Federal agents are directed to stop physicians who assist suicides
Taking square aim at a measure approved twice by voters in Oregon, Attorney General John Ashcroft authorized federal agents yesterday to take action against doctors who prescribe lethal drugs for terminally ill patients.
Oregon is the only state and one of the few places in the world where people are allowed to kill themselves with a doctor’s prescription. Under the state’s so-called Death with Dignity Act, a terminally ill patient may take the lethal drugs if two doctors agree the person has less than six months to live and is mentally competent to make the decision to end his or her life.
Since the law took effect in 1997, at least 70 people have killed themselves in this way, according to the annual reports kept by the Oregon Health Division, a state agency. Many more have obtained lethal prescriptions but have died of natural causes before taking the drugs.
But under yesterday’s action by Mr. Ashcroft, which was outlined in a letter to the Drug Enforcement Administration, any doctor who prescribes such drugs, even one acting under all terms of the Oregon law, can face revocation of his or her license to prescribe any drugs. Reversing the policy of the Clinton administration, Mr. Ashcroft said assisted suicide was not a ”legitimate medical purpose” for prescribing or handing out drugs.
Oregon officials said they would go to court today to try to block the order, and even those who said they were personally opposed to physician-assisted suicide, generally responded with outrage to an action in the nation’s capital that so clearly undercut the expressed will of the state’s voters. Several said it flew in the face of the Bush administration’s avowed interest in upholding the rights of states to make their own decisions on most policy matters.
”They’ve tossed the ballots of Oregon voters in the trash can,” Senator Ron Wyden, a Democrat, said in a telephone interview. ”They’re frustrated by the inconvenience of the democratic process. That’s what Mr. Ashcroft’s action is all about today.”
Other critics of the decision predicted that it could have broad negative ramifications for doctors and seriously ill patients far beyond Oregon because it would allow federal law enforcement agents to ”second-guess” any doctor who prescribes medication to relieve pain. Mr. Ashcroft rejected that argument, suggesting that drug agents could easily discern the ”important medical, ethical and legal distinctions between intentionally causing a patient’s death and providing sufficient dosages of pain medication necessary to eliminate or alleviate pain.”
Social and religious conservatives have long sought to undermine or even abolish the Oregon law, contending that any official sanction of suicide is immoral, and Mr. Ashcroft himself, a former Republican senator from Missouri, has long held that position. His action yesterday may help to mollify some conservative groups who have been frustrated that the administration has not done more to oppose abortion and who also opposed President Bush’s compromise decision this summer on allowing stem cell research.
Still, it also angered many Oregonians and others who feel physician-assisted suicide is precisely the kind of issue that should be decided at the state level. In 1994, Oregonians passionately debated and narrowly approved a measure making theirs the first state to legalize physician-assisted suicide. Two years later, amid legal challenges, the state’s voters decided to reaffirm it by 60 percent to 40 percent.
Opponents of doctor-assisted suicide passed a measure in the United States House of Representatives two years ago that would have effectively overturned the Oregon law, but it never came to a vote in the Senate. Mr. Wyden, who says he voted twice against the Oregon initiative and is opposed to physician-assisted suicide, nonetheless led the fight to block the House bill because, he said, he objected to federal interference with the will of his state’s voters.
Oregon’s attorney general, Hardy Myers, said the state would seek to block the drug agency from taking any action against Oregon doctors who prescribe the medication ”until the legality of the U.S. Department of Justice decision is resolved,” he said.
The essential question of whether the state law should trump the attorney general’s directive, or vice versa, is one that is almost certain to wind up in a court battle.
Advocates of the law, along with Oregon officials, contend that Mr. Ashcroft has grossly exceeded the terms of the federal controlled-substances law, which they say was intended to prevent illegal trafficking of drugs when it was passed three decades ago but not to interfere with states’ abilities to regulate the practice of medicine.
But opponents of physician-assisted suicide say there is ample precedent for legal action, including a Supreme Court ruling in May that said federal drug laws did not provide an exception for the medical use of marijuana even though several states had approved the use of medical marijuana through voter initiatives.
Barbara Coombs Lee, chief sponsor of the ballot measures that established the Oregon law, criticized Mr. Ashcroft yesterday for what she called his ”heavy-handed and brazen usurpation of state sovereignty” as well as his ”insult to Oregon and its government that have regulated assisted dying carefully and responsibly for four years.”
Several groups offered support for Mr. Ashcroft’s directive, including the National Right to Life Committee, whose director of medical ethics, Burke Balch, said, ”Americans overwhelmingly agree the federal government should not be facilitating euthanasia and assisting suicide with federally controlled drugs.”
Oregon’s governor, John Kitzhaber, a Democrat who earlier this year passed on a potential challenge to Senator Smith, said yesterday that there was no reason for the administration to stir the controversy at such a difficult time.
”Given everything that the country is going through right now,” Governor Kitzhaber said, ”with the country trying to respond to anthrax, why John Ashcroft picked this moment to inject this divisive issue into the public debate is just beyond me.” Autor: Sam Howe Verhovek