The Supreme Court on Tuesday blocked the Bush administration's attempt to punish doctors who help terminally ill patients die, protecting Oregon's one-of-a-kind assisted-suicide law.

It was the first loss for Chief Justice John Roberts, who joined the court's most conservative members -- Antonin Scalia and Clarence Thomas -- in a long but restrained dissent.

The majority's newfound understanding of the (Controlled Substances Act) as a statute of limited reach is all the more puzzling because it rests upon constitutional principles that the majority of the Court rejected in Raich... the Raich majority concluded that the CSA applied to the intrastate possession of marijuana for medicinal purposes authorized by California law because "Congress could have rationally" concluded that such an application was necessary to the regulation of the "larger interstate marijuana market."  Here, by contrast, the majority's restrictive interpretation of the CSA is based in no small part on "the structure and limitations of federalism, which allow the States'"great latitude under their police powers to legislate as to the protection of the lives, limbs, health, comfort, and quiet of all persons."'

The Supreme Court has in the past demonstrated a reluctance to reach verdicts which set broad precedence. 

The Supremacy Clause unambiguously provides that if there is any conflict between federal and state law, federal law shall prevail.

The CSA is a statue that regulates the production, distribution, and consumption of commodities for which there is an established, and lucrative, interstate market. 

Finally, the majority's view—that because some of the CSA's applications are constitutional, they must all be constitutional—undermines its reliance on the substantial effects test. The intrastate conduct swept within a general regulatory scheme may or may not have a substantial effect on the relevant interstate market. "[O]ne always can draw the circle broadly enough to cover an activity that, when taken in isolation, would not have substantial effects on commerce." Id., at 600 (Thomas, J., concurring). The breadth of legislation that Congress enacts says nothing about whether the intrastate activity substantially affects interstate commerce, let alone whether it is necessary to the scheme. Because medical marijuana users in California and elsewhere are not placing substantial amounts of cannabis into the stream of interstate commerce, Congress may not regulate them under the substantial effects test, no matter how broadly it drafts the CSA.

[Scalia’s] Principle 2 is to stick to the text of what you're evaluating—the Constitution, laws, regulations—and avoid reading new meanings into it. In Casey and Stenberg, Scalia said the Constitution can't protect a right to abortions, since it doesn't mention them. He criticized Roe for asserting "a value found nowhere in the constitutional text." He insisted that "the text of the Constitution, and our traditions, say what they say and there is no fiddling with them." He chided his colleagues for suggesting that "the Constitution has an evolving meaning." Wednesday's ruling in Ayotte, which Scalia joins, reaffirms, "The touchstone for any decision about remedy is legislative intent."

Scalia's six colleagues follow this principle scrupulously in the assisted-suicide case. Since the CSA's text applies to drug addiction and recreational abuse, and since Congress "relied not on Executive ingenuity, but rather on specific legislation" when it wanted to broaden the law's coverage, the justices conclude that the CSA says what it says and shouldn't be fiddled with. Scalia, however, discards legislative intent and discovers the law's evolving meaning. "Even assuming, however, that the principal concern of the CSA is the curtailment of 'addiction and recreational abuse,' there is no reason to think that this is its exclusive concern," he writes. "We have repeatedly observed that Congress often passes statutes that sweep more broadly than the main problem they were designed to address."

Principle 3 is to defer to the states. In Stenberg, Scalia urged his colleagues to "return [abortion] to the people—where the Constitution, by its silence on the subject, left it—and let them decide, State by State, whether this practice should be allowed." In Casey, he warned that the court's job wasn't "determining some kind of social consensus," and he explained the arrogance and folly of nationalizing moral issues: […]

It's a pretty compelling argument. Not compelling enough to sustain the loyalty of its author, however. In the assisted-suicide case, he argues exactly the opposite: "The fact that many in Oregon believe that the boundaries of 'legitimate medicine' should be extended to include assisted suicide does not change the fact that the overwhelming weight of authority (including the 47 States that condemn physician-assisted suicide) confirms that they have not yet been so extended."

Scalia doesn’t like textualist interpretations when the conclusion gnaws at his conscience.