WASHINGTON — Advocates for terminally ill patients are breathing easier in Oregon.
That's because U.S. Attorney General John Ashcroft ruled Nov. 6 that Oregon doctors cannot end people's lives with drugs already illegal under federal law.
“I am today restoring a judgment made by the Drug Enforcement Administration that narcotics and other dangerous drugs controlled by federal law may not be legally used to assist suicide or for euthanasia in any part of our nation,” Ashcroft said.
The decision leaves Oregon's physician assisted law on the books but will render it ineffective. The new policy will become effective within weeks when it is officially recorded in the Federal Register.
However, Ashcroft's move will have to withstand a court challenge. U.S. District Judge Robert Jones in Portland granted a temporary restraining order Nov. 8 against Ashcroft's decision, at the request of Oregon Attorney General Hardy Myers, three terminally ill patients, a doctor and a pharmacist. The restraining order will remain in effect until Nov. 20, during which time hearings in the matter will be scheduled.
Bishop Joseph Fiorenza, president of the U.S. bishop's conference, applauded Ashcroft's move.
“Suicide among the sick and elderly is not a medical practice,” said Bishop Fiorenza. “It is a tragic public health problem that deserves our concern and caring response.”
Dr. Gregory Hamilton, executive director of the Portland-based Physicians for Compassionate Care, also hailed Ashcroft's decision.
“It protects innocent patients and requires Oregon doctors to treat patients the same way doctors in the other 49 states do,” Hamilton told the Register.
Oregon's physician-assisted suicide law took effect Oct. 27, 1997, after two consecutive victories in state referendums. The Portland Oregonian reported that doctors have reported 70 cases of assisted suicide since its inception.
Ashcroft's ruling reverses former Attorney General Janet Reno's 1998 interpretation of the 1968 Controlled Substances Act, allowing doctors to prescribe drugs such as barbiturates specifically to cause a patient's death.
Most Oregon officials oppose Ashcroft's decision.
Gov. John Kitzhaber called the move an “unprecedented intrusion” in Oregon's ability to regulate medicine, and Oregon Attorney General Myers launched the court action to overturn it.
Said Sen. Ron Wyden, an Oregon Democrat, “It's going to leave doctors frightened about the prospect of sanctions for aggressively treating pain.” Wyden last year stalled legislation in the U.S. Senate that would have had the same effect as Ashcroft's decision.
But not all politicians in the Beaver State are lining up in support of the assisted-suicide law.
“There's no doubt this is a political issue for some,” said Sen. Gordon Smith, a Republican. “For me, it's an issue of principle upon which I'm prepared to stake my political career.”
Smith also disagreed with Wyden's comments about pain management.
“My mother died of the most painful kind of pancreatic cancer, and her physician along with hospice kept her comfortable, at peace and without pain,” said Smith. “They did it with federal drugs and in accordance with the law.”
Assisted-suicide activists promised to go to court over Ashcroft's decision.
“Our clients would be irreparably harmed if this action were allowed to become effective,” said Barbara Coombs Lee, president of Compassion in Dying. “We will vigorously oppose this unwarranted, heavy-handed federal intrusion.”
But Hamilton of Physicians for Compassionate Care said that individual states cannot exempt themselves from federal law, especially when they try to encourage doctors to end patient's lives.
“It's not medical to kill people. It's medical to treat people,” he said.
Hamilton also predicted that Ashcroft's decision would hold up in court, citing a May case in which the U.S. Supreme Court ruled that there was no special exemption allowed under current federal law for marijuana under a law passed by California voters in 1996. “They tried the same argument with medical marijuana,” he said, “but the U.S. Supreme Court said that states don't have the right to disobey the Controlled Substances Act.”
Hamilton also noted that Ashcroft's support for the aggressive use of drugs to treat pain will likely help patients get appropriate palliative care.
“Attorney General John Ashcroft sent a letter to Physicians for Compassionate Care to reassure doctors that aggressive pain management will be protected,” Hamilton said. The attorney general sent a similar letter to the Oregon Medical Association.
Ashcroft stated, “I want the nation's doctors to know that under this decision they will have no reason to fear that prescription of controlled substances to control pain will lead to increased scrutiny by the DEA, even when high doses of painkilling drugs are necessary and even when dosages needed to control pain may increase the risk of death.”
In his 1998 ad limina address to the bishops of California, Nevada and Hawaii, Pope John Paul II spoke about the dangers of legalizing physician-assisted suicide.
Said the Pope, “The Church offers a truly vital service to the nation when she awakens public awareness to the morally objectionable nature of campaigns for the legalization of physician-assisted suicide and euthanasia. Euthanasia and suicide are grave violations of God's law; their legalization introduces a direct threat to the persons least capable of defending themselves and it proves most harmful to the democratic institutions of society.”
Joshua Mercer writes from Washington, D.C.