Justices to Hear Case on Oregon’s Suicide Law

The Supreme Court agreed Tuesday to hear the Bush administration’s challenge to the nation’s only right-to-die law, setting the stage for a showdown over whether states may permit doctors to prescribe drugs intended to end patients’ lives.

The justices will decide whether Oregon’s Death With Dignity Act violates federal drug-control laws. The case will be argued during the court’s fall term.

Oregon’s voters have approved the right-to-die measure twice. In 1994, the law passed 51% to 49%, but never went into effect because of a court ruling. In 1997, voters rejected an effort to repeal the law, endorsing it 60% to 40%.

The law extends a right to die only to capable adults who are diagnosed as “suffering from a terminal disease” that is likely to take their lives within six months. A second doctor must confirm that the patient is dying, acting voluntarily and competent to choose to end his or her life. Only then may a doctor prescribe lethal medication.

Hundreds of patients have consulted doctors and obtained lethal medication in the seven years since the law took effect, supporters of the law said; 171 have followed through.

“Many patients are comforted by having the medication that gives them the choice to hasten their death, but it is used rarely,” said Kathryn L. Tucker, legal director for Compassion in Dying, the Portland, Ore., group that sponsored the law.

Traditionally, states regulate the practice of medicine and license physicians to work within their borders.

In 1998, conservatives in Congress, led by Rep. Henry J. Hyde (R-Ill.), urged federal action to block Oregon’s law. But then-Atty. Gen. Janet Reno refused to intervene, determining that Oregon had set stringent rules to assure that only mentally competent terminally ill patients could obtain the medication.

But in November 2001, Atty. Gen. John Ashcroft said he would seek to punish doctors who prescribed the medication to dying patients, regardless of the wishes of Oregon’s voters.

“I hereby determine that assisting suicide is not a legitimate medical purpose,” Ashcroft said. Doctors who did so would be in violation of the federal Controlled Substances Act, he said, and would have their right to prescribe medicine suspended or revoked.

Ashcroft’s order set in motion the legal battle to be heard by the Supreme Court.

When Oregon Atty. Gen. Hardy Myers, several patients and others challenged Ashcroft, a federal judge in Portland blocked the order from taking effect. Ashcroft appealed, and the U.S. 9th Circuit Court ruled last year that the attorney general had exceeded his authority.

The federal drug control law “was enacted to combat drug abuse,” wrote Judge Richard Tallman.

“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.”

Tallman’s opinion included a subtle jab at Ashcroft. He wrote that the attorney general was seeking to “alter the usual constitutional balance between the states and the federal government,” quoting a 1991 Supreme Court ruling in Gregory vs. Ashcroft.

In that ruling, Ashcroft -- then the governor of Missouri -- won a victory for states’ rights by arguing that state judges could be subjected to a mandatory state retirement law, despite a federal law that barred such retirements. The high court agreed with Ashcroft that states historically had controlled their judiciaries. Adopting that theme in the right-to-die case, Tallman said control of medical practice had been historically within the powers of the state.

On Nov. 10, the day he announced his resignation from the Bush Cabinet, Ashcroft asked the Supreme Court to reverse the 9th Circuit ruling. He accused the appeals court of “misconstruing and dramatically expanding the scope” of the Gregory vs. Ashcroft decision in a way that “threatens to undermine federal authority.”

It takes the votes of at least four of the nine justices to hear an appeal; in a one-line order Tuesday, the court announced it had voted to hear the case -- renamed Gonzales vs. Oregon, now that Alberto R. Gonzales is U.S. attorney general.

Opponents of the Oregon law applauded the court’s decision.

“The court has an opportunity to ensure that patients receive truly compassionate care and pain relief by limiting physicians’ use of narcotics for healing -- not death,” said Dr. David Stevens, executive director of the 17,000-member Christian Medical Assn.

Oregon officials and leaders of the right-to-die movement said they were disappointed that the high court had intervened. They noted that voters had approved the law twice, and that two lower courts had upheld it.

“This is an opportunity for the Death With Dignity law to win at the highest level, to finally be validated on a national stage,” said Eli D. Stutsman, a Portland lawyer who helped draft the legislation and now represents a physician and a pharmacist who challenged Ashcroft’s order. “We are confident that states’ rights and the rights of the terminally ill will carry the day.”

Eight years ago, the Supreme Court took up the right-to-die issue, but in a different context. A judge in Seattle and the 9th Circuit had ruled that dying patients had a constitutional right to end their lives with the help of a doctor, despite a Washington state law that made assisted suicide illegal.

The Supreme Court unanimously reversed the 9th Circuit -- saying there was no such constitutional right, but adding that the decision on physician-assisted suicide should be left to the states, not judges.

“Throughout the nation, Americans are engaged in an earnest and profound debate about the morality, legality and practicality of physician-assisted suicide,” Chief Justice William H. Rehnquist said. “Our holding permits this debate to continue, as it should in a democratic society.”

On Tuesday, lawyers for Compassion in Dying cited the high court’s 1997 statement as a reason to uphold the Oregon law.

“The court invited the states to grapple with the issue of physician aid in dying,” Tucker, the group’s legal director, said. “Oregon has done so for seven years, and serves as a model for other states.”

Legislation based on the Oregon law was introduced in the California Assembly last week. The Vermont Legislature is considering a similar proposal.

The court is not likely to rule on the issue until early next year.

If the Bush administration wins, the decision would all but void Oregon’s law and prevent other states from adopting similar measures. If Oregon prevails, it could encourage other states or their voters to seek passage of similar laws.

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A decade of dispute

Significant events in the legal battle between the U.S. government and Oregon over assisted suicide:

1994

* Nov. 8: Oregonians narrowly approve Measure 16, the nation’s first law permitting physician-assisted suicide. A U.S. District Court judge prevents it from going into effect, calling it unconstitutional because it lifts society’s protection against self-harm for a vulnerable class of people, the terminally ill.

1997

* April 30: President Clinton signs legislation barring the use of federal money for physician-assisted suicide or euthanasia.

* July 23: The Oregon Legislature approves a measure for the Nov. 4 ballot asking voters to decide whether Measure 16 should be repealed.

* Oct. 27: Oregon’s Death With Dignity Act takes effect when the U.S. 9th Circuit Court of Appeals lifts an injunction that had blocked the law’s implementation.

* Nov. 4: Oregon voters reject the proposed repeal of the law, 60% to 40%.

* Nov. 5: U.S. Drug Enforcement Administration says a federal law can be used to penalize doctors who prescribe federally controlled drugs for patients to commit suicide.

1998

* April 2: U.S. Atty. Gen. Janet Reno reverses the DEA position, saying federal law does not prohibit Oregon doctors from participating in assisted suicide. Legislation in Congress to block the Oregon law eventually falters.

2001

* Nov. 6: U.S. Atty. Gen. John Ashcroft says that assisted suicide is not a legitimate medical practice and that he would use the Controlled Substances Act to punish doctors who prescribe federally controlled drugs to help terminally ill patients die.

* Nov. 7: Oregon Atty. Gen. Hardy Myers files suit in federal court seeking to prevent the federal government from interfering with the assisted-suicide law.

* Nov. 8: U.S. District Court Judge Robert Jones issues a 10-day stay barring implementation of Ashcroft’s order.

* Nov. 20: Judge Jones extends the stay four months.

2002

* Feb. 21: Ashcroft appeals Jones’ ruling.

* April 17: Jones places a permanent injunction on Ashcroft’s directive.

* Sept. 23: Ashcroft appeals Jones’ ruling to the 9th Circuit Court.

2004

* May 26: 9th Circuit orders Bush administration to not interfere with the state law.

* Nov. 10: Ashcroft appeals 9th Circuit ruling to the Supreme Court.

2005

* Feb. 22: The U.S. Supreme Court agrees to hear arguments in its fall term, which begins in October.

Source: Associated Press

Los Angeles Times