SAN FRANCISCO (AP) — The U.S. Supreme Court handed a major victory to the nine states that allow the medical use of marijuana, refusing to let the federal government punish doctors for recommending pot to their ill patients.

The justices declined without comment to review a lower-court ruling that said doctors should be able to speak frankly with their patients.

“My goodness, this is so incredible,” said California cancer patient Angel Raich, who smokes medical marijuana with a doctor’s recommendation. “Hopefully, there’ll be more doctors now that will feel safer in recommending cannabis to patients that need it.”

The ruling was a setback for the Bush administration, which had sought to punish doctors who recommend marijuana — or who simply discuss the drug’s benefits — by revoking the all-important federal licenses they need to write prescriptions.

A ruling in favor of the federal government would have gutted the state marijuana laws, which generally depend on a patient’s ability to get a doctor’s recommendation. The nine states are Alaska, Arizona, California, Colorado, Hawaii, Maine, Nevada, Oregon and Washington.

Nevertheless, it is still illegal under federal law to grow, sell or possess marijuana, and federal prosecutors can still go after cultivators, dealers and users, just as they have done in raids on “cannabis clubs” and other locations in California over the past few years.

In fact, the U.S. Supreme Court ruled against medical marijuana clubs in 2001, declaring there is no medical exception to the federal law against marijuana.

Still, Dr. Frank Lucido of Berkeley, Raich’s physician, said the justices’ move “takes some of the fear and intimidation factor out of doctors performing their practice.”

Even some supporters of these laws had expected the Supreme Court to step into the case. They said the court’s refusal to intervene 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.

Attorney General John Ashcroft had no comment on the decision, and White House spokeswoman Claire Buchan merely restated the Bush administration’s position on the topic, saying, “As a matter of policy we oppose any efforts to legalize marijuana.”

John Walters, director of the White House Office of National Drug Control Policy, noted that the Supreme Court decision revolved around doctor-patient practices, not the efficacy of smoking marijuana as medicine.

“It remains the charge of every responsible public official and medical professional to continue to protect the health of American citizens and reduce the harms caused by marijuana and other dependency-producing drugs,” Walters said in a statement, adding that cultivating and trafficking in marijuana remains a federal offense.

Patients with cancer, AIDS, glaucoma and other illnesses who use marijuana say it alleviates pain, helps them eat and keeps them from becoming nauseated.

Without comment, the justices let stand a decision last October by the Ninth U.S. Circuit Court of Appeals, which held that physicians have a constitutional right to speak candidly with their patients about marijuana without fear of government sanctions.

“An integral component of the practice of medicine is the communication between doctor and a patient. Physicians must be able to speak frankly and openly to patients,” Chief Circuit Judge Mary Schroeder ruled.

Acting on a lawsuit filed by seven California doctors and some of their patients during the Clinton Administration, a federal judge three years ago had blocked the Justice Department from taking any punitive action against doctors who recommend marijuana.

In their appeal, federal prosecutors argued that doctors who recommend marijuana are interfering with the drug war and circumventing the government’s judgment that the illegal drug has no medical benefit.

The conflict began after California voters passed the nation’s first medical marijuana law, Proposition 215, in 1996. The Clinton administration said doctors who recommended marijuana would lose their federal licenses to prescribe medicine, could be excluded from Medicare and Medicaid programs, and could face criminal charges if they help patients actually obtain marijuana. The Bush administration continued Clinton’s fight.

In 2001, the Supreme Court ruled against medical marijuana clubs. In that case, Justice Clarence Thomas wrote that an Oakland pot club could not defend its actions against federal drug laws by declaring it was dispensing marijuana to the medically needy.

Thomas wrote in a footnote then that important underlying constitutional questions remained unresolved, such as Congress’ ability to interfere with intrastate commerce, the right of states to experiment with their own laws and whether Americans have a fundamental right to marijuana as an avenue to be free of pain.

Since the justices acted without comment on the merits of the Bush administration’s case, the decision does little to resolve the constitutional issues Thomas raised.

But Raich and others have seized on that footnote, suing the government to be able to obtain marijuana without the threat of federal prosecution. At least two such cases are still pending before the Ninth Circuit.

The case against the doctors pitted the First Amendment free-speech rights of physicians against government power to keep them from encouraging illegal drug use.

The administration argued that public heath — not free speech — 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 had said in court papers.