Assisted suicide ruling may not have wide impact

Published: Wednesday, January 18, 2006 at 6:01 a.m.
Last Modified: Wednesday, January 18, 2006 at 12:00 a.m.
PORTLAND, Ore. - Just 30 terminally ill people exercise a right each year that is unique to the small state of Oregon, hastening their deaths with a lethal dose of drugs prescribed by doctors. The U.S. Supreme Court's decision on Tuesday rejecting the Justice Department's effort to block the state's Death with Dignity Act will allow such suicides to continue, but it may not have the broad impact people on both sides of the debate are predicting.
There is no reason to think that the pace of physician-assisted suicides will quicken in Oregon. And the decision lends little support, one way or the other, to the efforts in state legislatures around the country that have stalled for more than a decade since the Oregon law was enacted in 1994.
The Supreme Court's ruling was, in fact, notably focused and technical. It did not address whether there is a constitutional right to die. It did not say that Congress was powerless to override state laws that allow doctors to help their patients end their lives.
It said only that a particular federal law, the Controlled Substances Act, which is mainly concerned with drug abuse and illegal drug trafficking, had not given John Ashcroft, then the attorney general, the authority to punish Oregon doctors who complied with requests under the state's law. The law allows mentally competent patients who are terminally ill to ask their doctors for lethal drugs.
"What the court decision means is simply that you won't have federal agents trying to put an end to this in the state of Oregon," said Dr. Timothy E. Quill, a professor of medicine and psychiatry at the University of Rochester, who is a prominent supporter of physician-assisted suicide. "We were very fearful of what might have happened had the ruling gone the other way."
Here in Oregon, the issue was initially contentious, passed by a bare margin in 1994. But the more that people outside the state criticized the law, the more support it gained here. When it came up for a second referendum in 1997, it was upheld by a 60-40 voter margin.
"I would not expect to see an increase in doctor-assisted suicides here," said Mary Williams, Oregon's solicitor general. "But I do expect more states will at least have discussion now."
But states have been free to pass such laws, and they have not followed Oregon's example in the dozen years the Death with Dignity Act has been on the books. Ashcroft did not issue his interpretation of the Controlled Substances Act until 2001, and it was soon enjoined. The federal government lost in the courts every step of the way.
Still, Tuesday's decision may prompt lawmakers in some states to give the matter a fresh look. "This decision gives the green light to the rest of the nation to move forward with assisted-suicide laws," said Mathew D. Staver, the president of Liberty Counsel, which filed a brief supporting the federal government in the Oregon case. "This particular case was either going to close the door or to open it, and it opened it."
In the handful of states where a similar measure had been under consideration, supporters of assisted suicide said they hoped the court decision would give their fledgling efforts a boost.
"This will be a tremendous momentum builder for Vermont and other states who want to bring compassionate care to end-of-life issues," said Dr. David Babbott, a member of the board of Death With Dignity Vermont.
Lloyd E. Levine, a Democratic assemblyman in California who is a sponsor of a California bill that largely tracks the Oregon law, said he was hopeful that Tuesday's decision would help propel it into law this year.
Opponents of assisted suicide said that Tuesday's decision was a narrow and technical one that did not endorse any particular approach to these issues but rather freed the states from one potential impediment to enacting whatever laws voters considered appropriate.
"I don't think its impact will be great," Dr. Robert D. Orr, the president of the Vermont Alliance for Ethical Healthcare, said of the decision. "Some have misunderstood the Oregon case as a challenge to the Oregon statute itself."
The Oregon law was initially held up by an injunction, and not fully put into effect until 1998. Since then, through 2004, a total of 208 people have taken their lives by lethal injection from a physician-prescribed drug, usually a barbiturate. Critics had predicted that Oregon would become a suicide center, with people flying in to end their lives. They also predicted that the law would be unfairly used against uneducated people or those without health insurance or adequate medical choices.

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