Justices turned down the Bush administration’s request to consider whether the federal government can punish doctors for recommending or talking about the benefits of the drug to sick patients. An appeals court said the government cannot.

Nine states have laws legalizing marijuana for people with physician recommendations or prescriptions: Alaska, Arizona, California, Colorado, Hawaii, Maine, Nevada, Oregon and Washington. And 35 states have passed legislation recognizing marijuana’s medicinal value.

But federal law bans the use of pot under any circumstances.

In Hawai'i, the medical marijuana program falls under the jurisdiction of the state Narcotics Enforcement Division. Administrator Keith Kamita said he’s not sure how much of an impact the court’s ruling will have.

As of August, Kamita said, 1,039 people in Hawai'i were registered to use and grow marijuana, a number that increases each year. Patients need an annual certification from a doctor to qualify. To get certified for medical marijuana, patients must have a "debilitating medical condition" that could include cancer, AIDS, glaucoma or other chronic diseases that cause nausea, pain or other problems.

O'ahu medical marijuana user Tom Mountain said he believes today’s action supports the free-speech rights of physicians working to treat their patients.

Dr. Philip Hellreich, past president of the Hawai'i Medical Association and current legislative chairman, said the organization is pleased that the ruling means that doctors won’t be punished for recommending marijuana for their patients.

But the Hawai'i doctors’ organization has remained opposed to the medical marijuana law saying members await medical evidence that marijuana is uniquely more effective than other treatments. Hellreich said he thinks the ruling could increase the number of doctors who recommend marijuana.

But he questioned whether the ruling also means that physicians don’t have to fear that the government could still rescind federal narcotics licenses from the Drug Enforcement Administration. Fear of losing that narcotics license has discouraged some doctors from considering marijuana, Hellreich said.

The case gave the court an opportunity to review its second medical marijuana case in two years. The last one involved cannabis clubs.

This one presented a more difficult issue, pitting free-speech rights of doctors against government power to keep physicians from encouraging illegal drug use. A ruling for the Bush administration would have made the state medical marijuana laws unusable.

The administration argued that public heath — not the First Amendment free-speech rights of doctors or patients — was at stake.

"The provision of medical advice — whether it be that the patient take aspirin or Vitamin C, lose or gain weight, exercise or rest, smoke or refrain from smoking marijuana — is not pure speech. It is the conduct of the practice of medicine. As such, it is subject to reasonable regulation," Solicitor General Theodore Olson said in court papers.

Even some supporters of the laws had expected the Supreme Court to step into the case. They said the court’s refusal to intervene, although it does not address the merits of the case, could encourage other states to consider passing medical marijuana laws.

"It finally definitively puts to rest these federal threats against doctors and patients," said Graham Boyd, an American Civil Liberties Union attorney representing patients, doctors, and other groups in the case.

This report was written by the Associated Press with Advertiser staff writer Robbie Dingeman contributing the Hawai'i portion of the story.

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