April 25, 2000 (Washington) -- Legislation that would gut Oregon's physician-assisted suicide law is on the move in the U.S. Senate, after Tuesday's Judiciary Committee hearing on the "Pain Relief Promotion Act."
Oregon is the only state in the nation that permits doctors to aid in patient suicides. In the first two years of the "Death with Dignity" program, which was twice approved by voters in special state ballots, some 43 people have committed suicide with the aid of a physician in that state.
But the federal bill would make a physician liable to criminal penalties for intentionally causing death through the use of federally controlled substances regulated by the Drug Enforcement Administration (DEA).
At the same time, the legislation would provide that doctors may prescribe controlled substances for pain relief, even if they hasten death. The bill also includes $5 million in federal grants to train health professionals in end-of-life care.
The judiciary committee plans to meet on Thursday to approve the bill, and a vote by the full Senate could happen later this year. Last October, the House approved similar legislation, 271 to 156.
Last week, Oregon Sen. Ron Wyden (D) blocked the committee from voting on the measure, forcing today's hearing. He told reporters that he expects that the committee will approve the bill on Thursday, but continued to threaten to try and stall the legislation if it comes before the full Senate.
Meanwhile, Wyden's state colleague in the Senate, Gordon Smith (R.), announced today that he supported the legislation. "I'm caught in the crosshairs between the majority [of Oregonians] and my conscience," he told reporters. The bill already has 43 Senate co-sponsors, including six Democrats.
Sen. Don Nickles (R, Okla.) said today that enactment of the measure "gets the federal government back in the business of caring for people in pain rather than participating in causing their death."
But Wyden argued that the bill "would authorize local, state, and federal law enforcement officials, with no expertise and scant training in health care, to dissect a physician's intent with respect to prescribing pain relief medications." He claimed that the DEA has indicated that it could spend as much as $80 million per year investigating physicians under the measure.
At today's hearing, a panel of medical professionals weighed in on both sides of the highly controversial issue. Walter Hunter, MD, a physician with VistaCare Hospice, testified, "Nothing in this bill frightens me that I will become a 'target' of the DEA. The legislation is a timely, necessary, and explicit clarification."
But Kathleen Foley, MD, from Memorial Sloan-Kettering Cancer Center in New York, contended that the bill would increase federal regulation of medical practice. She claimed, "A strict regulatory environment negatively impacts physician prescribing practices and leads them to intentionally undertreat patients with pain because of concern of regulatory oversight."
Arthur Caplan, PhD, director of the University of Pennsylvania's Center for Bioethics, tells WebMD, "The bill really is about physician-assisted suicide, not pain control. There is a pittance of money in the bill to do something about pain control -- it doesn't show a true commitment. This is Congress reacting in abhorrence to what took place in Oregon."
Medical groups supporting the bill include the American Medical Association, the National Hospice Organization, the Hospice Association of America, the American Academy of Pain Management, and American Society of Anesthesiologists.
But the American Academy of Family Physicians and a number of state medical societies have opposed the measure, saying it would frighten physicians away from pain management.
Caplan tells WebMD that he believes Congress may pass a final bill blocking Oregon's law. But that won't be the end of the story, he says. "I suspect that this is going to lead to some huge litigation," such as a suit by Oregon's attorney general. Caplan predicts that such a case testing whether or not the legislation is constitutional could go all the way to the U.S. Supreme Court.