In a 6-3 ruling, the Supreme Court Jan. 17 upheld Oregon's physician-assisted suicide law, rejecting the U.S. attorney general's attempt to use federal drug control laws to stop doctors from prescribing lethal doses of medicine to people who are terminally ill.
Writing for the majority, Justice Anthony Kennedy said although the federal government may apply drug laws to states, the "authority claimed by the attorney general is both beyond his expertise and incongruous with the statutory purposes and design."
If the attorney general's argument were to stand, the government could apply the same logic to other types of medical judgments, Kennedy wrote.
"He could decide whether any particular drug may be used for any particular purpose, or indeed whether a physician who administers any controversial treatment could be deregistered," or effectively barred from practicing medicine, Kennedy wrote. The attorney general would have such power even though the law limits his authority to the registration and control of drugs "and despite the statutory purposes to combat drug abuse and prevent illicit drug trafficking," he said.
Kennedy was joined in the majority opinion by Justices John Paul Stevens, Sandra Day O'Connor, Stephen Breyer, David Souter and Ruth Bader Ginsberg. Justice Antonin Scalia wrote a dissenting opinion, in which he was joined by Chief Justice John Roberts and Justice Clarence Thomas. Thomas also wrote a separate dissent.
In his dissent in Gonzales v. Oregon, Scalia said it was perfectly valid for the Justice Department to define "legitimate medical purpose" in applying its own regulation, and to conclude that the term cannot be applied to intentionally assisting suicide.
"Our presumption that the Controlled Substances Act creates a uniform federal law regulating the dispensation of controlled substances ... means that this objective standard must be a federal one," he wrote.
Scalia also took issue with the majority's finding that assisted suicide is a legitimate medical practice.
"The fact that many in Oregon believe that the boundaries of 'legitimate medicine' should be extended to include assisted suicide does not change the fact that the overwhelming weight of authority (including the 47 states that condemn physician-assisted suicide) confirms that they have not yet been so extended," he wrote. "Not even those ... cases most generous in discerning an 'evolution' of national standards would have found, on this record, that the concept of 'legitimate medicine' has evolved so far."
He concluded by saying, "If the term 'legitimate medical purpose' has any meaning, it surely excludes the prescription of drugs to produce death."
The majority opinion discussed in great detail a disagreement with the idea that the attorney general was making a legal interpretation, not a medical one, in determining what is a legitimate medical purpose.
Even the structure of the Controlled Substances Act "conveys unwillingness to cede medical judgments to an executive official who lacks medical expertise," Kennedy wrote.
In an amicus, or friend-of-the-court, brief urging the court to uphold the federal restrictions on lethal drugs, the U.S. Conference of Catholic Bishops and other church organizations argued that assisting suicide is not a legitimate medical purpose. In fact, the brief said, establishing a medical distinction between assisted suicide and effective pain control has led to more effective treatment of pain.
Oregon became the first state to legalize physician-assisted suicide when voters passed the Death With Dignity Act in 1994. The law exempts doctors from civil or criminal liability if they prescribe lethal doses of drugs in keeping with the procedures spelled out in the statute.
The law took effect after a 1997 voter initiative to repeal the statute failed.
Since the law was enacted, about 200 people have committed suicide by following its provisions. It applies only to people in the final stages of terminal illness and requires a second doctor to confirm the diagnosis. Doctors do not administer the drugs; they only prescribe them.
In 2001 then-Attorney General John Ashcroft issued a directive saying that prescribing drugs limited by the Controlled Substances Act for the purpose of assisted suicide would violate the federal law. The case reached the Supreme Court just as Ashcroft's resignation was announced in 2004, and current Attorney General Alberto Gonzales continued the case when he took over the office.
The Supreme Court in 1997 upheld the right of states to pass laws prohibiting physician-assisted suicide, but this is the first time it has ruled on Oregon's statute. Oregon remains the only state to permit physician-assisted suicide.
Catholics in the Archdiocese of Los Angeles expressed disappointment and concern about the Court's decision.
Sister of Social Service Paula Vandegaer, a licensed clinical social worker, said that physician-assisted suicide subverts the natural dying process in which people go through a period of depression but then come to accept their death and can experience forgiveness and reconciliation with themselves and others.
"The dying process is a time of God's grace poured out in abundance. To take advantage of a person who is feeling suicidal is abhorrent," said Sister Vandegaer, a member of the Commission for Catholic Life Issues in the Archdiocese of Los Angeles. "I don't understand a society that would offer that person anything but love and pain control."
Vincentian Father Richard Benson, academic dean and professor of moral theology at St. John's Seminary in Camarillo, said that physician-assisted suicide could impact how the country approaches geriatrics research and long-term care for seniors with an aging population and a privatized health system.
"The greatest danger to seniors is that it will be much cheaper to encourage euthanasia or physician-assisted suicide than it would be to care for people," said Father Benson.
In California, AB651 would make physician-assisted suicide legal in the state, a bill currently being considered in the State Senate.
Carol Hogan, lobbyist for the bishops' California Catholic Conference said that the Supreme Court ruled narrowly and that proponents of physician-assisted suicide will make more of the Court's decision than is warranted.
"The Supreme Court did not rule on the merits, or morality or the ethics of physician assisted suicide," she said.
Catholics are being urged to contact state senators to voice their opposition to bills that would legalize physician-assisted suicide.
"It is our job, as concerned Catholics living in a democratic society, to actively support a pro-life political agenda -- with our votes, with well-reasoned public argument, and with financial contributions to get the word out to the general electorate, said William Anderson, an attorney and member of the archdiocesan Commission for Catholic Life Issues. "We simply cannot expect the court system to do our job for us."
-- Ellie Hidalgo contributed to this article.
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