Suicide Lobby Targets Pain Relief Act

While it approved the Pain Relief Promotion Act (H.R.2260) on April 27, the Senate Judiciary Committee waited until May 23 to file its report on the measure and clear it for full Senate consideration. While supportive groups are anxious that the legislation move forward as soon as possible, Senate Majority Leader Trent Lott has yet to schedule it for a vote.

The committee report includes a minority statement riddled with factual errors, signed by only four Democrats out of the committee's 18 members. The minority statement misreports the number of patients who have used Oregon's assisted suicide law to kill themselves using federally controlled drugs. That statement also quotes Justice Department criticisms made against a different 1998 bill, mistakenly citing them as criticisms of the current bill; and it claims the Act would overturn a "states' rights" feature of the federal Controlled Substances Act that was already repealed by Congress in 1984.

Judiciary Committee changes to the bill's language have won support from groups who earlier had concerns, including the American Academy of Pain Medicine and American Pain Society and some state medical societies. While some medical groups still oppose the Act, these are generally groups that do not share the American Medical Association's position against assisted suicide.

The American Academy of Family Physicians, for example, has urged President Clinton to veto the bill because it would require training of law enforcement personnel in "how to conduct investigations and enforcement actions" involving physicians' use of controlled substances [AAFP release, 5/23/00]. Actually it is existing law that calls for such training; the new bill urges training these officials in how to "better accommodate" physicians' use of controlled substances for pain control. In fact AAFP may have another reason for opposing the bill. In 1996 its board endorsed a resolution, supported by almost half its Congress of Delegates, to formally reject the AMA position against assisted suicide [Physician's Weekly, 11/1/96]; the group has declined in recent years to join medical groups' Supreme Court briefs and other statements against the practice.

A more egregious example of hidden agendas can be found on the Web site of Hemlock of Wisconsin. The site urges members to help defeat the Act because it would "invalidate the Oregon Law legalizing Physician Aid in Dying." But it encourages them to use other arguments when they contact Senators. "Identifying as a Hemlock member probably won't help," the site advises [www.hemlock.wis.org/Hyde-Nickles.html].

It now seems that Senator Ron Wyden of Oregon, the Act's chief Senate opponent, may not have been candid about his own agenda. In an October 23, 1999 opinion piece in the New York Times, Wyden declared that he disagrees with his home state's policy allowing assisted suicide but opposes federal intrusion in that policy. But in the May 29 issue of The Weekly Standard, attorney Wesley Smith reveals that Wyden's chief aide working against the pain relief bill is a well-known pro-suicide activist. James L. Werth, a congressional fellow in Wyden's office, is a former board member of the Nebraska Hemlock Society and the Death with Dignity National Center. His books justifying "rational suicide" are sold on the national Hemlock Society's Web site.

Wyden and his allies in the assisted suicide movement do not have the votes or the arguments to defeat the Act outright. But they hope to make it controversial enough that Majority Leader Lott, facing a crowded Senate calendar in this election year, will not bring it to the Senate floor. Their ploy may still succeed.

News Briefs

"No" to Patent for Human Euthanasia

The European Union's patent office has ruled that a "euthanasia cocktail" devised by Michigan State University can't be used on humans.

The university first applied for the patent in 1994 for use in "mammals." But when critics pointed out that the application did not exclude use in humans, the university refused to amend it, saying that the law may change in the future to allow such use (see December 1996 Life at Risk).

The patent office's ruling was sought by the German Hospice Foundation, the drug company Hoechst and others. It requires re-formulating the patent to specifically exclude use on human beings (Reuters, 5/23/00; ZENIT News Agency, 5/26).


Assisted Suicide in State Courts

In Colorado, the state Court of Appeals has rejected a claim by an 81-year-old man that the state's ban on assisted suicide violates his federal constitutional right to "free exercise of religion."

Robert Sanderson, a former district judge, had made various constitutional claims in favor of a right to assisted suicide in 1996, but these were dismissed by a state district judge in 1998. He had appealed only his "freedom of religion" claim to the Court of Appeals, arguing that he "believes that God, or nature, intended that the free will of man be exercised in all circumstances according to his own best judgment with due consideration for others."

Citing the U.S. Supreme Court's 1990 ruling in Employment Division v. Smith, however, a three-judge panel of the Court of Appeals unanimously ruled that "an individual's religious beliefs do not excuse the individual from 'compliance with an otherwise valid law prohibiting conduct that the State is free to regulate'." The court said it knows of no other case in which laws against assisted suicide were challenged on religious grounds [Associated Press, 6/8; Sanderson v. State of Colorado, Colo. Ct. of Appeals, No. 96CV0012 (June 8, 2000)].

In Alaska, however, a claim on behalf of a state constitutional right to assisted suicide will be heard by the state supreme court. The case is on appeal from a September ruling by a superior court judge, who found no such right in the Alaska constitution. The American Civil Liberties Union has filed a "friend of the court" brief in favor of the constitutional claim. Filing briefs against it are the National Legal Center for the Medically Dependent and Disabled, Alaska Catholic Conference, Alaskan Doctors Against Physician Assisted Suicide, Physicians for Compassionate Care, and the Alaska chapter of the disability rights group Not Dead Yet. The case will be argued this fall, with a ruling expected next year [Catholic News Service, 5/10].


Maine Campaign Kicks Off

A proposal to legalize physician-assisted suicide will appear at the top of Maine's November ballot this year. The ballot question, crafted by supporters, will read: "Should a terminally ill adult, who is of sound mind, be allowed to ask for and receive a doctor's help to die?"

Campaign finance reports show that Mainers for Death with Dignity raised $605,018 through June 1 (chiefly from out-of-state sources) and spent $595,384. Two groups opposing the initiative, the Coalition for the Compassionate Care of the Dying and Maine Citizens Against the Dangers of Physician Assisted Suicide, raised $223,988 and spent $156,499 in the same period. This led to reports that supporters are "outspending opponents by better than 3-1" [AP, 6/8] – which is somewhat misleading, because supporters spent almost half a million dollars solely for paid signature-gatherers to get the proposal on the ballot.

Reporting on a forum on the Portland campus of the University of New England on June 9, a local newspaper described it as a "major coup" for supporters that Dr. Marcia Angell, an editor of the New England Journal of Medicine, came out in support of the Maine proposal. Apparently the paper was unaware that Angell has ardently supported legalization of assisted suicide for years [Portland Press Herald, 6/10].

Verbatim: Senator Joseph Biden on the Pain Relief Promotion Act

Mr. Chairman, I want to say a few words about the Pain Relief Promotion Act, a bill which I am proud to support.

This bill does two important things: it makes clear that prescribing pain medication -- even when it may increase the risk of death -- is a "legitimate medical purpose" under the Controlled Substances Act and it makes clear that prescribing medication for the purpose of assisting suicide is not.

Now, truth in advertising here – I am opposed to legalizing physician-assisted suicide in this country, period.

In contrast to abortion – where some may argue about whether or not there is a life at stake – in assisted suicide there is no question that there is a human life in being. Physician-assisted suicide is the most dangerous slippery slope, in my view, that the nation can embark upon.

But this bill does more than just rule out the use of controlled substances to kill a patient. Just as important, it also urges doctors to educate themselves about pain management and palliative care and it makes clear that prescribing adequate pain medication is a legitimate use of controlled substances.

Currently, too many doctors are afraid to give a patient a high dose of pain killers for fear that their actions will appear suspicious or for fear that the remedy may have the "double effect" of hastening death. It is critical that doctors feel free to adequately manage pain so that patients do not suffer needlessly.

Now, let me dispel a couple of myths and tell you what this bill will not do. It will not have a "chilling effect" on pain management. Critics have alleged that if this legislation passes, the Drug Enforcement Administration will begin to investigate doctors more vigorously. That is certainly not the intent of this bill.

And furthermore the DEA has stated that they have no intention of investigating doctors unless the doctor has admitted to using controlled substances to kill a patient or if state authorities have concluded that was the case. The DEA has written:

Even if H.R. 2260 were enacted, it is not feasible that DEA would devote its limited resources to investigate an allegation that a practitioner assisted a suicide unless either: (i) the practitioner made a clear admission that s/he dispensed controlled substances with the specific intent to assist suicide or (ii) competent state and local authorities concluded – based on sufficient evidence provided to DEA – that the practitioner dispensed controlled substances with the specific intent to assist suicide.

If you need proof, just look at states which have passed measures similar to the one we are debating today. There has been no "chilling effect." Iowa, Kansas, Kentucky, Louisiana, Michigan, Tennessee, Rhode Island and Virginia have enacted laws making clear that providing pain medication even to the point where death is hastened is legitimate medical practice. And in each of those states, per capita use of morphine has increased as doctors feel more comfortable giving their patients the medication they need. I fully expect that passing the bill before us today will increase proper pain management nationwide.

This bill has the support of the medical community – the American Medical Association, American Academy of Pain Management, National Hospice Organization, American Pain Society, American Academy of Pain Management, and the Catholic Medical Association. These groups would not lend their names to a piece of legislation which is not in the best interest of patients. I hope that my colleagues will join me in supporting this bill today.

- Statement in Senate Committee on the Judiciary,
April 27, 2000

Background: Poll on Assisted Suicide and Federal Drugs

As the U.S. Senate prepares to consider the Pain Relief Promotion Act, a new national poll indicates strong support for the Act's policy – and remarkably high interest in assisted suicide as an election-year issue.

The Wirthlin Worldwide poll surveyed 1001 adults by phone May 19-23. It found 66% opposing use of federally controlled drugs for assisted suicide and euthanasia. Asked how important a candidate's position on assisted suicide and euthanasia would be in their vote, 31% said it would be "very important" in how they vote on election day – and 81% of that group would be more likely to support a candidate who opposes assisted suicide and euthanasia.

The survey, commissioned by the National Right to Life Committee, had a margin of error of ±3% for answers from the total sample. Questions were as follows:

"As you may or may not know, the use of narcotics and other dangerous drugs is generally prohibited by federal law except when a doctor prescribes them for a legitimate medical purpose. Should the federal law allow use of these federally controlled drugs for the purpose of assisted suicide and euthanasia?"

Yes - 29%
No - 66%
Don't know/refused - 5%

"Generally speaking, how important will a candidate's position on the issues of assisted suicide and euthanasia be in determining whether or not you will vote for that candidate?"

Important - 64% (very important - 31%)
Not so important - 36% (not important at all -18%)
Don't know/refused - 1%

Asked of the 638 respondents answering "very important" or "somewhat important":

"And, would you be more likely to vote for a candidate who [ROTATE] favors assisted suicide and euthanasia, or a candidate who opposes assisted suicide and euthanasia?"

Favor candidate opposing assisted suicide - 65%
Favor candidate supporting it - 32%
Depends on the candidate - 2%
Don't know/refused - 2%

Same question asked of the 311 respondents viewing the issue as "very important":

Favor candidate opposing assisted suicide - 81%
Favor candidate supporting it - 18%
Depends on the candidate - 1%
Don't know/refused - 1%

[Source: Release by National Right to Life Committee and Wirthlin Worldwide, 5/30/00]

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