft directive's effects," Wallace said. The latest legal wrangling stems from April 2002, when a federal judge in Portland, Ore., blocked the Justice Department from threatening to punish doctors, for example by stripping them of their federal licenses to dispense medication.
In a sharp rebuke to Ashcroft, U.S. District Judge Robert Jones ruled that the Controlled Substances Act -- the federal law declaring what drugs doctors may prescribe -- does not give the federal government the power to say what is a legitimate medical practice.
Oregon Attorney General Hardy Myers brought the challenge after Ashcroft first declared the federal government had such power on Nov. 6, 2001, and the Justice Department made the same argument to the San Francisco-based appeals court. Oregon voters first approved the act in 1994 and overwhelmingly affirmed it again three years later when it was returned to the ballot following a failed legal challenge that stalled its implementation.
The law allows terminally ill patients with less than six months to live to request a lethal dose of drugs after two doctors confirm the diagnosis and determine the patient to be mentally competent to make the request. Since 1998, at least 171 people have used the law to end their lives, according to state records. Most of them suffered from cancer.
"Certainly it's a good ruling if you believe in this cause," said Kevin Neely, a Myers spokesman. "From our perspective, this is a clear defense not just of the Death With Dignity Act but a clear defense of the state's authority to regulate its own medical
Justice Department spokesman Charles Miller said the government was reviewing the court's decision, and was not prepared to comment on whether it would appeal to the Supreme Court or ask the 9th Circuit to reconsider.
"No determination has been made to what the government's next step will be," Miller said. The decision is unlikely to immediately open the floodgates for similar legislation in other states. While Congress failed to pass measures banning assisted suicide in 1998 and 2000, the states have been unreceptive to the idea.
Hawaii lawmakers in March shelved a proposal. And in Vermont, the only other known state to recently grapple with it, lawmakers balked last week.
Scott Swenson, executive director of the Death With Dignity National Center, was optimistic the decision might get the
attention of statehouse lawmakers. But, he noted, the moral questions the law raise make it a difficult sell that won't happen
"This isn't something that is going to rush out in 20 states tomorrow," he said. "The onus is for us to secure a couple more
states to prove it can work."
Barbara Coombs Lee, the president of Portland-based Compassion in Dying who co-wrote the law, said assisted suicide "improves care and greatly eases suffering of terminally ill people."
With Wednesday's decision, she said, "Politicians no longer have an excuse not to pass this law."
Ashcroft's directive, which reversed a 1998 opinion by former U.S. Attorney General Janet Reno, also banned any lethal prescriptions on grounds they did not qualify as medication under the federal Controlled Substances Act.
Oregon argued that regulating and licensing doctors generally has been the sole responsibility of the states, which license
doctors to practice medicine. Oregon also said that Congress intended only to prevent illegal drug trafficking by doctors under
the Controlled Substances Act, and that it left decisions about medical practice up to the states. The appeals court agreed.
Sen. Ron Wyden, D-Oregon, called on Ashcroft "to finally accept 'no' for an answer and attend to the many more pressing challenges confronting the Department of Justice." It was the second time the circuit court had grappled with
In a 1996 Washington state case, the 9th Circuit ruled that assisted suicide was permitted because there was a constitutional right to die. That decision meant Washington state could not prosecute doctors who aided their patients' deaths.
But the following year, the U.S. Supreme Court reversed, saying states could prosecute doctors who assist in suicides -- a move some interpreted as signaling that the justices were freeing the states to decide for themselves whether assisted suicide should be allowed.
Washington state has abandoned its assisted suicide law. The court also ruled against the federal government in another
case involving efforts to nullify state rules governing medical practice.
In 2002, the court ruled for doctors in California who were threatened with federal sanctions -- including losing their licenses to prescribe medication -- if they recommended medical marijuana to their patients. The court said then that doctors had a First Amendment right to discuss marijuana use with their patients.
The assisted suicide case is Oregon v. Ashcroft, 02-35587.