States' Authority to Define "Legitimate Medical Purpose"
In Gonzales v. Oregon, the Supreme Court of the United States has affirmed the ruling of two lower federal courts that the states, not the U.S. Department of Justice (DOJ), have the authority to determine what prescriptions have been issued for a "legitimate medical purpose." The context of the case was a challenge to the Oregon Death With Dignity Act, but the legal principles resolved in the case have nothing to do with physician-assisted suicide or a patient's right to decide when to die. If the U.S. Attorney General had won this case, DOJ, through the Drug Enforcement Administration (DEA), would have been given the authority to make decisions about the legality of prescriptions in all situations, not just end-of-life care. DOJ could, for example, have ruled that under all circumstances the prescribing of Schedule II barbiturates for insomnia is not a legitimate medical purpose, that prescribing Schedule II stimulants for attention-deficit/hyperactivity disorder is not a legitimate medical purpose, or that prescribing Schedule II opioids for longer than 60 days is not a legitimate medical purpose. This is not to say that DOJ would have done this, but it could have if the Attorney General had won the case. By ruling in favor of the state of Oregon, the Supreme Court has ensured that states, through their legislatures, professional licensing boards, and citizen initiatives, will continue to decide what uses of medications are for a legitimate medical purpose.