Physician Assisted Suicide: Supreme Court Strikes Down Federal Rule Blocking Physician-Assisted Suicide — Gonzalez v. Oregon

Abstract

Physician Assisted Suicide: Supreme Court Strikes Down Federal Rule Blocking Physician-Assisted Suicide - Gonzalez v. Oregon1-With its recent 6-3 decision in Gonzalez v. Oregon, the Supreme Court held that the 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 incurable and irreversible disease that, within reasonable 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 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 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 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 'inconsistent with the public interest.'14 One such regulation under the CSA, promulgated by the General in 1971, requires that prescriptions be issued for a purpose by an individual practitioner acting in the 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 General declaring that the use of controlled substances in physician-assisted suicide was not a legitimate practice, thus making prescriptions under ODWDA a federal offense.16 Accordingly, a physician who prescribed a lethal dose of a controlled substance under ODWDA would render his registration . . . inconsistent with the public interest and would possibly subjected to suspension or revocation of his license.17 Because doctors could not prescribe controlled substances without a registration, the Rule effectively blocked the practice of physician-assisted suicide under the ODWDA.18 The State of Oregon, along with a doctor, a pharmacist, and several terminally ill patients, brought a suit seeking declaratory and injunctive relief that would prevent enforcement of the Rule.19 The United States District Court for the District of Oregon found for the plaintiffs and permanently enjoined its enforcement.20 On review, the Ninth Circuit Court of Appeals struck down the Rule, holding that it altered the usual constitutional balance between the States and the Federal Government . . . without the requisite clear statement that the CSA authorized the action.21 The CSA, the Ninth Circuit held, only addresses conventional drug abuse and does not give the General the authority to make medical policy decisions. …