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GONZALES v. OREGON Syllabus
to deregister a physician simply because he deemed a controversial practice permitted by state law to have an illegitimate medical purpose. The federal-law factor requires the Attorney General to decide “[c]om pliance” with the law but does not suggest that he may decide what the law is. To say that he can define the substantive standards of medical practice as part of his authority would also put 21 U. S. C. § 871(b) in considerable tension with the narrowly defined control and registration delegation. It would go, moreover, against the plain language of the text to treat a delegation for the “execution” of his functions as a further delegation to define other functions well beyond the Act’s specific grants of authority. The authority desired by the Government is inconsistent with the Act’s design in other fundamental respects, e. g., the Attorney General must share power with, and in some respect defer to, the Secre tary, whose functions are likewise delineated and confined by the Act. Postenactment congressional commentary on the CSA’s regulation of medical practice is also at odds with the Attorney General’s claimed authority. The Government’s claim that the Attorney General’s deci sion is a legal, not medical, one does not suffice, for the Interpretive Rule places extensive reliance on medical judgments and views of the medical community in concluding that assisted suicide is not a legitimate medical purpose. The idea that Congress gave him such broad and un usual authority through an implicit delegation is not sustainable. The importance of the issue of physician-assisted suicide makes the oblique form of the claimed delegation all the more suspect. Pp. 258–269. (d) The Attorney General’s opinion is unpersuasive under Skidmore. The CSA and this Court’s case law amply support the conclusion that Congress regulates medical practice insofar as it bars doctors from using their prescription-writing powers as a means to engage in illicit drug dealing and trafficking as conventionally understood. Beyond this, the Act manifests no intent to regulate the practice of medicine generally, which is understandable given federalism’s structure and limi tations. The CSA’s structure and operation presume and rely upon a functioning medical profession regulated under the States’ police pow ers. The Federal Government can set uniform standards for regulating health and safety. In connection with the CSA, however, the only pro vision in which Congress set general, uniform medical practice stand ards, 42 U. S. C. § 290bb–2a, strengthens the understanding of the CSA as a statute combating recreational drug abuse, and also indicates that when Congress wants to regulate medical practice in the given scheme, it does so by explicit statutory language. The difficulty in defending the Attorney General’s declaration that the CSA impliedly criminalizes physician-assisted suicide is compounded by the Act’s consistent delega tion of medical judgments to the Secretary and its otherwise careful
