The Roberts Court ruled 6–3 in Oregon v. Gonzales (2006) that the U.S. attorney general could not prohibit the operation of a state medical law that allowed for assisted suicide. In 1994, Oregon passed the Oregon Death with Dignity Act, which allows physicians to assist terminally ill patients six months from death by prescribing lethal doses. In 2001, then-U.S. Attorney General John Ashcroft announced a rule that “assisting suicide is not a ‘legitimate medical purpose’” and could be prohibited under the Controlled Substances Act (CSA).

The state of Oregon, a physician, a pharmacist, and some terminally ill patients sued, contending that the attorney general’s “interpretative rule” was unconstitutional.

The majority of the U.S. Supreme Court agreed, finding that federal law’s “prescription requirement does not authorize the Attorney General to bar dispensing controlled substances for assisted suicide in the face of a state medical regime permitting such suicide.” Anthony Kennedy, who issued the Court’s opinion, wrote that the “structure” of the Controlled Substances Act “conveys unwillingness to cede medical judgments to an Executive official who lacks medical expertise.” The majority viewed the CSA requirements as primarily concerned with “illicit drug dealing” and “trafficking.”

Chief Justice Roberts and Justices Antonin Scalia and Clarence Thomas dissented, with Scalia and Thomas writing opinions. Scalia wrote that the attorney general’s interpretation of federal drug regulations was entitled to substantial deference and questioned whether assisted suicide is medically legitimate. Thomas questioned how the majority could square its decision with the Rehnquist Court’s recent 2005 decision in Raich v. Gonzales, prohibiting the medical use of marijuana.