Justices Uphold Oregon Assisted-Suicide Law

In a Blow to Administration, Ruling Paves Way for Other States to Follow Suit

The Supreme Court upheld Oregon’s law on physician-assisted suicide yesterday, ruling that the Justice Department may not punish doctors who help terminally ill patients end their lives.

By a vote of 6 to 3, the court ruled that Attorney General John D. Ashcroft exceeded his legal authority in 2001 when he threatened to prohibit doctors from prescribing federally controlled drugs if they authorized lethal doses of the medications under the Oregon Death With Dignity Act.

The ruling struck down one of the administration’s signature policies regarding what President Bush calls the “culture of life” and lifts the last legal cloud over the state’s law, which is unique in the nation. It also frees other states to follow in Oregon’s footsteps, unless Congress acts to the contrary.

It is unclear how many states would join Oregon; assisted-suicide initiatives have not fared well in recent years. Still, coming a year after efforts by Republicans in Congress to block the removal of a feeding tube from Terri Schiavo, and after Chief Justice John G. Roberts Jr. and Supreme Court nominee Samuel A. Alito Jr. faced questions from the Senate about their views on end-of-life issues, the court’s decision could energize the political debate. Roberts dissented from the ruling, joined by Justices Antonin Scalia and Clarence Thomas.

Conservatives reacted angrily to the ruling. Jay Sekulow, chief counsel of the American Center for Law and Justice, a nonprofit litigation group founded by Pat Robertson, called it “a disturbing and dangerous decision that can only lessen the value of protecting human life.”

But Sen. Ron Wyden (D-Ore.) called it “a significant victory for Oregon’s voters,” who twice approved the Death With Dignity Act in statewide referendums. Looking ahead to possible Republican efforts to change federal law, Wyden said, “I will fight tooth and nail any congressional attempts to overturn this court ruling.”

A Pew Research Center for the People and the Press poll released Jan. 5 found that 46 percent of Americans support a right to assisted suicide while 45 percent oppose it. Assisting suicide is a crime in 44 states, including Maryland, as well as the District. It is a civil offense in Virginia. In three states — North Carolina, Utah and Wyoming — the law neither prohibits nor permits assisted suicide. Ohio’s Supreme Court has decriminalized assisted suicide, but state regulations do not condone it.

State referendums supporting assisted suicide have failed in California, Maine, Michigan and Washington. A bill failed in Maryland in 1995 and 1996. A measure modeled on Oregon’s passed two committees in the California Assembly last year but then fizzled from lack of support. An author of the bill, Assemblywoman Patty Berg (D), said she was “very optimistic” that the ruling would help prospects for the bill this year.

The Supreme Court was aware of the strong feelings on both sides — and portrayed itself as above them.

Although frequently described as a “right to die” case, Gonzales v. Oregon , No. 04-623, was not, strictly speaking, about the constitutional right to end one’s own life. The court has already ruled, in 1997, that there is no such right and did not revisit that holding yesterday.

Instead, Justice Anthony M. Kennedy noted in the majority opinion that the question was whether Ashcroft acted in accordance with the Controlled Substances Act when he issued an “interpretive rule” in 2001, declaring that assisting suicide is not a “legitimate medical purpose” for which federally regulated drugs may lawfully be prescribed. Ashcroft’s successor, Alberto R. Gonzales, has continued the policy.

Kennedy acknowledged that the case was partly a product of the national debate over end-of-life issues but noted that the “resolution requires an inquiry familiar to the courts: interpreting a federal statute to determine whether Executive action is authorized by, or otherwise consistent with, the enactment.”

The answer, Kennedy wrote, is no: Recasting the issue as involving the states’ right to regulate medical practice rather than a patient’s right to die, he concluded that Ashcroft had made an overly broad interpretation of the 35-year-old federal Controlled Substances Act (CSA). Kennedy wrote that the law was meant to stop drug abuse and drug trafficking, not to replace the states’ traditional role in deciding what state-licensed doctors may and may not do within state borders.

“The Government, in the end, maintains that the prescription requirement [of the CSA] 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,” Kennedy wrote. “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.”

Kennedy was joined by Justices John Paul Stevens, Sandra Day O’Connor, David H. Souter, Ruth Bader Ginsburg and Stephen G. Breyer.

In dissent, Scalia argued that Ashcroft had acted well within his legal powers. “If the term legitimate medical purpose has any meaning, it surely excludes the prescription of drugs to produce death,” Scalia wrote.

He was joined by Roberts — dissenting for the first time on the court — and Thomas. Thomas wrote separately to argue that the court’s ruling was inconsistent with its opinion last year upholding a federal override of a California law legalizing the medical use of marijuana.

The Oregon Death With Dignity Act was adopted by the state’s voters in 1994. It permits doctors to prescribe, but not administer, a lethal dose to a terminally ill patient who requests it, provided that the patient is mentally competent.

State voters rejected a challenge to the law in 1997; two efforts to override it in Congress, supported by Ashcroft when he was a senator, failed. President Bill Clinton’s attorney general, Janet Reno, declined to act against the law.

From 1997 to 2004, 208 people ended their lives by physician-assisted suicide in Oregon.

After Ashcroft issued his declaration as attorney general, a federal district court in Oregon upheld the law, as did the San Francisco-based U.S. Court of Appeals for the 9th Circuit. The Bush administration appealed to the Supreme Court, which agreed last year to take the case.

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