Oregon's assisted suicide
I was asked by one of our fellow bloggers to comment on “assisted suicide”. Since this topic is extremely complex and challenging in many ways, I decided to blog on the topic over a few days.
To begin, we’ll give a little history on the legislation affecting us in the United States. Other countries have varying degrees of acceptance and their own legislation.
Oregon’s Death with Dignity Act was originally enacted in 1994 and was the U.S.'s first law authorizing physician assisted suicide. It allows physicians to prescribe lethal doses of controlled substances to terminally ill residents for the sole purpose of terminating life. This law established certain procedures to help protect vulnerable patients and ensure that their decisions were voluntary and informed. Oregon voters reaffirmed their support for the Death with Dignity Act on November 4, 1997, by defeating a ballot measure that sought to repeal the law.
Shortly after Oregon passed this law, several Congressmen, including then Senator John Ashcroft, urged then Attorney General Janet Reno to declare that physician assisted suicide violated the federal Controlled Substances Act (CSA). She declined to do so. On November 9, 2001 when John Ashcroft was appointed Attorney General, he reversed the position of his predecessor and issued the “Ashcroft Directive,” declaring that physician assisted suicide serves no "legitimate medical purpose" under DEA regulations. This directive made it unlawful for a physician to prescribe medications for assisted suicide and for a pharmacist to knowingly dispense medications for that purpose.
The Ashcroft Directive brought about a lawsuit from a doctor, a pharmacist, several terminally ill patients, and the state of Oregon. They contended that the “Federal” directive criminalized conduct that was specifically authorized under Oregon State law. The case was originally filed in federal district court, where the judge issued a ruling in favor of the state of Oregon and later the case was transferred to the Ninth Circuit Court of Appeals.
The sole issue considered by the court was whether Congress had authorized the Attorney General to determine that physician assisted suicide violates the Controlled Substances Act (CSA) The appellate court took no position on the merits or morality of physician assisted suicide. The CSA expressly limits federal authority under the act to the "field of drug abuse." The court said: "To the limited extent that the CSA does authorize federal regulation of medical practice, Congress carefully circumscribed the Attorney General's role. The Attorney General may not define the scope of legitimate medical practice."
The court held that the Ashcroft Directive violated the "clear statement" rule, contradicted the plain language of the CSA, and contravened the express intent of Congress and it was basically struck down.
According to congressional testimony, all decisions of a medical nature, if made by a federal agency at all, are to be made by the Secretary of Health and Human Services (HHS). Law enforcement decisions made by the Attorney General are limited to those related to "the security of stocks of narcotic drugs and the maintenance of records on such drugs."
In summary, the court said: “The Attorney General's unilateral attempt to regulate general medical practices historically entrusted to state lawmakers interferes with the democratic debate about physician assisted suicide and far exceeds the scope of his authority under federal law."
Oregon is left to continue its’ State authorized assisted suicide!!
More to follow in the next few days.
To begin, we’ll give a little history on the legislation affecting us in the United States. Other countries have varying degrees of acceptance and their own legislation.
Oregon’s Death with Dignity Act was originally enacted in 1994 and was the U.S.'s first law authorizing physician assisted suicide. It allows physicians to prescribe lethal doses of controlled substances to terminally ill residents for the sole purpose of terminating life. This law established certain procedures to help protect vulnerable patients and ensure that their decisions were voluntary and informed. Oregon voters reaffirmed their support for the Death with Dignity Act on November 4, 1997, by defeating a ballot measure that sought to repeal the law.
Shortly after Oregon passed this law, several Congressmen, including then Senator John Ashcroft, urged then Attorney General Janet Reno to declare that physician assisted suicide violated the federal Controlled Substances Act (CSA). She declined to do so. On November 9, 2001 when John Ashcroft was appointed Attorney General, he reversed the position of his predecessor and issued the “Ashcroft Directive,” declaring that physician assisted suicide serves no "legitimate medical purpose" under DEA regulations. This directive made it unlawful for a physician to prescribe medications for assisted suicide and for a pharmacist to knowingly dispense medications for that purpose.
The Ashcroft Directive brought about a lawsuit from a doctor, a pharmacist, several terminally ill patients, and the state of Oregon. They contended that the “Federal” directive criminalized conduct that was specifically authorized under Oregon State law. The case was originally filed in federal district court, where the judge issued a ruling in favor of the state of Oregon and later the case was transferred to the Ninth Circuit Court of Appeals.
The sole issue considered by the court was whether Congress had authorized the Attorney General to determine that physician assisted suicide violates the Controlled Substances Act (CSA) The appellate court took no position on the merits or morality of physician assisted suicide. The CSA expressly limits federal authority under the act to the "field of drug abuse." The court said: "To the limited extent that the CSA does authorize federal regulation of medical practice, Congress carefully circumscribed the Attorney General's role. The Attorney General may not define the scope of legitimate medical practice."
The court held that the Ashcroft Directive violated the "clear statement" rule, contradicted the plain language of the CSA, and contravened the express intent of Congress and it was basically struck down.
According to congressional testimony, all decisions of a medical nature, if made by a federal agency at all, are to be made by the Secretary of Health and Human Services (HHS). Law enforcement decisions made by the Attorney General are limited to those related to "the security of stocks of narcotic drugs and the maintenance of records on such drugs."
In summary, the court said: “The Attorney General's unilateral attempt to regulate general medical practices historically entrusted to state lawmakers interferes with the democratic debate about physician assisted suicide and far exceeds the scope of his authority under federal law."
Oregon is left to continue its’ State authorized assisted suicide!!
More to follow in the next few days.
posted by Anonymous at 6:00 AM
4 Comments:
Most won't care but I was the one who asked HB to do this topic. I thought he could bring a somewhat unique perspective due to his medical training and his theological beliefs. So if you don't like the topic, blame me not HB.
Nice groundwork HB.
My first comment is why is the U.S. attorney general doing messing in the states business anyway. The Republican touts itself as being the party of decentralized government, but this appears only to be the case when the states dont agree with the Republican viewpoint. Another example is the medical marijuana laws passed in several states.
As we health professionals know, there is assisted suicide going on in every hospital every day, lets face it. The only difference is in the manner it is carried out, passively versus actively.
There is primarily a difference in definitions. I do not believe that assisted suicide occurs frequently.
Assisted suicide, terminal sedation, and withholding care are all different even though they may have the same result.
The primary difference in a legal and moral sense is "intent".
The intent in each of these types of medical practice is different and therefore morally and legally separate.
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