American Politics Today - Essentials (3rd Ed)

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MEDICAL MARIJUANA AND ASSISTED SUICIDE

The debate over devolving power from the national government
to the states has grown increasingly complicated in the past
several years. The partisan nature of the debate has shifted, the
courts have played a larger but inconsistent role, and issues
of states’ rights increasingly cut across normal ideological and
partisan divisions. In the 1990s, Republicans continued to favor
greater state control, and Democratic president Bill Clinton
also supported devolution to the states in several areas, includ-
ing welfare policy. Since the mid-1990s, the Supreme Court has
played a central role in the shift of power to the states, but two
recent cases involving medical marijuana (Gonzales v. Raich,
2005) and assisted suicide (Gonzales v. Oregon, 2006) show how
the typical debate between national and state power can shift
when a moral dimension is introduced.
In both cases, state voters supported liberal policies. In
1996, California voters passed the Compassionate Use Act,
by a margin of 56 to 44 percent. This law allowed seriously ill
Californians, typically AIDS and cancer patients, to use mari-
juana as part of their medical treatment with the permission
of a doctor. Oregon voters approved the Death with Dignity
Act in 1994 by a margin of 51 to 49 percent. This law allows
physicians to prescribe a lethal drug dosage for terminally
ill patients who wish to end their lives. A court order delayed
implementation of the law until 1997, the same year that the
matter was put before the voters again, but they rejected
repealing the law by a margin of 60 to 40 percent. Both of
these states’ laws were challenged in federal court in classic
confrontations between the states’ rights and national power
perspectives. Surprisingly, the Supreme Court ruled against
medical marijuana and in favor of assisted suicide (this over-
simplifi es the legal arguments, but these were the bottom-
line outcomes).
Should Congress be able to tell a state that it cannot allow
the use of medical marijuana? Can the attorney general interpret
a congressional law as a prohibition of assisted suicide? Unlike
many of the cases discussed in this chapter, the states’ rights
position in these cases represented the liberal perspective, rather
than the conservative position typically associated with state-
centered federalism. Social liberals tended to support both
the medical marijuana law and the assisted suicide law, while
social conservatives tended to oppose them both. However, if
you examine these cases in terms of the question of federal
versus state power, a central ideological divide in this nation
since the Constitutional Convention, the traditional liberal and
conservative perspectives both look more complex. That is, a
national-power liberal and a social conservative would agree
that the national government should regulate medical mari-
juana and assisted suicide. Likewise, states’ rights conserva-
tives and social liberals would share the view that the states
should decide these issues on their own.

Somewhat surprisingly, there was almost no consistency

among the eight justices who voted on both cases (Chief Justice

William Rehnquist was replaced by John Roberts between the

two cases). Only Justice Sandra Day O’Connor supported the

states’ rights position in both cases while Justice Antonin Sca-

lia voted as a moral conservative against both laws—and coun-

ter to his previously articulated views on national power and

federalism. The other six justices mixed their views, voting to

uphold one of the laws and to strike down the other. The result-

ing rulings were inconsistent on the question of federalism as

well. In the medical marijuana case, the Court upheld Con-

gress’s power to regulate the medical use of marijuana under

the Controlled Substances Act. But in the assisted suicide case,

the Court said that under that same congressional law, the U.S.

attorney general did not have the power to limit the drugs that

doctors in Oregon could prescribe for use in an assisted suicide.

Federal drug enforcement agents raid a medical marijuana club.

You Decide

Critical Thinking Questions

1. As a matter of policy, should doctors be able to pre-
   scribe marijuana to alleviate pain? Should they be
   able to prescribe lethal drugs to terminally ill pa-
   tients?


2. Do you tend to support a state-centered or nation-
   centered perspective on federalism? Now revisit
   your answers to the fi rst two questions. Are your
   positions more consistent with your views on fed-
   eralism or with your policy concerns?