Impact of Oregon ruling: Will more states allow assisted suicide?

The Supreme Court finds that the U.S. attorney general can't ban Oregon physicians from prescribing life-ending drug doses. But the debate isn't over.

By Kevin B. O'Reilly, AMNews staff. Feb. 6, 2006.

For the second time in a decade, the U.S. Supreme Court refused to overturn the unique Oregon law that allows physicians to prescribe life-ending drug doses to terminally ill patients who ask for them.

The ruling in Gonzales v. Oregon upheld a well-rooted notion that the practice of medicine should be left to the states, with justices saying the U.S. attorney general doesn't have the power to ban the use of controlled substances in physician-assisted suicides. If the court had ruled the opposite way, it would have effectively gutted Oregon's Death With Dignity Act without actually overturning it.

The court's 6-3 ruling upholding the law might jump-start efforts to copy Oregon's law in states that have physician-assisted suicide legislation pending, including California, Hawaii, Vermont and Wisconsin. Supporters concede that the legislation would be harder to sell politically, ethically and aesthetically if patients' deaths were hastened in a way other than by physicians prescribing a large dose of sleeping pills.

The ruling turned on the question of whether former U.S. Attorney General John Ashcroft exceeded his authority under the Controlled Substances Act when he issued the directive in 2001. The court decision might allow Congress to amend the act to specify that physician-assisted suicide is not a legitimate medical purpose for which physicians can prescribe federally regulated drugs.

"What the court simply said was that under the Controlled Substances Act, the attorney general can't determine what's medically legitimate," said Paul G. Arshagouni, MD, director of the health law program at the Michigan State University College of Law. "This ruling leaves the door wide open for Congress to step in and say, 'We want to legislate that issue.' This is a win for people who support physician-assisted suicide, but it's not a slam dunk. It doesn't end the debate."