In a 6-3 decision, the Supreme Court upheld Oregon's assisted suicide law.  The majority opinion concluded that the Department of Justice did not have authority to issue a directive prohibiting physicians from prescribing federally controlled drugs to assist patients commit suicide in Oregon.  The ACLJ filed a brief in support of the government's position.

In a directive issued by then-Attorney General John Ashcroft in 2001, the government said that assisting in suicide is not a "legitimate medical purpose" and stated that physicians who prescribed life-ending drugs would lose their licenses to prescribe federally controlled drugs under the Controlled Substances Act.  The state of Oregon challenged that directive claiming it represented a federal usurpation of state control over the practice of medicine.

The ACLJ filed on behalf of the Department of Justice and the case number is 04-623.  Oral arguments took place on October 5, 2005 and the high court issued its decision on January 17, 2006.