Death with Dignity or Criminal Act?

Doctors must report all prescriptions for the medications to the Department of Human Services. They and their patients are protected from prosecution, and the decision does not affect patients' health or life insurance policies. Doctors can prescribe the drugs but cannot administer them.

According to the report, 37 people in 2004 ingested medications prescribed under provisions of the law -- five fewer than in 2003, though the numbers have increased since legalization.

In addition, the report found that 40 physicians wrote a total of 60 prescriptions for lethal doses last year, the first decrease in the annual total of prescriptions written under the law. Thirty-five of the prescription recipients died after ingesting the medication, and of the 25 who did not ingest it, 13 died from their illnesses and 12 were alive at the end of the year. The other two people who died had received prescriptions in 2003.

Rasmussen said "a small number of people" ask him about assisted suicide -- 150 of his patients have seriously inquired over the years, and he estimates more than a dozen have carried out their suicides.

Arguments Center on Legal Issues, Not Moral

The question before the court is whether the attorney general has "permissibly construed" the Controlled Substances Act and its regulations to prohibit the distribution of federally controlled substances to facilitate an individual's suicide, regardless of the state law allowing it.

As opening arguments begin today, people on both sides said much is at stake, beyond just the ethics of the law.

Eli D. Stutsman, a Portland lawyer representing the physician and pharmacist in the case, said Attorney General Alberto Gonzales does not have the right under the Controlled Substances Act to criminally prosecute doctors because, unlike in medical marijuana cases, the drugs are not federally banned outright, though they are controlled.

"In Oregon, we're not using illegal substances," Stutsman said. "We're using lawful substances, and what he's doing is disagreeing with the practice of medicine."

The barbiturates prescribed for assisted suicide are considered "Schedule II" drugs under the Controlled Substances Act, which recognizes that they have accepted medical use but requires that their distribution be closely monitored by the Drug Enforcement Administration due to their high potential for abuse.

Stutsman said the attorney general's office has no history of opposing the use of these drugs. "In all other cases, the attorney general is regulating drugs because of the nature of the drug itself," he said.

But Greg Lynch, a lawyer from Bend, Ore., who wrote briefs on behalf of Physicians for Compassionate Care, said the attorney general's position is correct.

"The physician has always been seen as a healer," Lynch said, "so the attorney general said that that is not a legitimate medical purpose."

Lynch also opposes the law's provision that doctors can prescribe the medication if they are acting in "good faith," arguing that assisted suicide does not fall under the acceptable standards of care. Good faith is subjective, he said, and the provision exempts them from being prosecuted, sued or censured, which goes against medical standards.

"Good faith is a term unknown in a medical sense," he said.

'The American Way'

Supporters of physician-assisted suicide say allowing the prosecution of doctors would open a door for further government involvement in the practice of medicine.

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