US: The Bush administration cannot stop doctors from helping terminally-ill patients end their lives under the US's only doctor-assisted suicide law, the US Supreme Court ruled yesterday.
The ruling comes as new British research suggests that as many as 3,000 patients were illegally helped to die by doctors in Britain last year. The independent academic report also revealed that an estimated one-third of people who died in the year - 192,000 patients - had their deaths accelerated by doctors using pain relief, the so-called "double effect".
The study by Prof Clive Seale of Brunel University in London, based on an anonymous survey of doctors, showed just under half of 1 per cent of deaths were assisted by doctors last year or, if extrapolated nationally, 2,865 cases. Published in the journal Palliative Medicine, the survey showed 0.16 per cent of the surveyed deaths in 2004 were described by doctors as voluntary euthanasia. A further 0.33 per cent were described as "ending life without an explicit request from the patient", which is also known as non-voluntary euthanasia.
Such cases usually involved patients very close to death who had previously indicated their wishes for euthanasia, but were unable to give a specific instruction to doctors, said Prof Seale.
Both voluntary and involuntary euthanasia are illegal under British law. There were no cases of suicide assisted by doctors reported in the survey.
Prof Seale said: "The rate in the UK is significantly lower than in other countries where this survey has been conducted."
Fourteen per cent of doctors surveyed said they were dissatisfied with the current law on euthanasia. In all, 857 GPs and hospital specialists responded to the anonymous survey.
The US Supreme Court ruling is a stinging defeat for the administration. It ruled on a 6-3 vote that then attorney general John Ashcroft in 2001 impermissibly interpreted federal law to bar distribution of controlled drugs to assist suicides, regardless of the Oregon law authorising it.
The judges upheld a US appeals court ruling that Mr Ashcroft's directive was unlawful and unenforceable and that he had overstepped his authority.
The Oregon law - the Death with Dignity Act - was twice approved by the voters. The only state law in the US allowing physician-assisted suicide, it has been used by more than 200 people since it took effect in 1997.
Under Oregon law, terminally- ill patients must get a certification from two doctors stating they are of sound mind and have less than six months to live. A prescription for lethal drugs is then written by the doctor and the patients administer the drugs themselves.
Mr Ashcroft's directive said that assisting suicide was not a legitimate medical purpose under the Controlled Substances Act and that prescribing federally- controlled drugs for that purpose was against the federal law.
The directive threatened to revoke prescription-writing licences for physicians and pharmacists who filled orders for life-ending drugs.
Writing the majority opinion, Judge Anthony Kennedy said the federal drug law did not allow the attorney general to prohibit doctors from prescribing regulated drugs for use in physician-assisted suicide under state law permitting the procedure.
The court's most conservative members, Judge Antonin Scalia and Judge Clarence Thomas and new chief justice Judge John Roberts, dissented.