By Dan Eggen and Ceci Connolly (Washington Post Staff Writers)
Attorney General John D. Ashcroft effectively blocked Oregon’s landmark assisted-suicide law yesterday, authorizing federal drug agents to identify and punish doctors who prescribe federally controlled drugs to help terminally ill patients die.
In a memorandum to Drug Enforcement Administration chief Asa Hutchinson, Ashcroft wrote that assisting in a suicide is not a “legitimate medical purpose” under federal law. He said DEA agents should seek to revoke the drug licenses of Oregon physicians who help patients commit suicide.
The opinion reverses a 1998 administrative decision by former attorney general Janet Reno and effectively bars Oregon physicians from legally prescribing narcotics to help patients commit suicide under the state’s Death With Dignity Act, according to Oregon officials and medical experts. All 70 people known to have died under the law took federally controlled drugs such as the barbiturate secobarbitol, state officials said.
Although Ashcroft’s decision appears to leave open the possibility of using less powerful drugs not regulated by the DEA, Oregon officials and medical experts said the risk of harm to patients and difficulties for physicians would be too high. Other states that enact assisted-suicide laws would face the same restrictions, officials said.
Ashcroft’s letter does not call for criminal prosecution of physicians. But some predicted the decision would make doctors more hesitant to prescribe powerful painkillers that could be used to commit suicide.
The assisted-suicide order is the latest social policy decision by Ashcroft likely to please conservatives. The attorney general raised the ire of gun control groups by adopting a view of the Second Amendment advocated by the National Rifle Association, and has indicated a willingness to settle the federal government’s landmark lawsuit against the tobacco industry.
Kevin Neely, a spokesman for Oregon Attorney General Hardy Myers (D), said the state would seek a court injunction today to prevent the DEA from acting on Ashcroft’s decision.
Sen. Ron Wyden (D-Ore.), who personally opposed the assisted-suicide law but has led efforts to block Congress from overruling it, said the opinion undermines the will of Oregon voters. They approved assisted suicide in 1994 and 1997 referenda.
“I guess the Bush administration is frustrated by the inconvenience of the democratic process,” Wyden said. “They have administratively tossed the ballots of Oregon’s voters in the trash.” No other state has a law allowing assisted suicide.
But Sen. Gordon Smith (R-Ore.) hailed the decision as a triumph of principle over politics. A broad alliance of religious, medical and social groups that oppose Oregon’s law said the order was a sensible way to halt what they consider a violation ofa physician’s ethical code.
The influential American Medical Association also supported the move, although with misgivings.
Burke Balch, medical ethics director of the National Right to Life Committee, said drugs “should be used to cure and to relieve pain, not to kill.”
The ruling “is a carefully crafted one that, at one and the same time, ensures that patients will get adequate pain relief while preventing facilitating their killing with federally controlled drugs,” Balch said.
Ashcroft based his decision on a unanimous ruling by the Supreme Court in May that said federal drug laws do not allow for the medical use of marijuana to ease pain from AIDS, cancer and other diseases.
The court did not overturn state laws allowing patients to use marijuana for medical reasons, but made the drug more difficult to obtain by denying patients the right to claim “medical necessity” as a reason to ignore federal statutes.
In a separate 1997 decision, a unanimous Supreme Court ruled that the Constitution does not guarantee Americans the right to commit suicide with the help of a physician, leaving the issue to state legislatures to decide. The ruling upheld laws in New York and Washington states that made it a crime for doctors to give lethal drugs to dying patients.
The high court also refused in 1997 to hear a challenge to Oregon’s assisted-suicide law.
Under Oregon’s Death With Dignity Act, physicians may provide, but not administer, a lethal prescription to terminally ill adults who are Oregon residents. The legislation requires that two physicians agree that the patient has less than six months to live, has voluntarily chosen to die and is able to make health-related decisions.
Former DEA chief Thomas Constantine determined in 1997 that doctors could not prescribe deadly doses of drugs, including narcotics such as morphine, covered by the 1970 Controlled Substances Act. But Reno overruled Constantine in 1998, saying that the federal statute was never meant to regulate medical practices.
Ashcroft, an ardent abortion foe who was then a U.S. senator from Missouri, complained that Reno was “bending the rules” in issuing her administrative decision.
At least 70 terminally ill people have ended their lives since the law took effect, and at least 26 others have received prescriptions for lethal doses of drugs under the program, according to Oregon health officials.
Scott Swenson, executive director of Oregon Death With Dignity, predicted that the Justice Department decision would make doctors, both in Oregon and elsewhere, less willing to prescribe sufficiently strong pain medicines for people with cancer and other chronic diseases.
“It is going to have a chilling effect on doctors, pharmacists, hospices and anyone else concerned with pain care and palliative care across the country,” he said.
Yank D. Coble Jr., incoming president of the AMA, which has long opposed physician-assisted suicide, said the group shares those concerns.
But Hutchinson sought to ease such fears yesterday, saying that the DEA “fully supports the use of appropriate medications” to help alleviate pain.
Staff writer Susan Okie contributed to this report.