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News of the Day ... In Perspective

01/20/2006

Supreme Court limits federal interference in medical decisionmaking

In upholding the Oregon physician-assisted suicide law in a 6-to-3 decision, Justice Anthony Kennedy wrote for the majority of the Supreme Court:

“The structure and operation of the [Controlled Substances Act] presume and rely upon a functioning medical profession regulated under the States' police powers.… The Government, in the end, maintains that the prescription requirement delegates to a single Executive officer the power to effect a radical shift of authority from the States to the Federal Government to define general standards of medical practice in every locality. The text and structure of the CSA show that Congress did not have this far-reaching intent to alter the federal-state balance and the congressional role in maintaining it.”

Kennedy wrote that the federal government does have the authority to prosecute drug dealers and pass rules for health and safety. The Oregon statute, however, was limited in scope to terminally ill patients. U.S. Attorney General Ashcroft claimed authority that was “both beyond his expertise and incongruous with the statutory purpose and design.”

In his dissent, Justice Antonin Scalia wrote that federal officials did have the right to regulate prescriptions. “If the term ‘legitimate medical purpose’ has any meaning, it surely excludes the prescription of drugs to cause death.”

Justice Thomas, also dissenting, said that the decision was inconsistent with a 2004 ruling that drug laws could be used to regulate medical marijuana.

Chief Justice Roberts did not explain how his dissent comported with a 1997 court ruling that said states should determine how to handle end-of-life issues (Stephen Henderson, Knight-Ridder newspapers, 1/17/06).

Those who are concerned about overzealous prosecution of physicians who prescribe opioids for pain relief believe that this ruling may help to rein in overly aggressive U.S. Attorneys.

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