The U.S. Supreme Court will begin hearing arguments Wednesday on whether Oregon physicians can be prosecuted by the federal government for carrying out Oregon’s assisted suicide law.
The case, Gonzales v. Oregon, revolves around Oregon’s Death With Dignity Act.
The ODWDA allows people to end their own lives if they are diagnosed with a terminal disease and given six months to live. The most common method of assisted suicide is orally taking a barbiturate drug, though that is up to the physician. Patients must be Oregon residents over the age of 18 able to make medical decisions for themselves. No one but the patient can make a request to utilize the act.
Patients must make two oral requests at least 15 days apart and submit a written request to their physician. Physicians can refuse a request if they believe the patient’s judgment is impaired.
Since 1998, 208 people have used the ODWDA to end their lives.
Oregon voters approved the ODWDA in 1994 and in 1997. The act has survived appeals in both the district court and the 9th Circuit Court of Appeals, as well as an attempt by the U.S. Congress to outlaw the drugs used in the act.
The technical issues of Gonzales v. Oregon involve whether former Attorney General John Ashcroft correctly interpreted the Controlled Substances Act’s provision which allows the attorney general to prohibit medical practices he or she deems are “inconsistent with the public interest.”
Ashcroft issued the “Ashcroft Directive” in 2001, stating that “assisting suicide is not a legitimate medical purpose.” He authorized the prosecution of physicians who distributed drugs to patients under ODWDA.
A judge issued an injunction, and the district court ruled that Ashcroft did not have the authority to overturn Oregon law. Ashcroft appealed to the 9th Circuit Court of Appeals, which ruled in favor of the state, prompting Ashcroft to appeal to the U.S. Supreme Court.
The case was transferred to current Attorney General Alberto Gonzales after Ashcroft resigned in 2004.
The case touches on other controversial issues. Many groups wish for the law to be abolished because they believe that assisted suicide is morally wrong. Others see the case as a clash between states’ rights and the federal government’s ability to enact a consistent drug policy.
“This is a case that will test whether or not the court is serious about federalism,” University School of Law assistant professor Robert Tsai said.
Though Tsai says the case looks good for Oregon, the fact that it involves drugs complicates things.
“When the case of drug regulation comes up, the court normally sides with the federal government,” Tsai said.
Whether the Supreme Court rules in favor of Oregon or not, ODWDA will still stand. The issue the court will decide is whether the federal government can prosecute Oregon physicians for following ODWDA.
Another issue with this case, and all cases this session, is the uncertainty surrounding the court. With two vacancies being filled, there are questions about how the new court will act and rule cases. With John Roberts confirmed as the 17th chief justice of the United States, he will begin the session leading the court.
Tsai guessed that Roberts, like many conservatives, will be torn between whether to support the administration’s case or support states’ rights.
Supporters of the law believe it is necessary to give relief to those suffering from terminal illnesses.
“We think it is important for people who are terminally ill and facing a prolonged, painful death,” Executive Director of the Death with Dignity National Center Peg Sandeen said. “It offers peace of mind and control of one’s final days.”
Sandeen also sees the law as an important tool to regulate the practice of assisted suicide.
“What we see in other states is that this practice happens in every state,” Sandeen said. “In Oregon, physicians have to report it to the state, and it’s not so in other states.”
Opponents of the act focus on the morality of assisted suicide and the legal issues surrounding the case itself.
The International Task Force on Euthanasia and Assisted Suicide filed a brief with the court regarding the case, saying that “throughout this nation’s history, intentionally participating in causing or enabling drug-induced death has never been considered a ‘legitimate medical practice.’”
The ITF also believes that the court finding in favor of Oregon will hurt the federal government’s ability to enforce a national drug policy.
Many religious groups oppose assisted suicide under any circumstances. Catholicism, Islam, Lutheranism and many other religious groups see ending life prematurely as immoral, according to deathwithdignity.org.
“The Catholic Church believes that each human life is a sacred gift from God, from the moment of conception until the moment of natural death,” wrote Dr. Christin McIntyre, secretary of the Portland Guild of the Catholic Medical Association and a practicing psychiatrist in the Portland area, in an e-mail. “The action of taking any life, even ones own, is against God’s commandment not to kill.”
McIntyre believes that a desire to commit suicide is more a symptom to be treated than a possible treatment itself.
“I believe, as a physician and as a Catholic, that assisted suicide is not an acceptable solution to the problem of end-of-life suffering,” McIntyre said. “We as a profession and as a society must instead more aggressively treat the physical and psychological pain that causes people to want to take their own lives.”
With so many aspects to this case, Tsai said it is difficult to pin down which way the court may go.
“This one is a real toss up,” Tsai said.

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