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Oregon Stands Alone on Assisted Suicide

RENEE MONTAGNE, host:

This is Morning Edition from NPR News, I'm Renee Montagne.

STEVE INSKEEP, host:

And I'm Steve Inskeep. The U.S. Supreme Court has upheld Oregon's law permitting physician-assisted suicides. The court let the law stand by a vote of six to three. It allows doctors to prescribe lethal doses of narcotics to terminally ill patients who want to end their lives. It's the only law of its kind in the country.

NPR Legal Affairs Correspondent Nina Totenberg reports.

NINA TOTENBERG reporting:

The battle over the Oregon law is the latest in a long struggle over the so-called right to die. In 1997, the Supreme Court ruled there is no constitutional right to die, but at the same time, the Court seemed to suggest that the practice could be legalized by state legislatures. When Oregon voters twice approved an assisted suicide law, though, the Bush administration took the state to court, contending that the state law violated the federal drug control law.

The Oregon law allows doctors to prescribe lethal narcotics to Oregon residents who've been certified by two physicians as psychologically unimpaired and having six months or less to live. In the first seven years of the law's existence, a total of 208 people used doctor-prescribed medications to end their lives, according to statistics maintained by the state.

More than the 208 actually got the prescriptions but never used them, relying on the prescriptions for, as they put it, comfort. One of those was 59-year-old Jack Newbold(ph) who had bone cancer and spoke in favor of the law before his death.

Mr. JACK NEWBOLD (Cancer patient): It's one of the most intimate moments in anybody's life, is birth and death, obviously. And I don't see where the federal government has a right to meddle in that affair, especially in light of the fact that the people of the state of Oregon have voted twice now, overwhelmingly, to allow a hastened death, as they call it.

TOTENBERG: The Bush administration contended that it's illegal for the state to authorize the use of narcotics to end a terminally ill person's life because the federal drug law only permits the use of such drugs for professional practice. And, so the argument goes, professional practice does not include the use of drugs to hasten death. Assisted suicide, the administration argued, is not a legitimate medical use of a drug.

The attorney general's interpretation of the law, shortly after the Bush administration took office, reversed a different ruling by the Clinton administration, which had concluded that the federal drug control law was never meant to deal with the question of assisted suicide. The Bush administration's new interpretation came from then Attorney General John Ashcroft and was strongly backed by right to life advocates like James Bopp.

Mr. JAMES BOPP (Attorney): How can one say that Congress allowed use of controlled substances to kill patients, because they never contemplated the absolutely absurd proposition that any state would authorize doctors to actively kill patients rather than treat them.

TOTENBERG: Yesterday though, the Supreme Court, by a six-to-three vote, ruled against the administration and in favor of the Oregon law. Writing for the court majority, Justice Anthony Kennedy said that the authority claimed by the Attorney General in this case is both beyond his law enforcement expertise and beyond the design and intent of the federal law.

That law was aimed, the court said, only at preventing drug trafficking and drug abuse. "Indeed," said Justice Kennedy, "the federal drug control law pre-supposes that states will control the practice of medicine within their own borders. Thus, Oregon was within its rights to enact a physician-assisted suicide law."

Dissenting from the ruling were Justices Scalia, Thomas and Chief Justice Roberts. Oregon officials and those in the so-called death with dignity movement were elated by the court's ruling. But it seems unlikely that the Oregon law will be replicated in any other state any time soon.

Dr. Howard Brody, of Michigan State University, is the former chairman of his state's Death and Dying Commission.

Dr. HOWARD BRODY (Former Chairman, Death and Dying Commission, Michigan): Oregon has really, for many years now, been on its own and most efforts in most other states, including an effort to put it on the ballot in Michigan nearly 10 years ago now, have essentially fizzled.

Dr. DIANE MEIER (Director, Center to Advance Palliative Care, Mount Sinai): In a way, I think the movement promoting legalization of physician-assisted suicide had a very happy silver lining.

TOTENBERG: Dr. Diane Meier is director of the Center to Advance Palliative Care at Mount Sinai School of Medicine in New York. She says the drive to enact assisted suicide laws in the 1990s was a wakeup call to the medical profession that terminally ill patients were not willing to die painful and agonized deaths. As a result, both the profession and the states began working to increase training for doctors, so that they could provide better palliative care, care to ease pain and suffering particularly in dying patients.

Dr. MEIER: There is less of a perceived need, I hope, on the part of the public and on the part of patients and their families, for being able to take control of the situation and hasten one's own death because the fear of uncontrolled suffering has lessened.

TOTENBERG: The Bush administration's action in the Oregon case, however, inspired great consternation in the medical profession where many saw it as allowing the federal bureaucracy to second guess on-the-ground medical judgments, and so yesterday's ruling provoked a big sigh of relief, even among those doctors opposed to doctor assisted suicide. Nina Totenberg, NPR News, Washington. Transcript provided by NPR, Copyright NPR.

Nina Totenberg is NPR's award-winning legal affairs correspondent. Her reports air regularly on NPR's critically acclaimed newsmagazines All Things Considered, Morning Edition, and Weekend Edition.