X-Message-Number: 10469
Date: Fri, 25 Sep 1998 07:10:25 -0700
From: David Brandt-Erichsen <>
Subject: Congressional action on PAS

The following article appears in CONGRESS DAILY/A.M.
(Sept 25/98)
A bill to ban physicians from using controlled substances to assist in a
suicide appears to be in danger of a premature death from a fatal malady
unique to legislation, a lack of votes.

On Thursday, the House pulled the bill from the schedule for the third time
in a week. The Senate Judiciary Committee approved 11-6 its version of the
measure, but a key opponent took to the floor and threatened to filibuster
if leaders tried to bring up the bill.

The "Lethal Drug Abuse Prevention Act" would indirectly overturn Oregon's
landmark "Death With Dignity Act" by making it a crime for physicians to
use substances regulated by the federal government under the auspices of
the Controlled Substances Act in order to assist a suicide.

Backed by organizations led by the National Right to Life Committee, the
measure would overturn a June ruling by Attorney General Reno that using
controlled substances to assist a suicide in a state where the practice is
legal would not violate the federal law.

So far, only Oregon has legalized assisted  suicide .
Despite opposition from the Clinton administration, the bill, sponsored by
two legislative heavyweights, House Judiciary Chairman Hyde and Senate
Majority Whip Nickles, appeared a sure bet for passage.

But its route to enactment has been stalled by an aggressive lobbying
effort launched by physician and other health groups.

Most of the groups, led by the National Hospice Association, American
College of Physicians, the American Geriatrics Society, the American
Pharmaceutical Association and the American Medical Association, oppose
physician assisted  suicide .

In the House, a leading opponent is renegade GOP Rep. Greg Ganske of Iowa,
a physician who broke with GOP leaders earlier this year by endorsing the
Democratic-sponsored managed care reform bill.

"The terminally ill frequently live in intractable pain. Studies have shown
that they rarely get proper palliative care, often because physicians fear
regulatory action if they prescribe doses of drugs which prove lethal, a
well-recognized risk in aggressive pain management," Ganske wrote in a
"Dear Colleague" last week.

He added, "Fear of investigation will lead to less appropriate pain care
and could have the unintended result of increasing the demand for assisted
suicide ."

Even strong supporters such as Rep. Charles Canady, R- Fla., concede that
the bill is unlikely to pass before the end of the session.

Canady told reporters Thursday that among other things, the Judiciary
Committee is too preoccupied with its impeachment investigation to
concentrate on other legislation.

Meanwhile, in the Senate, Judiciary Chairman Hatch did alter the bill for
Thursday's markup in an attempt to address some of the concerns from the
medical community.

As approved by the Judiciary panel with the support of all its Republicans
and ranking member Joseph Biden, D-Del., the bill would allow the Justice
Department to consult with the HHS Department to help determine appropriate
use of drugs, and would have HHS, rather than Justice, appoint a "Medical
Advisory Board on Pain Relief," to which those suspected of violating the
law could appeal.

But committee Democrats and other opponents remained unconvinced.

"The substitute amendment does not address the underlying concerns about
DEA investigations, triggers for those investigations, and numerous other
objections raised in the original bill," said a letter from the Coalition
to Improve Pain Management, which consists of patient, physician, pharmacy
and hospice interests as well as other opponents.

Almost immediately after the markup, bill sponsor Nickles vowed to move the
bill to the Senate floor.

"We want to make clear that this legislation does not interfere with
patient care at the end stages of life, but reaffirms that prescribing
drugs for the purpose of assisting in suicide is not a legitimate medical
purpose," Nickles said in a statement. "It is my intention to help the
Senate pass this important bill before we adjourn."

But Nickles will have to overcome the vehement objections of Sen. Ron
Wyden, D-Ore., who said on the Senate floor Thursday afternoon that he was
putting a hold on the measure and would filibuster if necessary to keep the
Senate from passing the bill.

"The people of my state entered into an honest, direct, and exhausting
discussion on the issue of assisted  suicide , not once, but twice, through
our public referenda process," said Wyden. "I am not going to let that vote
be set aside without an extended debate on the floor of the United States

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