BILL TO LIMIT EUTHANASIA, PROMOTE ALTERNATIVES AT CRUCIAL JUNCTURE

The Pain Relief Promotion Act is headed for critical votes in Congress. The act would prevent the use of federally controlled drugs for euthanasia or assisting suicide while providing statutory changes and funding for programs that would significantly enhance the availability of adequate pain control.

As NRL News goes to press, the bill is expected to come up for a House floor vote during the week of October 18, after House Commerce Committee consideration on October 13. (A hearing covering the bill was also scheduled in the Senate Health, Education, Labor, and Pensions Committee on October 13.)

The bill, H.R. 2260 in the House and S. 1272 in the Senate, would restore the Drug Enforcement Administration's (DEA) position reversed in 1998 by Attorney General Janet Reno. The DEA's position is that since federally controlled drugs may be prescribed only for a "legitimate medical purpose," they may not lawfully be used to kill patients.

All of the deaths so far officially reported as a result of Oregon's legalization of assisting suicide have been caused by such federally controlled substances.

In contrast to their position on a predecessor bill in the previous Congress, many major medical organizations are publicly backing the Pain Relief Promotion Act. These powerful and influential groups include the American Academy of Pain Management, the American Society of Anesthesiologists, the National Hospice Organization, and the American Medical Association (AMA), among others.

Effect on Pain Relief

As noted on the AMA web site (www.ama- assn.org/ama/basic/article/0,1059,199-483-1,00.html), "the bill would add a provision to the Controlled Substances Act (CSA) acknowledging the legitimate medical purpose of controlled substances in the management of pain or discomfort, even if their use increases the risk of death for the patient (the so- called 'double effect'). The bill has the potential, through its educational provisions, of sensitizing law enforcement personnel to the multiple issues of end-of-life care and prescribing."

Enforcement in Oregon

Even under Attorney General Reno's ruling, a doctor's registration to prescribe federally controlled substances can be revoked if he or she uses them to assist suicide in any state where that is not authorized by state law, or even in Oregon to the extent not authorized by state law (if the patient is not terminally ill or if the statutory waiting period is not observed, for example). The Pain Relief Promotion Act would not change this existing situation.

But what of cases of assisted suicide now legal under Oregon law? To be free of criminal penalties under state law in Oregon, a doctor who assists a suicide must submit a report to Oregon authorities that includes information on the drugs prescribed to assist the suicide.

The DEA would simply subpoena those reports and records. There would be no need for the DEA to make any further investigation or judgments about the dosages of controlled substances used, since the records subpoenaed would effectively contain an unambiguous confession that the doctor was using federally controlled substances to assist suicide.

It follows that any doctors in Oregon who prescribe controlled substances for pain relief need not fear DEA agents even investigating them, and therefore should not in any way be deterred from prescribing adequate pain relief.

Burke Balch, director of the NRLC Department of Medical Ethics, told NRL News, "It is no exaggeration to say" that the lives of millions are at stake with this legislation. "If we fail to stymie the legalization of euthanasia now, Balch added, " while its death toll, though tragic, is still low, it may well spread slowly but inexorably until the routine killing of older people and people with disabilities becomes as prevalent in practice as abortion is today."

(See action alert, below.)

ACTION ALERT
S.1272, The Pain Relief Promotion Act

MAY YET COME BEFORE THE SENATE FOR A FLOOR VOTE THIS YEAR

This is our chance to help stop euthanasia before it becomes embedded in American medicine and culture. Please urge your senators to vote FOR S. 1272, the Pain Relief Promotion Act.

KEY POINTS:

On June 5, 1998, overturning an earlier policy determination by the Drug Enforcement Administration (DEA), U.S. Attorney General Janet Reno announced that the federal Controlled Substances Act establishes no uniform national policy against the use of federally regulated drugs for assisted suicide. Thus, she said, these drugs may be used to assist patients' suicides in any state which, like Oregon, allows the practice under state law.

Under federal law and regulations, the use and prescription of certain narcotics and other dangerous drugs is generally prohibited unless a doctor with a special federal "registration" to prescribe them does so for a "legitimate medical purpose."

In contrast, when it comes to marijuana, whose "medicinal use" has been legalized by referenda in a number of states, the Justice Department continues to maintain that it remains illegal under the Controlled Substances Act no matter what state law may say.

Under Reno's ruling, the federal government facilitates the killing of patients in Oregon by acknowledging their killing as " legitimate" and providing access to the lethal drugs needed to carry it out.

A bill introduced last year to overturn the Reno decision and restore the original professional judgment of the DEA that killing a patient is not a "legitimate medical purpose" was opposed by the National Hospice Organization and other medical groups who said they feared it might inhibit doctors from prescribing appropriate pain relief. This year, however, the bill has been rewritten both to address this concern and to provide $25 million over five years to foster pain management and palliative care as positive alternatives to euthanasia, and the National Hospice Organization, American Medical Association, and many other medical groups have endorsed the new bill.

By 64% to 31%, Americans say "no" when asked whether federal law should allow use of federally controlled drugs for the purpose of assisted suicide and euthanasia.

Capitol Switchboard: 202-224-3121

(In-state office of your U.S. senator available from local telephone information.)

Or write:

Senator _________________,
Senate Office Building,
Washington, D.C. 20510