By Burke J. Balch
Director, NRLC Dep't of Medical Ethics
Responding rapidly to Attorney General Janet Reno's June 5 decision to allow the use of federally controlled drugs to assist suicide, House Judiciary Chairman Henry J. Hyde (R-Il.) the same day introduced H.R. 4006, the Lethal Drug Abuse Prevention Act of 1998, to reinstate the previous Drug Enforcement Administration (DEA) policy against such use which was overturned by Reno. Majority Whip Senator Don Nickles (R- Ok.) introduced a similar bill in the U.S. Senate.
"The legislation reaffirms that physicians should use federally regulated drugs for legitimate medical goals such as relief of pain and suffering," Hyde said. "Medicine is and ought to be a healing force, not a killing one."
In a letter issued November 5, 1997, the professional head of the U.S. Drug Enforcement Administration, Thomas Constantine, had noted that under the federal Controlled Substances Act and implementing regulations, certain narcotics and other dangerous drugs can be prescribed only by a physician with a special federal DEA registration and only under carefully controlled circumstances for a "legitimate medical purpose." Killing a patient through euthanasia or assisted suicide, Constantine wrote, was not a legitimate medical purpose and a doctor who prescribed federally controlled substances to do so could have his or her DEA registration revoked, regardless of whether the action was legal under state law.
The DEA ruling was particularly applicable in Oregon, which the previous day had reaffirmed by referendum a measure, originally passed in 1994 but not then implemented due to litigation. The Oregon law legalizes the prescription of lethal drugs to kill people who, without lifesaving treatment, are likely to die within six months. Oregon Senator Ron Wyden thereupon pressured Attorney General Reno to overrule the DEA determination, and she quickly announced that it would be reviewed by the Justice Department. While the review was pending, the Oregon suicide measure went into effect as a matter of state law, and at least four patients have since been killed under it, according to published reports.
Before Reno's decision reversing the DEA was announced, 37 senators and 169 representatives had agreed to sign letters to the Attorney General urging her to reaffirm the DEA. In addition, a national opinion poll conducted by Wirthlin Worldwide in March 1998 found that by 65% to 29%, Americans oppose allowing the use of "federally controlled drugs for the purpose of assisted suicide and euthanasia." (Margin of error 4.3%.)
The Nickles-Hyde Lethal Drug Abuse Prevention Act of 1998 provides that a doctor's DEA registration must be revoked if the doctor prescribes federally controlled substances "with a purpose of causing, or assisting in causing, the suicide or euthanasia of any individual." It makes clear that providing such drugs to alleviate pain, even with the risk of causing death, is not prohibited if the purpose is not to cause death. To deal with circumstances in which a physician claims that a particular prescription was to relieve pain rather than cause death, the bill establishes a Medical Review Board on Pain Relief composed of experts who can make findings admissible in registration revocation proceedings.
Sounding a theme likely to be heard repeatedly from euthanasia advocates during the congressional debate over the Nickles-Hyde bill, Barbara Combs Lee, executive director of Compassion in Dying, said of Reno's decision that it "clearly supports our society's belief that decisions about health care should be made based on local community standards and enforced by local authorities, not the DEA or the federal government."
Commenting in response, Lori Hougens, senior congressional liason for NRLC's Department of Medical Ethics, said, "It is ironic that Compassion in Dying should now invoke the banner of local option in decisions about assisted suicide, since it is the very organization that took to the U.S. Supreme Court a case seeking to strip states of the option to prevent assisted suicide, claiming that under the U.S. Constitution no state could do so."
Hougens pointed out that, "Under the federal Controlled Substances Act, the Clinton Administration Justice Department is currently shutting down California stores for providing marijuana for claimed medicinal purposes. Such use of marijuana was approved by California voters in a referendum. If a state were to pass a law allowing doctors to write heroin prescriptions to treat depression by making patients 'high,' does anyone suppose that the federal law would be interpreted to create no barrier to medically licensed heroin pushers?"
The bill is expected to receive rapid consideration in Congress, where it will probably be assigned to the House Judiciary and Commerce Committees. Despite the Justice Department's action, it is possible that Clinton might still sign the bill should it pass both houses.
Reno's statement said "it is important to underscore that the President continues to maintain his longstanding position against assisted suicide and any Federal support for that procedure.... While states ordinarily have primary responsibility for regulating physicians, the President and Administration nonetheless remain open to working with you and other interested members of Congress on this complex but extremely important issue." "We are now at a critical phase of the struggle to save the lives of our most vulnerable citizens, especially older people and people with disabilities," said David N. O'Steen, Ph.D., NRLC executive director.
"It is urgently necessary to communicate rapidly with members of Congress to ask their supportfor the Nickles-Hyde Lethal Drug Abuse Prevention Act of 1998. What would the pro-life movement have given to have had the realistic opportunity, in the 1970s, to stop abortion's legalization just as it was getting started? How many millions of lives might we have saved? We now have the briefly available prospect of stopping euthanasia in the United States before it becomes entrenched and spreads. What will history say of this generation of pro-life Americans if we fail to do all we can, in the next crucial weeks and months, to avert so grave and irremediable a tragedy?"