Whether a person should be able to take his own life with the help of a medical doctor has become the new battleground for those on either side of the "pro-choice" vs. "pro-life" divide.
Here in Oregon, voters approved a "death with dignity" law in 1994 and again in 1997, when state lawmakers tried to overturn it. But US Attorney General John Ashcroft argues that prescribing lethal drugs for assisted suicide does not serve a "legitimate medical purpose" and so violates the federal Controlled Substances Act.
In federal district court this week, the Bush administration (and many conservative members of Congress) lost an important round in the debate.
Federal District Judge Robert Jones ruled against Mr. Ashcroft, rejecting the assertion that the Controlled Substances Act trumps state law and the long-held position that medical practices are to be regulated by states, and not the federal government.
Oregon's law applies only to mentally competent adults who declare their intentions in writing, are diagnosed as terminally ill, and take the prescribed drug themselves orally after a waiting period. The law prohibits "lethal injection, mercy killing, or active euthanasia."
Supporters say such safeguards prevent patients from being pressured to take their own lives (by family members wishing to limit the high cost of prolonged care, for example), or deciding to do so at a low moment or in a violent manner.
"Judge Jones has recognized that sensitive issues of medical judgment should rest with doctors and their patients, not with the federal government," says Estelle Rogers, executive director of the Death with Dignity National Center in Washington.
In the years since the law took effect, there apparently have been no abuses, nor have those wishing to kill themselves rushed to Oregon, as critics warned might happen. Only about 25 people a year have taken their lives under the law. Meanwhile, hospice care for those diagnosed with terminal illnesses has increased here.
Conservative groups see the issue as akin to abortion, calling it the taking of human life something they vigorously oppose. "Medicine by definition is the art of treating and curing," says Jan LaRue, director of legal studies for the Family Research Council in Washington. "If prescribing deadly drugs is practicing medicine, why is it that the [Oregon state law] doesn't permit doctors to inject the 'medicine'?"
A study published in 2000 by the American Medical Association (which opposes doctor-assisted suicide), found that "among patients who were neither depressed nor hopeless, none had high desire for hastened death."
"That's because we can treat pain," says Oregon physician Gregory Hamilton, founder of Physicians for Compassionate Care, an Oregon-based national organization that opposes doctor-assisted suicide. "The problem is depression and feelings of hopelessness."
Still, most Americans apparently want the option of ending their own lives with the help of their doctors.
For 20 years, polls have shown consistent support for physician- assisted suicide. In a recent Harris Poll, a substantial majority (65 percent) agree that "the law should allow doctors to comply with the wishes of a dying patient in severe distress who asks to have his or her life ended."
Nevertheless, efforts to enact a law like Oregon's have failed in other states, and anything like euthanasia is outlawed in 43 states.
In rejecting Ashcroft's argument, federal judge Jones said the attorney general had "evidently sought to stifle an ongoing 'earnest and profound debate' in the various states...." He was quoting from a Supreme Court case in which the justices called for such a debate, while declining to rule on the issue at that time.
"Many of our citizens, including the highest respected leaders of this country, oppose assisted suicide," Mr. Jones wrote. "But the fact that opposition ... may be fully justified, morally, ethically, religiously or otherwise, does not permit a federal statute to be manipulated from its true meaning to satisfy even a worthy goal."
Since both sides said they would appeal a court loss, the debate will doubtless continue.