Medical Marijuana, American Federalism, and the Supreme Court

August 16, 2005

Lawrence O. Gostin, JD, LLD, Journal of the American Medical Association

In Gonzalez v Raich, the US Supreme Court held that federallaw enforcement authorities could criminally prosecute patientsfor possessing marijuana prescribed by a physician in accordancewith state law.1 The Court did not overturn state medical marijuanalaws but did open the door to criminal prosecution under federaldrug statutes.

The Court also did not foreclose future challengesto federal enforcement on other constitutional grounds (eg,an unwarranted invasion of patient-physician privacy).

Explaining the significance of Raich requires examination of2 issues. The first concerns American federalism and raisesan important constitutional principle about the appropriatescope of federal public health powers. The second issue concernsthe use of marijuana as a medical treatment and raises intriguingquestions about the practice of medicine and the patient-physicianrelationship. In Raich, the Supreme Court pointedly questionedthe wisdom of prosecuting patients: "The . . . [Full Text of this Article]

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