LATEST SHOWDOWN OVER ASSISTED SUICIDE

US Supreme Court Is Likely To Be Asked To Settle Dispute Between Bush
Administration And Oregon Over State's 'right To Die' Law.

Four years ago, Oregon began a social and medical experiment with profound
ethical implications: allowing physicians to help people end their lives.
Now, the Bush administration has chosen the state, with its unique suicide
law, as a place to shore up its conservative wing by asserting its
"pro-life" political credentials.

Leading the effort is Attorney General John Ashcroft, an opponent of
abortion and legalized suicide since his days as a US senator. Last week,
Mr. Ashcroft ruled that under the federal Controlled Substances Act,
doctors may not prescribe drugs for the purpose of hastening death. A
federal judge immediately placed a temporary restraining order on Justice
Department enforcement of Ashcroft's ruling, and the case is likely headed
for the US Supreme Court.

The issue is complicated, as a series of legislative debates, ballot
measures, and court cases around the country in recent years have shown. It
involves medical ethics, federal drug law, questions of privacy, and the
balance of legal and political power between states and the federal government.

Oregon's Death with Dignity Act became law in 1997, after voters twice had
approved it at the polls by wide margins. It applies only to mentally
competent adults who declare their intentions in writing, are diagnosed as
terminally ill, and take the prescribed drug themselves orally after a
waiting period. Oregon's law specifically prohibits "lethal injection,
mercy killing, or active euthanasia."

How Oregon's law has played out

Critics had predicted that vulnerable patients could be pressured by
doctors or family members to end their lives, and also warned that
out-of-staters might rush to Oregon to take advantage of its law.

Apparently, neither has happened. On average, roughly 20 people a year
chose to end their lives under the law.

At the same time, what medical practitioners consider ideal end-of-life
care has increased here, including palliative treatment for discomfort,
hospice care (twice the national average), and care that allows patients to
spend their last days at home with families and friends.

"Oregon's aid-in-dying law is working as intended," says Barbara Coombs
Lee, president of the Compassion in Dying Federation, the assisted-suicide
law's main advocacy group. "Very few people use medication to hasten their
death, yet thousands obtain comfort knowing the choice is theirs if they
experience intolerable suffering."

A federal or state issue?

But for others, Oregon's law is as abhorrent as laws that allow abortion.

"The idea of assisted suicide is a poison pill that kills the dignity of a
precious human life," says Ken Cooper, president of the Family Research
Council in Washington, the conservative organization once headed by
Republican presidential candidate Gary Bauer. "It invalidates the concept
that once a person becomes unproductive, or is a burden on society, he
loses his value and is unworthy of living."

The basis for the Ashcroft ruling is that federal law involving drugs
supercedes state laws regulating medical practice. It's the same reasoning
behind the Justice Department's recent crackdown on facilities in
California and other states that allow the provision of marijuana for
medical purposes.

"There are important medical, ethical, and legal distinctions between
intentionally causing a patient's death and providing sufficient dosages of
pain medication necessary to eliminate or alleviate pain," Ashcroft
declared in his directive to federal Drug Enforcement Administrator Asa
Hutchinson. "I hereby determine that assisting suicide is not a 'legitimate
medical purpose' under [federal law] and that prescribing, dispensing, or
administering federally-controlled substances to assist suicide violates
the Controlled Substances Act."

The United States Conference of Catholic Bishops, antiabortion groups, and
other conservative organizations hailed the attorney general's ruling.

Others see it as an unwarranted interference with a state law. Oregon Gov.
John Kitzhaber (who is also a medical doctor) called it an "unprecedented
intrusion" on the state's medical practices laws. Some critics suggest that
Ashcroft's move could cause a "chilling effect" on doctors who prescribe
pain-relieving drugs to patients diagnosed as terminally ill (since the
same drugs in larger doses can cause death), thereby increasing suffering
among such patients.

In previous cases, the US Supreme Court has ruled that assisted suicide is
not a constitutional right. But the high court also did not declare the
practice to be illegal, in essence inviting the states to grapple with the
issue. Or, as Associate Justice Sandra Day O'Connor wrote: "There is no
reason to think the democratic process will not strike the proper balance."

That would seem to suggest that Oregon was on the right track in following
the wishes of most Oregonians as expressed at the polls.

But the Supreme Court also ruled unanimously in a case earlier this year
that California's medical marijuana act violates the Controlled Substances Act.

One important question now is, should barbiturates and morphine (the legal
drugs typically used in physician-assisted suicide) be seen in the same
light as marijuana, which is an illegal drug?

Advocates of physician-assisted suicide say "no." Attorney General Ashcroft
says "yes."