Using "States' Rights" to Do Wrong

by Richard M. Doerflinger

October 7, 2005

The U.S. Supreme Court is taking up issues of life and death again, this time in the context of physician-assisted suicide.

Led by new Chief Justice John Roberts, the Court heard oral arguments October 5 in Gonzales v. Oregon. The case involves a 2001 directive by U.S. Attorney General John Ashcroft, saying that deliberately prescribing lethal overdoses for patients who want to commit suicide is not a "legitimate medical purpose" for federally controlled drugs under the Controlled Substances Act. The State of Oregon, with the nation's only law allowing physician-assisted suicide for the terminally ill, has sued against this directive. All of Oregon's reported assisted suicides have used federally controlled drugs (barbiturates).

The Ashcroft directive replaces a 1998 determination by U.S. Attorney General Janet Reno that had been more pleasing to euthanasia advocates. She ruled that by rescinding its own penalties for assisting the suicides of certain patients, Oregon had effectively succeeded in unilaterally amending federal drug laws as well, establishing assisted suicide as a "legitimate medical practice" within Oregon's borders.

But nothing in the federal Controlled Substances Act (CSA) indicates that an individual state, by dropping its own state penalties for a form of manslaughter, can convert such killing into "legitimate" medicine in the eyes of the federal government. In fact, provisions to ensure that narcotics and other dangerous drugs are used solely for a "legitimate medical purpose" and are never used to endanger "public health and safety" were incorporated into the federal Act and its implementing regulations precisely to establish a uniform federal standard that would not rely on the vagaries of individual state laws. A clear purpose of such provisions was to prevent the use of federally regulated drugs for lethal overdoses, not only their use for addiction.

Obviously, using drugs to cause people's deaths is an even greater threat to health and safety than using them to feed addiction. Over the years, a number of physicians have had their federal prescribing privileges revoked by the Drug Enforcement Administration precisely because they gave controlled substances to patients who used them to commit suicide. Even a negligent failure to prevent use of such drugs for suicide has been seen as a threat to patients' health and safety, whether or not the physician violated state laws or state medical licensing standards. Especially since the CSA was strengthened by Congress in 1984, "state licensure is a necessary but not sufficient condition for DEA registration" (63 Fed. Reg. 8479 [Feb. 19, 1998]).

The Ashcroft directive reaffirms a longstanding and consistent federal policy that all persons, including the terminally ill, deserve protection from the lethal misuse of potentially dangerous drugs. No state should unilaterally amend the federal law to say otherwise, so that vulnerable terminally ill patients are dismissed as having less valuable lives than others. The fundamental moral issue is not so much "states' rights," or federal power, as it is every human person's right to be treated as having inalienable and incalculable worth.

Mr. Doerflinger is Deputy Director of the Secretariat for Pro-Life Activities, U.S. Conference of Catholic Bishops.