Analysis: The Pain Relief Promotion Act (HR 2260)
by ALL
Released October 12, 2005
Introduction: Oregon’s ‘death with dignity’ law
The provisions of the Oregon suicide law enacted in an Autumn 1997 voter referendum (rejecting efforts to undo a previous statute) make it an inviting target for anyone concerned with protecting human life. For example, the Oregon law authorizes doctors to assist a patient with suicide if the patient is expected to die in six months (Or. Rev. Stat. 127.800, 127.805) and is not suffering from ``a psychiatric or psychological disorder, or depression causing impaired judgment.'' (Or. Rev. Stat. 127.825) Yet clinical experience and medical literature all point to the general unreliability of such judgments. And does impaired judgment mean the inability to remember the name of a casual acquaintance you met a year ago?
Possibility for abuse
Moreover, the chief author of the Oregon "Death with Dignity" law has stated that "depression in itself does not rule out the physician's assistance'' under the Act. (Cheryl K. Smith, "Safeguards for Physician_assisted Suicide: The Oregon Death with Dignity Act,'' in S. McLean (ed.), Death, Dying and the Law (Dartmouth Publishing 1996), 69_93 at 75.)
Even these loose legal guidelines are covered by a generous "good faith" standard which protects doctors from civil, professional and criminal liability so long as they believe "in good faith" that they have complied with the guidelines. (Or. Rev. Stat. 127.885) And the law's confidentiality provisions (Or. Rev. Stat. 127.865) and the section barring notification of family members without a suicide patient's express consent (who is presumed to be incompetent anyway) would insure that no oversight of "abuses" would occur. (Or. Rev. Stat. 127.835) Assassins must envy the protections given doctors who are called to assist an Oregon suicide.
It is already obvious that "abuses" have crept into the Oregon scheme of self-deliverance, which have produced inaction by state officials toward those who perpetrating the abuses, and hostility toward those disclosing them.
For example, Oregon Governor John Kitzhaber told a Congressional Committee that as far as he knows there are no penalties for violating the State assisted suicide guidelines. (Lethal Drug Abuse Prevention Act: Hearing on H.R. 4006 Before the Subcommittee on the Constitution of the House Committee on the Judiciary , 105th Cong. July 14, 1998) Further publicity attending the involuntary active euthanasia of an Oregon patient in violation of Oregon’s homicide law found officials declaring the doctor "unprosecutable" because of the climate created by Oregon’s assisted suicide law. (See "Doctor Won't Be Prosecuted," The Bulletin, Bend, Oregon, Dec. 11, 1997)
Then when Oregon public health workers released a report concerning assisted suicide, the Oregon Health Division issued a memo to state employees stating that state employees who reveal that a physician_assisted death has occurred in his or her county "will immediately be terminated." (Death with Dignity Memorandum from Sharon Rice, Manager Registration Unit, Center for Health Statistics of the Oregon Health Division, to County Vital Records Registrars and Deputies, Dec. 12, 1997, reprinted in Confidentiality of Death Certificates, 14 Issues in Law & Med. 333, 334 - 1998)
So, doing nothing is not really an option for persons whose consciences are troubled by assisted suicide.
Federal administrative response
First, federal administrative action was sought. The Administrator of the Drug Enforcement Agency, Thomas K. Constantine, in response to an inquiry from House Judiciary Committee Chairman Henry J. Hyde (11/5/97) that physician-assisted suicide with the use of federally controlled substances violated the Controlled Substances Act of 1970. Constantine stated that using drugs to intentionally kill patients was not a "legitimate medical purpose'' within the meaning of the Controlled Substances Act. (221 U.S.C. 801 971).
However, on June 5, 1998, Attorney General Janet Reno reversed Mr. Constantine's decision and stated that physician assisted suicide does not fall under the jurisdiction of the Controlled Substances Act (CSA) because such usage is now part of the ordinary practice of medicine in Oregon and, therefore, exempt from the CSA and also the oversight jurisdiction of the Drug Enforcement Agency.
Physicians receive licenses to practice medicine from state medical boards, but they must register with the DEA to prescribe controlled substances used in interstate commerce. Every time a physician orders a controlled substance, they must fill out a form in triplicate with one copy going to the DEA. If challenged by the DEA, doctors must, under the Controlled Substances Act, be prepared to explain to DEA officials their use of these drugs. They will lose their DEA registration and also risk criminal penalties if they prescribe drugs for any reason other than a "legitimate medical purpose."
Attorney General Reno's ruling commits the Drug Enforcement Administration to regulating assisted suicide as a ``legitimate medical practice.'' Her ruling prevents the DEA from denying, revoking or suspending the drug dispensing license of a doctor who assists in a suicide in compliance with Oregon law. DEA investigations in Oregon would focus on whether the doctor followed proper state guidelines in killing his patient.
by ALL
Released October 12, 2005
Introduction: Oregon’s ‘death with dignity’ law
The provisions of the Oregon suicide law enacted in an Autumn 1997 voter referendum (rejecting efforts to undo a previous statute) make it an inviting target for anyone concerned with protecting human life. For example, the Oregon law authorizes doctors to assist a patient with suicide if the patient is expected to die in six months (Or. Rev. Stat. 127.800, 127.805) and is not suffering from ``a psychiatric or psychological disorder, or depression causing impaired judgment.'' (Or. Rev. Stat. 127.825) Yet clinical experience and medical literature all point to the general unreliability of such judgments. And does impaired judgment mean the inability to remember the name of a casual acquaintance you met a year ago?
Possibility for abuse
Moreover, the chief author of the Oregon "Death with Dignity" law has stated that "depression in itself does not rule out the physician's assistance'' under the Act. (Cheryl K. Smith, "Safeguards for Physician_assisted Suicide: The Oregon Death with Dignity Act,'' in S. McLean (ed.), Death, Dying and the Law (Dartmouth Publishing 1996), 69_93 at 75.)
Even these loose legal guidelines are covered by a generous "good faith" standard which protects doctors from civil, professional and criminal liability so long as they believe "in good faith" that they have complied with the guidelines. (Or. Rev. Stat. 127.885) And the law's confidentiality provisions (Or. Rev. Stat. 127.865) and the section barring notification of family members without a suicide patient's express consent (who is presumed to be incompetent anyway) would insure that no oversight of "abuses" would occur. (Or. Rev. Stat. 127.835) Assassins must envy the protections given doctors who are called to assist an Oregon suicide.
It is already obvious that "abuses" have crept into the Oregon scheme of self-deliverance, which have produced inaction by state officials toward those who perpetrating the abuses, and hostility toward those disclosing them.
For example, Oregon Governor John Kitzhaber told a Congressional Committee that as far as he knows there are no penalties for violating the State assisted suicide guidelines. (Lethal Drug Abuse Prevention Act: Hearing on H.R. 4006 Before the Subcommittee on the Constitution of the House Committee on the Judiciary , 105th Cong. July 14, 1998) Further publicity attending the involuntary active euthanasia of an Oregon patient in violation of Oregon’s homicide law found officials declaring the doctor "unprosecutable" because of the climate created by Oregon’s assisted suicide law. (See "Doctor Won't Be Prosecuted," The Bulletin, Bend, Oregon, Dec. 11, 1997)
Then when Oregon public health workers released a report concerning assisted suicide, the Oregon Health Division issued a memo to state employees stating that state employees who reveal that a physician_assisted death has occurred in his or her county "will immediately be terminated." (Death with Dignity Memorandum from Sharon Rice, Manager Registration Unit, Center for Health Statistics of the Oregon Health Division, to County Vital Records Registrars and Deputies, Dec. 12, 1997, reprinted in Confidentiality of Death Certificates, 14 Issues in Law & Med. 333, 334 - 1998)
So, doing nothing is not really an option for persons whose consciences are troubled by assisted suicide.
Federal administrative response
First, federal administrative action was sought. The Administrator of the Drug Enforcement Agency, Thomas K. Constantine, in response to an inquiry from House Judiciary Committee Chairman Henry J. Hyde (11/5/97) that physician-assisted suicide with the use of federally controlled substances violated the Controlled Substances Act of 1970. Constantine stated that using drugs to intentionally kill patients was not a "legitimate medical purpose'' within the meaning of the Controlled Substances Act. (221 U.S.C. 801 971).
However, on June 5, 1998, Attorney General Janet Reno reversed Mr. Constantine's decision and stated that physician assisted suicide does not fall under the jurisdiction of the Controlled Substances Act (CSA) because such usage is now part of the ordinary practice of medicine in Oregon and, therefore, exempt from the CSA and also the oversight jurisdiction of the Drug Enforcement Agency.
Physicians receive licenses to practice medicine from state medical boards, but they must register with the DEA to prescribe controlled substances used in interstate commerce. Every time a physician orders a controlled substance, they must fill out a form in triplicate with one copy going to the DEA. If challenged by the DEA, doctors must, under the Controlled Substances Act, be prepared to explain to DEA officials their use of these drugs. They will lose their DEA registration and also risk criminal penalties if they prescribe drugs for any reason other than a "legitimate medical purpose."
Attorney General Reno's ruling commits the Drug Enforcement Administration to regulating assisted suicide as a ``legitimate medical practice.'' Her ruling prevents the DEA from denying, revoking or suspending the drug dispensing license of a doctor who assists in a suicide in compliance with Oregon law. DEA investigations in Oregon would focus on whether the doctor followed proper state guidelines in killing his patient.