Death with Dignity or Criminal Act?

After other legal challenges and a failed measure in Congress to overturn the law, the current case stems from former Attorney General John Ashcroft's 2001 directive that doctors who prescribe the lethal drugs would be prosecuted under the Controlled Substances Act. An injunction was issued to prevent that, and the law was eventually upheld last year by a federal appeals court.

Strong opposition remains among critics -- including some doctors, religious groups and people with disabilities -- for what one physician says is a simple reason. "It's not what doctors do," said Dr. Kenneth Stevens, a radiation oncologist from Portland, Ore., and one of the founders of Physicians for Compassionate Care, which opposes the law. "Basically, it turns medicine upside down."

Among other concerns, Stevens said his group is particularly worried that once a patient has been given a prescription for lethal medicine there is less incentive for doctors to provide palliative care, and the law can be used as a quick fix economically. He also said depressed patients are not always given psychological consideration in their request for assisted suicide, despite provisions to prevent that from happening.

He cited the death of Michael P. Freeland, a lung cancer patient whose case was presented at a 2004 meeting of the American Psychiatric Association. According to records, Freeland, who had been hospitalized for depression, was released despite the knowledge that he possessed a prescription from his doctor for a lethal dose of medicine, which critics say he should not have received in the first place due to his mental state. He later died from lung cancer.

A representative from the state's Department of Human Services said in published reports that the law should not be negated because it relies on physicians to make determinations about whether patients are appropriate candidates for assisted suicide, and Freeland's two doctors had not voiced concerns.

But others contend the law provides peace of mind to very ill patients and their families, and that it can protect against abuse. "I think the safeguards work very well," said Dr. Peter Rasmussen, a medical oncologist specializing in hospice and palliative medicine from Salem, Ore. He is a respondent in the Gonzales case.

"Any patient who early in the process wants to end his life would be disqualified," Rasmussen said. "I and other doctors I don't think would participate in anything like that. The people who use the law are people who are close to death. It's true they probably die days or even weeks earlier than they would have, but that's often the point."

Limited Cases

A limited number of people have actually used the Death with Dignity law to end their lives. According to a report released in March by Oregon's Department of Human Services, about one of every 800 deaths in Oregon last year resulted from physician-assisted suicide, and 208 people had used the law overall through the end of last year.

Oregon residents 18 or older with terminal illnesses must voluntarily request physician-assisted suicide. The person must state his intentions -- once in writing and twice verbally -- and must be determined to be fully competent and certified by two physicians to have six months or less to live. He or she also must be made aware of other treatment options.

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