Ruling doesn't affect state's law on medical use of pot

Betty Hiatt, frail with end-stage cancer, said she felt disrespected by the U.S. Supreme Court ruling yesterday that state laws allowing the medical use of marijuana don't protect patients from federal prosecution.

"I thought I was old enough to make my own decisions, but I guess the courts don't agree," said the 81-year-old Ballard woman, who has lost part of her intestines and smokes marijuana to calm nausea and help her appetite.

Despite the ruling, Hiatt says she's not about to stop: "I'll follow my doctor's orders."

Hiatt isn't in more danger of being busted than she was before, said those familiar with the legal conflicts surrounding medical marijuana.

The ruling doesn't affect the Washington state law that, like similar laws in nine other states, allows patients with certain conditions such as cancer, HIV and intractable pain to use marijuana with a doctor's authorization.

"This is not a surprise — nothing has changed," said Rob Killian, a family doctor who helped draft the 1998 voter initiative.

Federal agents always have had the right to arrest patients, Killian said. But most drug crimes are handled through local courts, where a patient's compliance with the state law still will be a defense.

"This decision does not obligate state law-enforcement agencies to do anything," said Stewart Jay, a constitutional-law professor at the University of Washington's School of Law. "They can continue to let people use medical marijuana, or let people use minor amounts, if they feel like it."

As for federal prosecutions, U.S. Attorney John McKay of the Western District of Seattle does not expect the ruling to affect policy, said his spokeswoman, Emily Langlie.

"We don't see this changing the way we've approached marijuana cases, particularly marijuana-manufacturing cases, " she said.

McKay's priority will remain "large, complex drug organizations, whether dealing in marijuana or other drugs," Langlie said.

As for elderly cancer patients who, like Hiatt, use marijuana to combat nausea or lack of appetite, Langlie said: "If you were to look at the people we have prosecuted in this area, those are not the people who have been prosecuted."

That's a good thing, said Hiatt's son, Douglas Hiatt, a Seattle lawyer who helps defend medical-marijuana patients.

"She'd have been dead a long time ago without the marijuana," he said. "I would hope and pray that John McKay realizes there are better things to do with scarce federal resources than waste them on trying to prosecute sick and dying people."

One of Betty Hiatt's doctors, Gregory Carter, a rehabilitation specialist at the UW, said he prescribes marijuana because it is effective, has fewer side effects than other drugs and is "remarkably safe."

Yesterday's ruling, he said, was based on "paranoia and fear, rather than science and logic," and won't change his willingness to sign patient-authorization forms.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com