Death With Dignity Before the Court

Chief Justice Roberts was immediately thrust into presiding over a highly controversial case today. The ability of doctors in Oregon to legally prescribe lethal doses of medication to terminally ill patients is being challenged by the U.S. Attorney General's office. In his very last day in office, Attorney General Ashcroft drew my ire by ruling that under the Controlled Substances Act, doctors' licenses to prescribe drugs could be revoked if they prescribed lethal doses for terminally ill patients meeting the qualifications of Oregon's Assisted Suicide Law, approved twice by Oregon voters, most recently by a wide margin.

The case is controversial, but it boggles my mind why it should be. Common decency and compassion dictate that patients enduring great pain, or facing terminal conditions should be able to obtain prescriptions making it possible for them to painlessly hasten their own passing. Assuming that we get past the current push toward theocracy in our country, one can easily imagine a day when people of the future will look back on this case as we currently look back on the Dred Scott decision. They (hopefully) will shake their heads in amazement and ask "You mean back then you could only get those prescriptions in Oregon?!"

Early indications are that Roberts is leaning toward ruling for the Attorney General's office. Supreme Court scholar, Jan Crawford Greenberg was quoted tonight on PBS' Newshour:

Chief Justice Roberts asked lawyers on both sides of this issue very aggressive questions; he saved most of his aggressive questions for the lawyer for the state of Oregon who was defending Oregon's law.

Souter, O'Connor, and Ginsberg were clearly more aggressive in questioning DOJ lawyer Paul Clement. But O'Connor may not get to rule in this case if her replacement is confirmed before a decision has been written, and previous precedent has been that such decisions are deferred in cases where the retiring justice would render a deciding vote.

Onlookers are split in reading how the court is likely to rule on this one, with Greenberg calling it too close to say, death with dignity activists Compassion & Choices writing "the Court is unlikely to uphold the Ashcroft Directive", and SCOTUSblog seeming to lean toward believing the feds will prevail. The calculus is that Souter, Ginsberg, and O'Connor will likely be joined by Stevens and/or Breyer, while Kennedy is more likely to join Thomas, Scalia, and Roberts in upholding the Attorney General's strictures against these prescriptions. Precedent would then hold the decision up until Miers joined the court, where immediately we would have a test of whether Bush has succeeded in tilting the court toward a ruling for the religious right. Perhaps Thomas or one of the conservatives could surprise us by allowing states' rights considerations to trump their cultural conservatism.

Compassion & Choices provides a full set of links at their summary page which goes on to say

The Justices appear reluctant to read the Controlled Substances so broadly. Several Justices repeatedly asked how Congress had empowered the Attorney General to preempt Oregon's law. With no sufficient answer, it seems clear the Attorney General exceeded his authority.

While I appreciate concerns for abuse of any death with dignity law, the Oregon law has multiple safeguards, and the history of its application bears out that it has not been abused, with those taking advantage of its provisions being exactly the sort of cases for whom it was designed. Concerns that it might be applied disproportionately among the poor or those whose primary motivation is to not be a burden on their families have not been borne out. It has also provided great comfort to many who know they have the means to choose for themselves when enough is enough.

In my view, concern for the patient should trump all other considerations in determining medical care. When the patient cannot be made comfortable and is expected to die within six months, it strikes me as the height of audacity and hypocrisy for anyone else to shake their finger at the sufferer and tell them they have no right to hasten their own death. If an animal is suffering we consider it an act of kindness to put them out of their misery. How much clearer it is in the case of a human being who can cogently express their desire to hasten their death, to allow them a dignified and painless method of doing so.

Doctors opposing this law point to their oath "to do no harm." If they cannot save the patient or alleviate their suffering, then they ARE doing harm by denying the patient a painless way out.