ASSISTED SUICIDE: DOJ Criticizes Parts of House Bill

      With the House scheduled to vote today on a the Pain Relief Promotion Act of 1999, a bill that would prohibit states from making individual policies regarding physician-assisted suicide law, the Department of Justice issued a letter Wednesday criticizing portions of the measure. The Portland Oregonian reports that in the letter addressed to Rep. Henry Hyde (R-IL), Assistant Attorney General Robert Raben wrote, "HR 2260 is particularly intrusive to state policy-making, and the Department accordingly opposes this portion of the bill." He stated that the bill was "especially troublesome" in light of a 1997 Supreme Court decision which said that states are still "engaged in an earnest and profound debate about the morality, legality and practicality" of physician-assisted suicide (Hogan/O'Keefe, 10/21). The bill would criminalize prescribing controlled substances such as morphine "with the intention of hasten death" and subject physicians to a 20 year prison sentence (Rubin, Los Angeles Times, 10/22). Opponents contend that the bill would have a "chilling effect" on physicians who want to prescribe pain medication for terminally ill patients. Rep. Steve Rothman (D-NJ) said that it "jeopardizes the ability of the terminally ill to live their final days without pain." But proponents argue that the bill will enhance pain management and reduce the need for assisted suicide. Hyde said, "I am concerned about old people who do not want to be a burden on their family and who can be easily coerced, gently coerced, benignly coerced, into attempting suicide' (Koch, USA Today, 10/22).

Oregonian Rep.s Applaud
      The bill targets Oregon's Death With Dignity Act -- the only law in the nation allowing terminally ill patients to request lethal doses of pain medication -- the state's five House members, who have been mounting opposition to the measure, "cheered" the letter. Rep. Peter DeFazio (D-OR) said, "To me, it implies that there is a potential for a veto threat. It doesn't state that there would be one, but it sure as heck opens the door." Justice Department Spokesperson Carole Florman said, "It would be premature to speculate at this point. There isn't a final bill, and we are hopeful that we will be able to work with them to craft a bill that will be satisfactory to all parties."

Administration Smoke Signal
      Although it did not imply a Presidential veto, the letter is the first signal that the White House has some problems with the bill (Portland Oregonian, 10/21). Hyde pointed out that the bill had been changed to "make clear that aggressive pain control would not be grounds for investigation or prosecution." He added, "We must take steps to kill the pain, not the patient." The President, an "ardent opponent" of assisted suicide, indicated that he would consider signing the bill if the penalties against doctors were toned down (Los Angeles Times, 10/22).

Medical Associations' View
      Medical associations contend that Hyde's bill will "lead many doctors to under-medicate terminal patients to avoid scrutiny from federal drug agents," making the bill "unacceptable," according to a Los Angeles Times editorial. Although the bill was written with outright "concern that the Oregon law ... could lead government down a slippery slope toward sanctioning the state or federal legalization of physicians-assisted suicide," the editorial contends that the bill "is by no means the best way to supervise and discipline doctors who stray from their proper role as healers." The editorial states that the "California Medical Association, along with physician groups representing a dozen other states, persuasively argue that the harsh sanctions would lead doctors to undermedicate patients to avoid prosecution -- thus inhibiting the effective pain management the bill purports to promote." But even a with reduction in those sanctions, the editorial argues that "the bill remains marred by its requirement that the Drug Enforcement Administration define legitimate medical uses of pain medications, then regulate and enforce those subjective determinations." While the DEA itself claims it "has neither the expertise nor the resources to play doctor," the editorial concludes that the "best way to prevent medical abuses that drift toward euthanasia is through vigilance by state medical authorities and legislators, not by passing a federal bill with a misleading title and unenforceable aims" (10/22).