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WASHINGTON—The stereotypes of the debate over medical marijuana haven’t changed much in the past 10 years: you’re either an opponent who hates sick people or an advocate who loves pot.

At a policy forum at the libertarian think tank Cato Institute Tuesday, two doctors—one pro-, one anti-medical marijuana—and a legalization advocate debated the merits of using cannabis to treat symptoms of terminally ill patients.

But the discussion quickly turned to digs, raised eyebrows and groans, particularly when opponent Dr. Robert DuPont said marijuana was a major cause of car accidents in the U.S.

Audience members yelled out “oh please,” and advocate Dr. Donald Abrams abruptly called for an end to the panel, saying “I can’t listen to this anymore.”

Although the standard arguments of treating pain and the dangers of smoking were voiced, the debate boiled down to a different topic: whether marijuana should be legalized in general.

DuPont, who called himself the “sacrificial lamb” opponent in a crowd that by definition leans toward deregulation of drugs, said medical marijuana advocates use it as a “stealth approach to approving marijuana.” He argued that marijuana should be studied so a synthetic medicine could be created with the same benefits.

“I want you to think about a doctor telling a patient to burn leaves and inhale the smoke as a drug-delivery system,” he said, comparing it to doctors recommending that patients smoke opium instead of administering morphine. “Smoke is not healthy.”

No one smokes leaves anyway, said Abrams, and research has shown that cannabis has potential for therapeutic value, including pain relief, control of nausea and vomiting and appetite stimulation.

Opposition to medical marijuana use is often an issue of morality, not science, he said.

“I think we live in something of a puritanical era, and I think people are opposed to euphoria,” Abrams said.

Rob Kampia, co-founder and executive director of Marijuana Policy Project, said he hoped the Drug Enforcement Administration and Justice Department would focus less on raiding warehouses in states where medical marijuana is legal— raids conducted under the Bush administration in what Kampia called a “sick perversion of federal priorities.” His organization works to end the prohibition of marijuana.

Public support is already leaning toward legalization, he said, citing successful ballot initiatives in Michigan, Colorado, California and 10 other states. After all, “medical marijuana got more votes than Obama did in Michigan.”