The Ashcroft Directive became the subject of court proceedings.  The Ninth Circuit Court of Appeals heard oral arguments in the case on May 7, 2003.  On May 26, 2004, in a 2-1 decision, the Ninth Circuit declared that Ashcroft overstepped his authority in issuing the Directive. 

On July 12, 2004, the Justice Department petitioned the Ninth Circuit Court of Appeals to reconsider its May decision.  The Court refused a rehearing.. 

On November 9, 2004, the Justice Department petitioned the U.S. Supreme Court to hear the case and, on February 22, 2005, the U.S. Supreme Court announced that it would hear the case (now titled "Gonzales v. Oregon" No. 04-623) during its session that begins in October 2005.

The State of Oregon and assisted-suicide activists claim that the Ashcroft Directive is a power grab that tramples on states' rights, overturns Oregon's assisted suicide law (the Oregon Death with Dignity Act), interferes with the practice of medicine and chills pain control. In fact, the Ashcroft Directive does none of those things.

• The Ashcroft Directive does not overturn Oregon's assisted suicide law. It simply states that federally controlled substances cannot be prescribed for the purpose of causing death.

• Nothing in the Ashcroft Directive prevents Oregon physicians from engaging in the practice of assisted suicide in accordance with Oregon law. Although all federally controlled substances are prescription medications, all prescription medications are not federally controlled substances. The Ashcroft Directive only applies to federally controlled substances. Oregon physicians could still assist suicides by prescribing medications that are not federally controlled substances.

• The Ashcroft Directive does not interfere with states' rights. On the contrary. Oregon is attempting to seize authority to exempt itself from provisions of the Controlled Substances Act. Although Oregon v. Ashcroft will be decided within the context of the debate over assisted suicide, it is not about whether Oregon may permit the practice of assisted suicide. It is about whether a state can unilaterally exempt itself from federal regulations. Oregon has given physicians the power to prescribe medication for the purpose of causing death, but it cannot dictate that federally controlled substances be used for that purpose.

• The Ashcroft Directive does not interfere with a doctor's right to practice medicine. States license doctors to practice medicine. The federal government registers doctors to prescribe controlled substances. If a physician's registration is revoked or suspended for prescribing federally controlled substances to induce death, that physician could still practice medicine and could still lawfully prescribe any of the thousands of medications that are not federally controlled substances.

• If Oregon or any other state is given the power to opt out of federal oversight under the Controlled Substances Act, then the ability of the federal government to enforce a unified and national drug policy is effectively over. A ruling against the Ashcroft Directive would permit a state to pass a law declaring that drug-induced euphoria for recreational purposes is a legitimate medical purpose for prescribing any federally controlled substance. The federal government would be powerless to stop federal registrations from being used for such prescribing.

• The Ashcroft Directive enhances the right to pain control. It provides the strongest assurances ever given to doctors so that prescribing controlled substances to manage pain is promoted and so that such prescribing will not subject them to any increased monitoring or investigation.

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