Hyde/Nickles Team Up Against Oregon Death With Dignity Act -- Again
Illinois Representative Henry Hyde and Oklahoma Senator Don Nickles have once again introduced bills into Congress to nullify Oregon's Death With Dignity Act.
Dubbed the "Pain Relief Promotion Act of 1999 (PRPA)," the bills would amend the Controlled Substances Act to make it illegal to use scheduled drugs to assist in hastening a death. Anyone "intentionally dispensing, distributing, or administering a controlled substance for the purpose of causing death or assisting another person in causing death" would be subject to federal prosecution -- and a prison term up to 20 years to life. Doctors could also lose their registrations to dispense controlled substances from the Drug Enforcement Administration.
Supporters of the Oregon Death with Dignity Act, including Compassion in Dying Federation, strongly oppose this bill. First, we oppose Congressional interference in the twice-expressed will of Oregon voters to legalize assisted dying in that state. But further, we feel that it will have a chilling effect on physicians' willingness to prescribe adequate medication for end of life care, much like last year's bills introduced by Sen. Nickles and Rep. Hyde. In their zeal to overturn Oregon's law, Hyde, Nickles and their supporters would condemn many Americans, mostly outside of Oregon, to agonizing, painful deaths to impose their personal beliefs and will on a single state -- Oregon. What makes this even more unacceptable is Oregon voters, and those of every state other than Illinois and Oklahoma, have no way of showing their displeasure at the ballot box. The result is wholly undemocratic.
Barbara Coombs Lee, Executive Director of Compassion in Dying Federation, said about the bills, "Last year's bills were, at their core, bad pieces of legislation. These bills are more artfully constructed, but the impact is even worse. They have the same purpose, but expand enforcement authority from the DEA to every police officer at the local, state and federal level. They are wolves in sheep's clothing.
"Much like last year's misguided bills, these bills would violate the intent and structure of the Controlled Substances Act. And much like last year's bills, these bills would attempt to define a crime based on a physician's state of mind during treatment of terminally ill patients."
The House Subcommittee on the Constitution met June 24 to hear testimony on PRPA. Sen. Nickles, at his press conference introducing the bill, indicated that proponents would be talking about all of the benefits the bill would generate for palliative care. But testimony could best be characterized as a frontal assault on Oregon's law. Proponents also denied that new police powers granted to federal, state and local law enforcement would in any way hinder the emerging field of palliative care or threaten doctors with additional scrutiny or investigation. Rep. Hyde, in his opening remarks, harkened back to Roe v. Wade, citing that ruling as "the beginning of a culture of death that now passes itself off as death with dignity, one of the greatest misnomers ever."
Testifying in opposition to the bill, Ann Jackson, Executive Director and CEO, Oregon Hospice Association, said there are a great number of hospices around the country that disagree with this bill. She talked about the difficulty of defining palliative care so narrowly. The fear of investigation, even under current regulations, has lead to the well-documented under treatment of pain. Jackson said she felt that more oversight would only add to that burden.
David Joranson, Senior Scientist and Director of The Pain and Policy Studies Group, Comprehensive Cancer Center, The University of Wisconsin, spoke about the Controlled Substances Act and the problems of using an Act that is designed to prevent drug abuse for the regulation of medical practice. He said that good progress has been made between DEA officials and experts in pain management in improving understanding of medical practice. He underscored his fear that this bill would undermine that progress and shift the balance back toward law enforcement and prosecution.
David Orentlicher, Professor, Indiana University School of Law and Director of the Center for Law and Health, also argued the bill defined palliative care too narrowly. It would freeze an emerging practice, he said, denying the laboratory of the states the right to find the best solutions to complex social policies. The bill threatens doctors with revocation of license and jail time. This risk rests solely on a determination of a physician's intent, something that is impossible to discern accurately. Oretlicher added that because countless law enforcement agencies would determine their own indicators of a physician's intent, the bill would create a lack of uniformity -- the goal it allegedly seeks.
Testifying in support of the bill were: Samira Beckwith, President and CEO, Hope Hospice (testifying on behalf of the National Hospice Organization); Gregory Hamilton, Physicians for Compassionate Care of Oregon; Richard Doerflinger, Associate Director for Policy Development, Secretariat for Pro-Life Activities, National Conference of Catholic Bishops; Walter Hunter, Associate National Medical Director, VistaCare Hospice; and Thomas Marzen, General Counsel, The National Legal Center for the Medically Dependent and Disabled, Inc. All made arguments against physician-assisted dying and stated these as the reason for their support of the bill.
The American Medical Association has joined the National Hospice Organization in endorsing the bill, instructing its staff to work with the bill's sponsors to work through any "technical problems" remaining.
It is clear sponsors of the bill have learned many lessons from last year's defeat. They have made the bill seem more palatable, have confused enough people in the short term, and are applying heavy pressure on groups to support the bill before strong defense emerges.
Within only one week the sponsors introduced the bill with an executive summary obfuscating its confusing language, convinced the NHO and the AMA to support the bill, scheduled and held the first hearing, and readied the bill for mark-up and votes.
It will take time for professional associations and other influential organizations to analyze the new Hyde/Nickles bill and discern its consequences.
This article was provided by Compassion in Dying. It is a part of the publication Compassion in Dying.