Atty. Gen.’s Power ‘Not Sustainable’

Justice Anthony M. Kennedy, writing for the majority:

The government’s claim that the attorney general’s decision is a legal, not medical, one does not suffice, for the Interpretive Rule places extensive reliance on medical judgments and views of the medical community in concluding that assisted suicide is not a legitimate medical purpose. The idea that Congress gave him such broad and unusual authority through an implicit delegation is not sustainable.

The importance of the issue of physician-assisted suicide makes the oblique form of the claimed delegation all the more suspect....The [law] and this court’s case law amply support the conclusion that Congress regulates medical practice insofar as it bars doctors from using their prescription-writing powers as a means to engage in illicit drug dealing and trafficking as conventionally understood. Beyond this, the act manifests no intent to regulate the practice of medicine generally, which is understandable given federalism’s structure and limitations.

The [law’s] structure and operation presume and rely upon a functioning medical profession regulated under the states’ police powers.

Justice Antonin Scalia, dissenting:

The court’s decision today is perhaps driven by a feeling that the subject of assisted suicide is none of the federal government’s business. It is easy to sympathize with that position.

The prohibition or deterrence of assisted suicide is certainly not among the enumerated powers conferred on the United States by the Constitution, and it is within the realm of public morality ... addressed by the so-called police power of the states. But then, neither is prohibiting the recreational use of drugs or discouraging drug addiction among the enumerated powers....

Unless we are to repudiate a long and well-established principle of our jurisprudence, using the federal commerce power to prevent assisted suicide is unquestionably permissible.

The question before us is not whether Congress can do this, or even whether Congress should do this; but simply whether Congress has done this in [the Controlled Substances Act]. There is no doubt that it has. If the term ‘legitimate medical purpose’ has any meaning, it surely excludes the prescription of drugs to produce death.

Justice Clarence Thomas, in a separate dissent:

Today this court concludes that the [Controlled Substances Act] is merely concerned with fighting ‘drug abuse’ and only insofar as that abuse leads to ‘addiction or abnormal effects on the nervous system....’

While the scope of the [act] and the attorney general’s power thereunder are sweeping, and perhaps troubling, such expansive federal legislation and broad grants of authority to administrative agencies are merely the inevitable and inexorable consequence of this court’s commerce clause and separation-of-powers jurisprudence.

Justice Kennedy:

We conclude the [law’s] prescription requirement does not authorize the attorney general to bar dispensing controlled substances for assisted suicide in the face of a state medical regime permitting such conduct. The government, in the end, maintains that the prescription requirement 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. The text and structure of the [law] show that Congress did not have this far-reaching intent to alter the federal-state balance.