Justices Accept Oregon Case Weighing Assisted Suicide

In an action likely to reopen a national debate over whether doctors should be able to help terminally ill patients end their lives, the Supreme Court agreed on Tuesday to hear the Bush administration’s challenge to the only state law in the country that authorizes physician-assisted suicide.

Oregon’s Death With Dignity Act, the administration’s target, was approved twice by the state’s voters and took effect in November 1997. According to the state, in a brief filed last month, 171 patients have used the law to administer lethal doses of federally regulated drugs that their doctors prescribed for them.

In the administration’s view, suicide is not a “legitimate medical purpose” under regulations that carry out the federal Controlled Substances Act. Consequently, the administration will argue before the Supreme Court, as it did unsuccessfully in the lower federal courts, that doctors who prescribe drugs for committing suicide violate the federal law and are subject to revocation of their federal prescription license. The license applies to broad categories of medications and is necessary, as a practical matter, for a doctor to remain in practice.

This case elicits multiple conflicting feelings for me. I clearly disapprove of active euthanasia on moral principles – More on passive euthanasia. In that 2003 rant, I quoted a rabbi. This paragraph is so powerful that I will quote it again (attribution can be found within the link).

In commenting on this, Moses Isserles makes a distinction between accelerating the death of a gosaiys, which Isserles agrees is forbidden, and removing obstacles that impede death, which he allows.

“Thus it is forbidden to accelerate a person’s death. For example, one may not remove the pillow or mattress of a person who has been a gosaiys for a long time and is unable to expire, on the grounds that some claim that the feathers of certain birds can be the cause of this condition”-you can’t hasten the death by removing the feather pillow. “Likewise, such a person is not to be moved, and it is forbidden to put the keys to the house under the head of a person in order to cause the person to die. However, if something is present which preventing the soul from leaving-for example, the sound of pounding near the house as is made by a woodcutter . . . and this is preventing the soul from leaving, it may be removed inasmuch as this does not constitute an act in and of itself beyond removal of the impediment. ”

Unlike some who will comment, I have resolved passive euthanasia as morally acceptable. I am not required to feed a patient, or assist respirations, if they do not or would not want that assistance. I will not knowingly hasten the natural death process.

Now with that moral underpinning, and my personal distaste for the Oregon law, I still disagree with the tactics that the Bush administration is using in this case. While I could not participate in these activities, I do understand that other physicians may resolve this issue and accept active euthanasia as morally acceptable.

The tactics of attacking the physicians crosses a reasonable boundary. Perhaps the Supreme Court could find the law unconstitutional, while forbidding retrospective penalties for those functioning under that laws of the state of Oregon.

As one who supports states rights, I believe that the citizens of Oregon have spoken in a clear way here. I do not have to agree with their decision to support their right to make that decision. I would not personally participate in active euthanasia, but I would not seek punishment for those physicians who have. I would debate them in public, while supporting their right to function under the mores established in their state.

Since finishing this rant, I found an additional interesting commentary on this issue – Prescription for Chaos

Here’s how Gonzales v. Oregon came to be: When Oregon voters legalized assisted suicide in 1994, state regulators had a problem. They wanted to authorize doctors to prescribe barbiturates as killing agents. But the federal government regulates the use of these drugs under the Controlled Substances Act (CSA), and under the law, “controlled substances” can only be used for legitimate medical purposes. Thus, while it is generally illegal to possess morphine, it can be prescribed legally to control pain because the federal government deems it to be a legitimate medical use of this narcotic.

Assisted suicide was not even a dark cloud on the horizon when the CSA was passed and thus it doesn’t take assisted suicide into account. But once Oregon legalized assisted suicide, it became important to determine whether controlled substances could be prescribed in Oregon not only to alleviate pain or aid in sleep as in other states, but also to intentionally kill.

The Drug Enforcement Administration issued an opinion (known as an “interpretation”) that assisted suicide is not a legitimate medical use of these drugs with regard to the enforcement of federal law. But Janet Reno overturned this interpretation and issued one of her own in a letter to Representative Henry Hyde (R., Ill.), in which she stated that Oregon doctors who prescribed controlled substances for use in assisted suicide would not be prosecuted — so long as the doctors followed the guidelines established by the Oregon law. Reno also wrote, however, that doctors in other states who prescribed or used controlled substances to kill could still be prosecuted, as could Oregon doctors who violated the terms of Oregon’s assisted suicide law.

Thus, this case is not about active euthanasia, but rather about what physicians can prescribe. I hope the Supreme Court can avoid the chaos that the Attorney General’s office desires. Thus I disagree with the commentary which (if I read it correctly) supports the Attorney General’s office.

Related posts:

1. Physician assisted suicide – the Oregon experience
2. Previous writings on physician assisted suicide
3. The Supremes and physician assisted suicide
4. More on the Oregon case
5. Medpundit on euthanasia

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