Gonzales v. Oregon

The Oregon Death with Dignity Act, a ballot initiative that legalized physician assisted suicide, won approval of Oregon voters in 1994. The law permits physicians to prescribe a lethal dose of medication to a patient agreed by two doctors to be within six months of dying from an incurable condition.

The Oregon Legislative Assembly attempted to repeal the Act, and was defeated. The legal issues relating to physician-assisted suicide ultimately came before the Supreme Court and concerned the use of controlled substances. Oregon v. Ashcroft, and later Gonzales v. Oregon, resulted in intense political, ethical, and legal debate in the United States. Questions raised included whether the U.S. attorney general had the right to determine if physician-assisted suicide did not serve a legitimate legal purpose. Issues related to drug policy included the problem of whether or not then Attorney General John Ashcroft could invalidate Oregon law on assisted physician suicide via the Controlled Substance Act (CSA) of 1970. In 1984, an amendment to the CSA authorized the attorney general to prohibit medical practitioners the delivery of a controlled substance if the use was “inconsistent with the public interest.”

In 1998 U.S. Attorney General Janet Reno had reversed Drug Enforcement Administration Director Thomas Constantine's decision that concerned controversial physician-assisted suicide. The director had issued a determination that narcotics and potentially dangerous drugs controlled by federal legislation would not legally permit physician-assisted suicide. Reno decided that doctors writing prescriptions for lethal overdoses did not violate federal law or Oregon law. However, doctors in states without legalized physician-assisted suicide would be in violation of federal law.

After President Bush appointed John Ashcroft to serve as U.S. attorney general in 2001, Ashcroft issued an interpretive ruling that declared any physician administering controlled drugs for assisting suicide was not legitimate, and in violation of the 1970 CSA. The CSA defined physicians as practitioners who prescribe controlled substances. However, the prescription must meet the criteria of being for some legitimate medical purpose. The Office of Legal Counsel and Attorney General Ashcroft [Page 325]determined that doctors who prescribe or use these controlled substances to assist suicide risk losing their federal government issued licenses.

Attorney General Alberto Gonzales speaking at a Drug Enforcement Administration event in September 2006.

Challenges to Attorney General Ashcroft's ruling unfolded in the U.S. District Court. Oregon v. Ashcroft was a suit brought by the state attorney general of Oregon. He argued that the newly appointed U.S. Attorney General Alberto Gonzales, who had replaced Ashcroft, must show Congress expressly intended that the U.S. attorney general has the right to regulate Oregon's medical practice procedures. The Ninth Circuit Court of Appeals ruled for the State of Oregon, issued a permanent injunction, and brought to enjoin the attorney general from giving any legal effect from the federal directive.

The Supreme Court agreed to hear Oregon v. Ashcroft, renaming the case Gonzales v. Oregon. In their final 6–3 decision, issued on January 17, 2006, and written by Justice Anthony Kennedy, the Court did not reject the power of the federal government to regulate drugs. They ultimately decided that federal law did not empower the U. S. attorney general to overrule Oregon state law. The decision was specific to law related to physician-assisted suicide and the use of controlled substances under the 1970 CSA. The “right to die” movement declared Gonzales v. Oregon a victory; however, the case was interpreted from a narrow perspective on physician-assisted suicide and controlled substances. This was not a big victory for euthanasia, and numerous thorny ethical and legal issues were left unresolved for dying patients, doctors, and the law. In summary, the Supreme Court decided that the Controlled Substances Act does not empower the attorney general of the United States to prohibit doctors from prescribing regulated drugs for use in physician-assisted suicide under state law permitting the procedure.

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