When one considers the protracted and continuing struggle of the citizens of Oregon to include physician-assisted suicide (also known as “physician aid in dying”) among the panoply of measures available to dying patients and the physicians who care for them, the depth and breadth of the issue becomes inescapable. The potential intractability of the dispute is illustrated by the very fact, noted in the preceding parenthetical phrase, that consensus eludes us on even the most basic of semantic points—how we are to most aptly characterize the conduct in question? The case featured in this issue's The Caduceus in Court must be examined as the latest battle in a long war of attrition waged by opponents of physician-assisted suicide against the Oregon Death with Dignity Act (“the Oregon Act”). After briefly reviewing that history, I will then consider the details of Oregon v. Ashcroft and the implications of the litigation not only for the care of dying patients but also for the regulation of medical practice in the United States and, more broadly still, the search for resolution of serious medical disputes in a democratic society.