High Court OKs Doctor-Assisted Suicide

Ruling Prevents Federal Officials From Interfering in Oregon Law

From the WebMD Archives

Jan. 17, 2006 - The U.S. Supreme Court upheld Oregon's physician-assisted suicide law Tuesday, ruling that federal agents cannot use antidrug statutes to interfere with the program.

Assisted-suicide advocates hailed the 6-3 ruling as a major victory that could allow other states to implement similar laws. The Bush administration said it was disappointed by the decision.

A total of 208 terminally ill Oregonians used the law to end their lives between 1998 and 2004, according to state records. Figures have not been released for 2005.

Oregon's Law

Oregon allows terminally ill adult patients who are expected to die within six months to seek a doctor's prescription for a lethal dose of medication. Patients must be at least 18 years old and a resident of the state. Under the law, patients must make verbal requests for assistance on two separate occasions at least 15 days apart.

The patient must also submit a written request -- signed by witnesses -- to his attending physician. The physician then has to consult with a second doctor to confirm the terminal diagnosis and determine that the patient is mentally competent and is not suffering from a psychiatric disorder that could impair decision making. The attending physician must request that the patient notify next of kin regarding the prescription. At any time, the patient may change his or her mind.

Doctors also have to inform patients about alternatives to suicide, including hospice care.

Legal Battle

The case began in 2001 when then-Attorney General John Ashcroft announced that the Justice Department would use the Controlled Substances Act to punish any doctor who used medications to help a patient commit suicide under the law.

Oregon sued, arguing that federal officials had no right to use the law to influence medical practices, which are traditionally regulated by the states.

A majority of justices agreed, noting Tuesday that Congress never intended for the Controlled Substances Act to be used to enforce medical policy.

Justices Stephen Breyer, Anthony Kennedy, Ruth Bader Ginsburg, John Paul Stevens, Sandra Day O'Connor, and David Souter backed the Oregon law. Justices Clarence Thomas, Antonin Scalia, and new Chief Justice John Roberts dissented.

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Advocates Applaud Decision

Assisted-suicide backers celebrated the decision.

"It is enormously important nationally," Barbara Coombs Lee, president of Compassion and Choices, said of the decision. The group lobbied for Oregon's law. "The Oregon experience makes it clear, this can be done reasonably, responsibly -- in a way that improves end-of-life care."

State legislatures in Vermont and California are considering laws similar to Oregon's. Supporters said Tuesday's decision improved their chances of passing the bills by easing the concerns of some lawmakers that the court could allow Washington to intervene to stop implementation.

"This decision by the Supreme Court today certainly gives us a lot of momentum, we believe. We've had a lot of members say let's wait to see what the Supreme Court has to say and now they've ruled," said California Assemblyman Lloyd E. Levine, a Democrat and chief sponsor of an assisted-suicide bill pending in the legislature there.

Is Legal Battle Over?

Despite the decision, legal fights may not be over. Dorothy Timbs, legislative council for the National Right to Life Committee, points out that the court's ruling was narrow and that it "left the door open" for later federal laws that could stop assisted suicide.

"Nothing in the decision will suggest that Congress can't amend the [Controlled Substances] Act to say that federally controlled drugs can't be used to kill people," Timbs tells WebMD.

White House press secretary Scott McClellan told reporters Tuesday that President Bush was "disappointed" by the court's decision. "The president has strongly advocated building a culture of life in America, and he's going to continue working to do that," McClellan said.

WebMD Health News Reviewed by Louise Chang, MD on January 17, 2006

Sources

Oregon records show that one in 50 terminally ill Oregon patients talks to a doctor about physician-assisted suicide. Assisted suicides account for about one in every 1,000 deaths in the state. SOURCES: Gonzales, Attorney General, et al. v. Oregon et al. Argued Oct. 5, 2005, decided Jan. 17, 2006, No. 04-623, United States Supreme Court. Oregon Department of Human Services: "Seventh Annual Report on Oregon's Death with Dignity Act." Barbara Coombs Lee, president, Compassion and Choices. California Assemblyman Lloyd Levine (D). Dorothy Timbs, legislative council, National Right to Life Committee. Scott McClellan, White House press secretary.
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