04:33 PM PDT on Tuesday, October 4, 2005

By CHARLES E. BEGGS, Associated Press Writer

WASHINGTON, D.C. -- One of the first tests of newly appointed U.S. Supreme Court Chief Justice John Roberts comes Wednesday when the state of Oregon defends its landmark assisted suicide law, in a key test of where states' rights end, and the federal government's reach begins.

kgw.com Photo

Lawyers in Oregon have vigorously defended the state's physician assisted suicide law. They speak to reporters in this file photo after a hearing in federal court on Oregon's "Death with Dignity" law.

The Bush administration has argued that assisted suicide is not a legitimate use of controlled substances, and the Oregon law therefore violates federal drug laws.

But the state of Oregon contends that regulation of medical practices -- including assisted suicide -- is a state matter.

An adverse ruling wouldn't sweep Oregon's law off the books. But assisted suicide advocates say the impact would be to end the practice because doctors could face prosecution or loss of federal licenses to prescribe drugs by giving barbiturates to terminally ill patients who want to end their lives.

"If you do that, you're not overturning the law but in effect are eviscerating it," said George Eighmey, executive director of the Oregon chapter of Compassion & Choices, which supports the law.

Physicians say drugs other than barbiturates would not be as effective in producing a humane death.

Since the law took effect seven years ago, 208 terminally ill patients have used doctor-prescribed barbiturates to end their lives. State officials say that in most cases the patients slipped into unconsciousness within a matter of minutes, and most died within a few hours.

Dr. Peter Rasmussen, a Salem cancer specialist who has assisted in suicides of terminally ill people, said doctors might be able to legally hasten death by providing such substances as anti-depressant drugs, insulin or potassium.

But there is "good reason to believe," he said, "that such a death would not be swift and would not be comfortable, therefore would not spare a patient a very miserable dying process."

Dr. Greg Hamilton, a founder of Physicians for Compassionate Care, an organization of medical professionals that opposes assisted suicide, said physicians have plenty of ways to ease pain without aiding in suicide.

"We can take care of pain and can take care of people at the end of life without them having to go through unbearable and intolerable pain," Hamilton said. "Assisted suicide is not ethical and is not necessary."

But appearing at a news conference Tuesday with advocates of assisted suicide, cancer patient Charlene Andrews of Salem said it was important for her to know she had a choice of when to die.

"I know I'm not one that will ever be cured," Andrews said. "Having the choice (to commit assisted suicide) gives me comfort. Oregonians like their choices! I don't want to be one of those people who have their life prolonged unconsciously. And I don't think I will be."

A retired teacher, Andrews, 68, was diagnosed with breast cancer five years ago. She is undergoing chemotherapy and plans to have a "big old 70th birthday party" in two years.

AP photo

Don James, a terminally ill cancer patient, looks over a prescription for a lethal dose of of pentobarbital obtained under Oregon's assisted suicide law at his home in Portland.

"There is a real human need" for control over one's life, she said. "We are terminal and we know when we have a few weeks left. We know when we're unconscious. We know when we're at the end."

Oregon voters first passed the assisted suicide law -- put on the ballot by initiative petition -- in 1994. They rejected an effort in 1997 to repeal the law that's still the only one of its kind in the nation.

The case before the Supreme Court stems from a 2001 directive issued by then-U.S. Attorney General John Ashcroft that threatened to punish physicians who prescribe barbiturates to cause death.

The federal Justice Department argues that assisting suicide is not a legitimate medical purpose for prescribing drugs. But U.S. District Judge Robert Jones of Portland in 2002 ruled against Ashcroft on grounds he exceeded his authority under the controlled substances law.

Jones said the law was passed to curb drug abuse and trafficking and not to have the federal government control medical practices. The 9th U.S. Court of Appeals upheld his decision in 2004.

The case will be one of the first argued before Roberts, who formally assumed his new duties on Monday, the first day of the high court's new term.

Eighmey said he and other assisted suicide advocates are optimistic that Roberts will end up on Oregon's side because of indications that he generally supports states' rights.

A ruling in Oregon's favor, though, likely would not end the political debate over assisted suicide. Republicans in Congress have unsuccessfully tried to block the law in the past and have indicated they might try again.

Whatever the outcome of those efforts, one researcher says Oregon's assisted suicide debate has had the effect of raising public awareness about the need to take better care of people suffering from terminal illlness.

Since Oregon's law took effect, the number of terminally ill people receiving hospice care has grown, more doctors are taking classes to improve their ability to manage patients' pain, and more people have filled out advance directives spelling out how they want their end-of-life care to be managed, Dr. Susan Tolle said.

"Whether one likes or dislikes assisted suicide, the fact is that several aspects of end-of-life care have improved in Oregon," said Tolle, who is director of the Center for Ethics in Health Care at Oregon Health & Science University.