WASHINGTON (October 1, 2002) -- In a friend-of-the-court brief filed in the U. S. Court of Appeals for the Ninth Circuit, the United States Conference of Catholic Bishops (USCCB) and other Catholic organizations supported an interpretive rule by the U.S. Attorney General that assisted suicide is not a legitimate medical practice under the Controlled Substances Act. They called for reversal of a District Court injunction which kept the Attorney General's ruling from taking effect.
The Amici Curiae brief was filed by the USCCB, the Oregon Catholic Conference, and The Catholic Health Association of the United States. The case is: State of Oregon v. John Ashcroft.
The brief emphasizes the "ethical distinction made in law and medicine between legitimate treatment of pain and assisting suicide." It supports the Attorney General's conclusion that assisted suicide is not a legitimate medical purpose for use of controlled substances, while pain management is. The groups signing the brief noted that this distinction, and the understanding of assisted suicide as being outside the scope of legitimate medical practice, is consistent with longstanding tenets of the medical profession and past interpretation and enforcement of the Controlled Substances Act.
The brief also explains how recognizing the distinction between treating pain and assisting suicide, and prohibiting the latter, has led to significant improvements in the ability of physicians to care for dying patients, while obliterating the distinction, as the District Court's opinion would do, could have a deleterious impact on pain management and palliative care.
"Medicine by its very definition aims to prevent illness, to heal, and to alleviate pain," the brief says. "Taking a human life accomplishes none of these objectives. To say that it does creates an inherent contradiction, like saying that the legitimate practice of law includes helping clients break the law. The analogy is apt because helping to kill is precisely the opposite of what medicine is and does...Allowing intentional lethal acts will not make it easier for patients to obtain the medical care they need, but will only impede their ability to obtain such care. What virtually every state regards as a crime, indeed as a form of homicide, does not become 'medicine' simply because the perpetrator is a doctor, the patient is terminally ill, or one state has decided to rescind its own criminal penalties for the act."
The fundamental distinction between assisting suicide and relieving pain is recognized in several ways by federal law, according to the brief. For example, under the Assisted Suicide Funding Restriction Act of 1997 (ASFRA), federal funds may not be used to pay for items and services the purpose of which is to cause or assist in causing the suicide of any individual:
"By its express terms, nothing in ASFRA applies to or imposes any limitation on 'the use of an item...or service furnished for the purpose of alleviating pain or discomfort, even if such use may increase the risk of death, so long as such item or service is not also furnished for the purpose of causing, or the purpose of assisting in causing, death, for any reason.'"
The brief also noted that the American Medical Association has declared its support for ASFRA, saying "The power to assist in intentionally taking the life of a patient is antithetical to the central mission of healing that guides physicians. The AMA continues to stand by its ethical principle that physician-assisted suicide is fundamentally incompatible with the physician's role as healer and that physicians must instead aggressively respond to the needs of patients at the end of life."
"Thus, since 1997, with the support of organizations representing the medical profession, all federal health programs, including those administered by the Department of Health and Human Services, have included pain management in the scope of legitimate medical procedures while explicitly excluding assisted suicide from that scope," the brief declared. "The construction given to the Controlled Substances Act must be consistent with this legislative directive absent some clear language of exception."
The brief says that enforcing the difference between palliative care and assisted suicide has led to improvements in patient care, while blurring the distinction, as proponents of assisted suicide have frequently done, threatens patient care. It cites evidence that "when the distinction between palliative care and assisted suicide is maintained in ethics and law, and the latter is prohibited, patient care improves. Conversely, there is evidence that when the distinction is blurred, as in the Netherlands and Oregon, patients and patient care suffer."
"The Attorney General was correct in finding that assisted suicide is not a legitimate medical practice under the Controlled Substances Act, and in clearly distinguishing this practice from the use of controlled substances to manage pain," the brief asserts. "Accordingly, the decision of the District Court should be reversed and the injunction vacated."
The full text of the brief is available on the USCCB Web site. See: http://www.usccb.org/ogc/ore-brf.shtml