Ashcroft Attacks Oregon’s Suicide Law

Atty. Gen. John Ashcroft on Tuesday directed U.S. Drug Enforcement Administration agents to go after Oregon doctors in assisted-suicide cases, saying it is against federal law to dispense or use controlled medications to help a terminally ill patient die.

The move by Ashcroft, a strident critic of assisted suicide, was aimed at overruling an Oregon law that allows doctors to help patients who want to hasten their deaths.

Ashcroft’s memo specifically allows for the revocation of drug prescription licenses of doctors who participate in an assisted suicide using federally controlled substances. His directive did not authorize criminal prosecution of those doctors.

In a memo to DEA Administrator Asa Hutchinson, Ashcroft said that assisted suicide is not a “legitimate medical purpose” for prescribing, dispensing or administering federally controlled substances. He said that the use of such drugs by physicians to manage patients’ pain is medically valid.

The action reignited the national debate over assisted suicide. It drew praise from anti-abortion groups and criticism from those who support doctors’ efforts to help patients who want to take a cocktail of barbiturates to end their pain and suffering.

Ashcroft’s directive reverses a June 1998 declaration by his predecessor, Janet Reno. She barred federal agents from moving against doctors who, in keeping with the requirements of Oregon’s assisted-suicide law, help terminally ill patients end their lives. That law was passed by voters in 1994, but because of court battles did not take effect until October 1997.

Within hours of Ashcroft’s announcement, Oregon officials vowed to go to court to obtain an injunction blocking the directive. Supporters and opponents alike predicted that the Supreme Court would ultimately decide the matter.

“It’s beyond my comprehension why, in the face of what’s happening in the world today, that this would be a priority of any type for our attorney general,” said George Eighmey, executive director of the Compassion in Dying Federation in Oregon.

The Oregon group was one of many that said Ashcroft’s directive would have a chilling effect on doctors nationwide over fears that their prescription decisions will be second-guessed by drug agents with no medical expertise.

Critics of assisted suicide, including anti-abortion organizations and some religious groups, hailed Ashcroft’s action. Some said it would protect the elderly and infirm in Oregon from pressure to take their own lives.

“This is a carefully crafted ruling that reassures doctors about their ability to prescribe federally controlled drugs to relieve pain while ensuring that the federal government does not facilitate assisted suicide,” said Burke Balch, director of medical ethics at the National Right to Life Committee.

Balch said the only doctors who will face increased scrutiny are those who fill out state paperwork admitting that they have participated in an assisted suicide.

“It’s not like the DEA is going in anywhere, trying to second-guess doctors,” Balch said.

Neither the attorney general nor his aides commented publicly on the directive, which resembled a legal brief and contained little in the way of explanation or Ashcroft’s reasons for issuing it.

“We’re letting the memo speak for itself,” said one Justice Department official.

Ashcroft’s memo cited the Supreme Court’s ruling in a medical marijuana case earlier this year that federal law regulating controlled substances is uniform throughout the United States, and cannot be superseded by state law.

Therefore, Ashcroft concluded, Oregon’s law permitting doctor-assisted suicide is now legally out of step with the law of the land.

Ashcroft told Hutchinson that drug agents around the nation, particularly in Oregon, should resume enforcement of a DEA policy prohibiting the dispensing of controlled substances to assist suicides. Hutchinson said in a statement that he will instruct agents to do so immediately.

“I am pleased that this issue has been clarified for the American public,” said Hutchinson, until recently a GOP congressman from Arkansas. “DEA will continue to maintain consistency in striking the balance between relieving pain and preventing the abuse of pain medication.”

Under Oregon’s Death With Dignity Act, doctors may provide--but not administer--a lethal prescription to terminally ill adult state residents. The law requires the assessment of two physicians that the patient has less than six months to live, has chosen to die voluntarily and is able to make health care decisions.

Seventy Oregon residents have used the law to end their lives. Another half dozen or so patients have completed the application process and have their prescriptions in hand; a few dozen more are in the middle of the application process and could be affected by Ashcroft’s directive.

Barbara Coombs Lee of Compassion in Dying Federation said the relatively small number of suicides has disproved opponents’ predictions that the law would cause a dramatic increase in suicides. “We now have four years of very careful implementation during which we have only seen a few people use the law under extraordinary and compelling circumstances,” she said.

She rejected Ashcroft’s linking of the assisted-suicide issue with the medical marijuana case, in which the Supreme Court essentially put an Oakland “buyers’ club” out of business.

In its ruling in May, the court said there is no exception in federal drug laws for the medical use of marijuana to ease pain from cancer, AIDS and other illnesses.

“It’s easy to distinguish the federal government’s ability to put these buyer clubs out of business from what the federal government is trying to do in this case, which is override state determination of what is [a] legitimate medical purpose for medication already in common use and under regulation by the state,” Lee said. “Marijuana is not a medication in common use.”

Oregon officials plan to argue that Ashcroft’s directive would have “dramatic and irreversible repercussions on the state,” said Kevin Neely, spokesman for the Oregon attorney general’s office. He said state lawyers would go to U.S. District Court in Portland today to seek a temporary restraining order and a preliminary injunction to bar enforcement of Ashcroft’s directive.

“Today’s Department of Justice decision was inevitable, as it simply restated federal law,” said Republican Sen. Gordon Smith, an opponent of the state law.

Democratic Sen. Ron Wyden, who blocked legislation in Congress that would have outlawed assisted suicide, accused Ashcroft of ignoring the will of the state’s voters and of compromising medical care throughout the country.