American Journal of Law & Medicine

Physician assisted suicide: Supreme Court strikes down federal rule blocking physician-assisted suicide--Gonzalez v. Oregon (1).

Physician Assisted Suicide: Supreme Court Strikes Down Federal Rule Blocking Physician-Assisted Suicide--Gonzalez v. Oregon (1)--With its recent 6-3 decision in Gonzales v. Oregon, the Supreme Court held that the Attorney General did not have the authority under the federal Controlled Substances Act ("CSA) to prohibit physicians from prescribing lethal doses of controlled substances under a state statute decriminalizing physician-assisted suicide. (2)

In 1994, Oregon voters approved a ballot initiative making Oregon the first state to legalize physician-assisted suicide. (3) Voters later affirmed that measure in 1997. (4) The Oregon Death with Dignity Act (ODWDA) exempts state-licensed physicians "who, in compliance with the specific safeguards in ODWDA, dispense or prescribe a lethal dose of drugs upon the request of a terminally ill patient" from civil or criminal liability. (5) ODWDA requires that patients seeking physician assistance in committing suicide first receive a diagnosis from their attending physicians that they suffer from "an incurable and irreversible disease that, within reasonable medical judgment, will cause death within six months." (6) In addition, two separate physicians must review that patient's request in order to determine that it was made voluntarily and the patient's decision is informed. (7) Since its enactment, about two hundred Oregonians have ended their lives pursuant to procedure approved by ODWDA. (8)

ODWDA, however, encountered resistance on the federal level from the Attorney General John Ashcroft. (9) The drugs that doctors use to assist patients with suicide are federally regulated under the CSA. (10) Enacted in 1970, the CSA's main objectives are "combating drug abuse and controlling the legitimate and illegitimate traffic of controlled substances." (11) Drugs used in physician-assisted suicide are grouped under Schedule II of the statutory scheme, and the CSA requires that patients receive a written, non-refillable prescription from a doctor before gaining access to them. (12) The Attorney General must grant physicians a registration subject to the regulations of the Justice Department in order for that physician to lawfully prescribe these Schedule II drugs. (13) Moreover, the CSA provides that the "Attorney General may deny, suspend, or revoke this registration if ... the physician's registration would be 'inconsistent

with the public interest."' (14) One such regulation under the CSA, promulgated by the Attorney General in 1971, requires that prescriptions "be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice." (15) Ashcroft, an opponent of physician-assisted suicide during his time in the Senate, issued an Interpretive Rule (the "Rule") as Attorney General declaring that the use of controlled substances in physician-assisted suicide was not a "legitimate medical practice," thus making prescriptions under ODWDA a federal offense. …

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