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9TH CIRCUIT DECISION — a panel of the 9th Circuit Court of Appeals [26May] struck down Attorney General John Ashcroft’s directive that doctors in OR may not misuse federally controlled drugs to assist suicides. The Ashcroft directive had reversed a Clinton Administration decision to allow Oregon doctors to ignore federal law and prescribe lethal doses of federally controlled substances. The decision in the case of Oregon v. Ashcroft will likely be appealed to the Supreme Court. “Suicide among the elderly and those suffering from serious illness or disability is not a ‘medical practice’ but a tragic public health problem deserving a thoughtful, caring response,” said Cathy Cleaver Ruse, Esq. “The 9th Circuit has just told these patients that their lives are expendable.” The Ashcroft directive restores the uniform enforcement of the longstanding federal Controlled Substances Act, and also clarifies that aggressive pain management is legitimate medical care even where it unintentionally increases the likelihood of a patient’s death. “This is not about an attempt by the Attorney General to control Oregon law,” the spokeswoman said. “Rather, it’s about whether Oregon should be able to ignore federal law and at the same time co-opt the federal government into facilitating assisted suicides by providing federal prescribing licenses and federally controlled drugs.” [26May;27May04, N.Valko RN] Wesley Smith notes: the Ninth Circuit Court of Appeals did not “uphold” the assisted-suicide law in Oregon by a vote of 2-1 in Oregon v. Ashcroft yesterday. The validity of the Oregon law was never at stake in the case. The case is actually very narrow and arcane…The question before the court was whether Ashcroft exceeded his legal authority when, in 2001, he interpreted the federal Controlled Substances Act (CSA) as prohibiting doctors from prescribing federally regulated drugs for use in assisted suicide on the basis that hastening death is not a “legitimate medical purpose” for the use of drugs under federal law. Even though the scope of decision itself was quite narrow, its impact could be disturbingly broad. If federal law is not nullified by a state declaring it a legitimate medical act for a physician to recommend cannabis to patients to palliate pain, how can the federal government be prohibited from enforcing the CSA against doctors who use controlled substances to intentionally kill patients? Of greater concern is that the majority’s decision threatens the uniform enforcement of the CSA throughout the nation. Under the ruling, the states in effect have the power to determine what constitutes legitimate medical uses of controlled substances under federal law as part of their power to regulate the practice of medicine within their borders. [, 29May04, #3271]