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    Taking Life Away

    A look at the legality of assisted suicide.

    Opposition from Congress

    Last October, the U.S. House of Representatives passed the Pain Relief Promotion Act, which would undermine Oregon's law and dampen other states' efforts to legalize assisted suicide. The Senate is likely to consider the bill sometime this year.

    The Pain Relief Promotion Act would make it illegal for a doctor to prescribe a controlled substance if he or she knows that the patient plans to use it to commit suicide. The act's net effect is to take away a physician's only realistic means of assisting a suicide.

    The bill has a host of supporters, including the American Medical Association, which officially opposes physician-assisted suicide, and several House members who are physicians. The most strident of the latter group is family physician Tom Coburn, a Republican from Oklahoma. While arguing in favor of the act in October, he denounced physicians who take part in assisted suicides. "As soon as doctors have made the decision that they are the givers or takers of life, they no longer are physicians," he said.

    But others, such as psychiatrist Jim McDermott, a Democratic representative from Washington, oppose the Pain Relief Promotion Act. McDermott feels Congress should not legislate how physicians help their patients cope with serious illnesses.

    McDermott and fellow opponents also fear that passage of the act will make physicians hesitate when prescribing pain medications for nonsuicidal patients. "Every day in the legitimate and accepted treatment of terminally ill patients, physicians prescribe controlled substances in dosages that will hasten death," John A. Kitzhaber, M.D. -- the Democratic governor of Oregon and an emergency room physician -- wrote in the Washington Post in November 1999. "This leaves thousands of cases each year in which the intent of the physician could be questioned. Faced with the specter of investigation by the Drug Enforcement Administration, prison, or loss of their practice, many doctors will treat pain less aggressively than is required for full relief."

    No matter what legislation Congress and state governments pass, and no matter what position organizations such as the AMA take, assisted suicide -- like euthanasia -- will remain a personal matter. To end the life of a terminally ill patient will continue to be a decision that a patient and the patient?s family and physician reach privately.

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