WASHINGTON (BP)–A new bill reasserting federally regulated drugs may not be used to assist in suicides evoked strong differences during a congressional hearing.
Proponents of the Lethal Drug Abuse Prevention Act contended it is needed to protect the lives of the vulnerable in society as well as Congress’ authority, while opponents argued for states’ and physicians’ rights.
The bill was introduced in response to a June 5 ruling by U.S. Attorney General Janet Reno clearing the way for doctors to use federally regulated drugs to help people commit suicide in Oregon, the only state that allows assisted suicide. Reno ruled the federal Controlled Substances Act does not authorize the federal government to take action against doctors who prescribe medication for terminally ill people who desire to take their lives under Oregon’s Death With Dignity Act.
Reno’s decision overturned a ruling by U.S. Drug Enforcement Agency administrator Thomas Constantine in November. The day after Oregon voters reaffirmed an assisted-suicide law, Constantine announced the federal law still prohibits doctors from prescribing controlled substances, such as morphine and barbiturates, to aid in a suicide.
The bill, with Rep. Henry Hyde, R.-Ill., and Sen. Don Nickles, R.-Okla., as chief sponsors, would amend the Controlled Substances Act to clarify it prohibits the distribution of a drug covered by the law for the purpose of causing, or helping to cause, suicide or euthanasia. It says the CSA is not applicable when the prescription of a drug for the purpose of relieving pain results unintentionally in hastening the death of a patient. The bill also requires the U.S. attorney general to appoint a board of experts in pain management to decide, when necessary, whether doctors have acted properly.
In a July 14 hearing before the Constitution Subcommittee of the House of Representatives Judiciary Committee, Oregon Gov. John Kitzhaber, a Democrat, said the Oregon law resulted from an “earnest and profound debate” on assisted suicide. If Congress found Oregon’s action “unconscionable,” it should conduct an “explicit debate” on assisted suicide.
“Don’t intimidate and put at risk physicians when your true objective is in fact altering the choices available to terminally ill patients,” said Kitzhaber, a licensed physician. The bill is “an unprecedented expansion of the federal government into the practice of medicine,” he said.
Gregory Hamilton of the Portland-based Physicians for Compassionate Care, however, told the panel immediately after Kitzhaber’s testimony assisted suicide is “fundamentally incompatible with the physician’s role” as a healer. Assisted suicide “is not medicine. … killing sick people is not medicine,” he said.
On a later panel, Rep. Tom Coburn, R.-Okla., also a doctor, said the debate about assisted suicide is a “matter of what the profession of medicine is to be about. … This is the beginning of a very, very slippery slope downward.
“There is no right to death in our society. There is a right to life.”
Coburn testified a colleague and he had provided pain relief for a terminally ill patient that resulted in hastening his death, but that was not their purpose. That is not the same as intending to take someone’s life, he said.
Thomas Reardon, president-elect of the American Medical Association, testified the AMA opposes assisted suicide but also opposes the Hyde-Nickles bill. The bill “would have a tremendous inhibiting effect” on the care of the terminally ill, he said. With the added DEA questioning of physicians, people “should not be surprised” if doctors avoid aggressive pain management, Reardon said.
The bill “actually promotes rather than chills” the appropriate use of drugs, countered Thomas Marzen, general counsel of the National Legal Center for the Medically Dependent and Disabled.
Reardon said a state review board, rather than a federal one, would be much more acceptable, when asked about the possibility by Rep. Charles Canady, R.-Fla., subcommittee chairman.
Canady told panelists he did not want to do anything to impede palliative care. Concerning a review board, Canady said, “I see the point you’re making, but I’m not persuaded.” He sees the board “as a shield, rather than a sword,” Canady said.
Herbert Hendin, a psychiatry professor at New York Medical College, testified, “Sanctioning assisted suicide — and permitting the use of controlled substances for assisted suicide is sanctioning the practice — should not be permitted because it would markedly worsen the care we provide to terminally ill patients.
“Studies have shown that the more physicians know about palliative care, the less they favor assisted suicide; the less they know, the more they favor it.
“Suprisingly, and contrary to the expectations of its proponents, sanction for assisted suicide and euthanasia increases the power and control of doctors, not patients,” Hendin said. “This happens because the doctor can suggest assisted suicide … can ignore patient ambivalence, not present suitable alternatives and even end the lives of patients who have not requested it.”
Rep. Darlene Hooley, D.-Ore., said the bill represents an intrusion of “big government” into the actions of a state’s voters. It “places the concept of state-centered federalism in jeopardy,” she said.
Canady said Congress has a responsibility to act when it believes a law has been misapplied.
Four of Oregon’s five representatives appeared before the subcommittee and testified against the bill. Rep. James Oberstar, D.-Minn., the lead Democratic sponsor of the bill, Rep. Joe Pitts, R.-Pa., and Coburn testified in support of it.
Oregon voters first approved a law legalizing assisted suicide in a 1994 initiative, but legal challenges blocked its enforcement for three years. The voters reaffirmed the law by a wider margin in 1997. The first confirmed death by assisted suicide came in late March of this year.
Last year, the U.S. Supreme Court ruled unanimously states could prohibit assisted suicide, but its action did not prevent states from legalizing the practice.
Earlier this month, the Michigan legislature — in its continuing attempt to stop notorious assisted-suicide practitioner Jack Kevorkian — approved a new law banning assisted suicide.
In her June statement, Reno reiterated President Clinton opposes assisted suicide and any federal funding of it. Last year, the president signed into law legislation banning federal funding of assisted suicide.
At its 1996 meeting, the Southern Baptist Convention adopted a resolution condemning assisted suicide.
