Ashcroft: Not Busy Enough?

Atty. Gen. John Ashcroft, obviously not busy enough with investigations on multiple terror fronts, will now be looking over the shoulders of Oregon doctors who care for terminally ill patients. His order Tuesday directing federal drug agents to go after doctors who participate in assisted suicide--a practice legal under Oregon law--is an unwarranted intrusion that makes no sense except as an exercise of unvarnished ideology.

Ashcroft is a longtime critic of assisted suicide. His directive is aimed squarely at overruling an Oregon law, twice approved by voters, that permits doctors to prescribe lethal drugs for terminally ill patients who ask for them under narrow and tightly controlled circumstances. But under the order to the U.S. Drug Enforcement Administration, any doctor who prescribes such drugs, even one acting within the terms of the Oregon law, can lose his or her license to prescribe, effectively making the physician unable to practice.

Exactly what is the problem Ashcroft believes needs solving? Since Oregon’s law took effect in 1997, about 70 people have killed themselves in this way. The relatively small number of suicides--and the long application process required to obtain the prescriptions--has disproved opponents’ predictions that the law would lead to a massive body count.

What happened to the rights of states to make their own decisions on most policy matters, a principle that Ashcroft would usually hold dear? The U.S. Supreme Court in 1997 rejected arguments that the Constitution embodies a right to assistance in dying. But the court cleared the way for Oregon’s law to take effect by turning aside an appeal that had kept the measure tied up in court. Ashcroft imperiously dismissed the court’s measured decision by simply declaring that assisted suicide “is not a legitimate medical purpose” for prescribing federally controlled substances. But the line between prescribing enough medication to make a wasted, dying person comfortable and to hasten the end can be precariously thin. Even the Supreme Court acknowledged that this gray area is one for “earnest and profound” debate. And by directing drug agents with no medical expertise to second-guess the decisions of physicians, Ashcroft’s order conjures the specter of G-men big-footing their way into hospital rooms and medicine chests.

Four times in the past three years Congress has rejected legislation that would have invalidated Oregon’s law through prosecution of physicians who prescribe under its authority. Ashcroft’s directive borrows liberally from those failed efforts without explaining where exactly the federal interest lies.

Oregon officials filed suit Wednesday seeking to block the directive. In the meantime, however, Ashcroft’s order is likely to hinder new efforts by doctors in Oregon and elsewhere to ease the suffering of their terminally ill patients. Effective pain management, often by the use of opiates, has long taken a back seat to nonsensical fears that dying patients would become drug addicts. The result has been that far too many of the 550,000 patients who die each year of cancer spend their last days in agony. Ashcroft said his order will not impede the efforts of physicians to manage patients’ pain--which still leaves patients to wonder why he butted in in the first place.