Representatives Henry Hyde (R-Ill.) and Bart Stupak (D-Mich.) introduced the Pain Relief Promotion Act 1999 (H.R. 2260) on June 17 as a response to the use of lethal drugs for the purposes of assisted suicide and euthanasia, as is legally taking place in the state of Oregon. An identical bill was introduced in the Senate by Senators Don Nickles (R-Okla.) and Joe Lieberman (D-Conn) on June 24. The legislation represents the culmination of a year-long debate over an effective response to assisted suicide that has seen two previous bills withdrawn due to technicalities.

This new bill would prevent federally controlled substances from being used to assist in suicides in a state like Oregon (which legalized physician-assisted suicide in a referendum last year).

The first section of the legislation reinforces existing standards in relation to controlled substances. It seeks to strengthen the proper use of pain control medication, allowing the use of controlled substances in the rare cases when such use may increase the risk of death, while forbidding the use of controlled substances in assisting a suicide.

This section of the bill also provides new training for health care professionals in the legitimate use of controlled substances for pain and symptom management. Training will be based on the recommendations of the secretary of health and human services, based on the best current medical knowledge.

The second section of the legislation gives new responsibilities to the agency for health care policy and research to promote a better understanding of, and expanded training in, palliative care. It also provides $5 million per year to support training programs in palliative care. These funds would be paid out to groups based upon application to the Health Resources and Services Administration.

The bill would effectively stop “mercy killing” in Oregon and in any other state that might choose to legalize the practice, because the act would make the use of a controlled substance to assist in suicide a violation of federal law, regardless of the legality of euthanasia on the state level. In effect, therefore, the act would create a uniform national standard under which it would never be legitimate to use controlled substances to assist in suicide or commit euthanasia.

If the Pain Relief Promotion Act becomes law, it is likely to deter virtually all assisted suicides, because under the Oregon Death with Dignity Act, the physician is required to send records to the state government concerning the act of assisted suicide. These records must include the use of prescribed substances for the assisted suicide. The Controlled Substances Act enables the federal government to subpoena these records, which would provide evidence for prosecutions.

Many organizations have stated their support for the legislation, including the American Medical Association, the Christian Medical Dental Society, the National Hospice Organization, the Hospice Association of America, Aging with Dignity, the American Academy of Pain Management, the American Society of Anesthesiologists, Americans for Integrity in Palliative Care, the National Conference of Catholic Bishops, the National Legal Center for the Medically Dependent and Disabled, and the National Right to Life Committee.

Many noted individuals, including Dr. C. Everett Koop, former U.S. surgeon-general, and Dr. Herbert Hendin, the director of the American Foundation for Suicide Prevention, have also endorsed the bill.

“This Act strikes the right balance, by promoting the much-needed role of federally regulated drugs for pain relief while reaffirming that they should not be abused to assist patients’ suicides,” said Koop.