Justices turned down the Bush administration's request to consider whether the federal government can punish doctors for recommending or perhaps even talking about the benefits of the drug to sick patients. An appeals court said they cannot.
Nine states have laws legalizing marijuana for patients 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.
"This is a clear defeat for the administration," says CBS News Legal Analyst Andrew Cohen. "Now, the real question is whether other states which might have been on the fence on this issue now will move forward with these types of laws."
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 administration would have made the state medical marijuana laws unusable.
In other Supreme Court decisions Tuesday:
Some California doctors and patients, in filings at the Supreme Court, compared doctor information on pot to physicians' advice on "red wine to reduce the risk of heart disease, Vitamin C, acupuncture, or chicken soup."
The administration, which has taken a hard stand against the state laws, argued that public health — 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.
Some people had expected the Supreme Court to step into the case, which comes from California, the battleground over the subject.
Keith Vines, a prosecutor in San Francisco who used marijuana to overcome HIV-related illnesses, was among those who challenged a policy, put in place during the Clinton administration. That policy requires the revocation of federal prescription licenses of doctors who recommend marijuana.
"If the government is zipping them up, and we're not being told about options, that's negligence," Vines said.
Policy supporters contend that the U.S. Drug Enforcement Administration must be allowed to protect the public.
The San Francisco-based 9th U.S. Circuit Court of Appeals said that physicians should be able to speak candidly with patients without fear of government sanctions, but they can be punished if they actually help patients obtain the drug.
Doctors fear losing their prescription-writing powers, which would put them out of business.
"It's taking the culture war issue of the moment and using it in a way that could undermine the First Amendment, medical profession, and patients' well-being," said Graham Boyd, an American Civil Liberties Union attorney representing patients, doctors, and other groups.
"This isn't a seal of approval from the court for these types of laws in California and elsewhere," says Cohen. "It's just a signal from the justices that they weren't ready or willing to embrace the government's position that doctors ought to be punished even for just talking about medical marijuana with their patients."