In the 2005 case Alberto R. Gonzales, Attorney General, et al. v. Oregon, et al., the U.S Supreme Court ruled in favor of Oregon's Death with Dignity Act which allows physicians to prescribe lethal doses of medication for terminally ill patients who wish to end their lives. The federal government under Attorney General Alberto Gonzales argued that this violated the Controlled Substances Act (CSA), as it was not a "legitimate medical purpose". However, the court held by a 6-3 vote that CSA does not give authority to an attorney general to prohibit doctors from prescribing regulated drugs for use in physician-assisted suicide under state law where it is legal.

In the dissenting opinion for Gonzales v. Oregon, Justice Scalia argued that the Controlled Substances Act (CSA) gives the Attorney General authority to prohibit doctors from prescribing drugs for assisted suicide. He contended that this interpretation is consistent with the CSA's purpose of preventing drug abuse and ensuring public safety. Furthermore, he asserted that it was not unreasonable for the Attorney General to conclude that using controlled substances to assist suicides does not constitute a "legitimate medical purpose." He also criticized the majority's reliance on principles of federalism in its decision, arguing instead that Congress has broad power under Commerce Clause jurisprudence to regulate local activities affecting interstate commerce such as prescription drug use.