Congressional Effort Mounts to Outlaw Assisted Suicide

By Christine Hall | July 7, 2008 | 8:26 PM EDT

( - Time is growing short in the 106th Congress, but US Senator Don Nickles (R-OK) continues to push for a bill that would outlaw a form of doctor-assisted suicide in all 50 states.

The Pain Relief Promotion Act, which has 42 co-sponsors, including Democratic Senator and vice presidential nominee Joseph Lieberman, is an attempt to offer greater legal protection and sanction to doctors who prescribe drugs to aggressively treat pain for chronic and terminally ill patients. It also forbids doctors from prescribing drugs to assist in a terminally ill patient's decision to commit suicide.

"Our hope and expectation is that we will pass that out [of committee] and send it on to the president before we adjourn," said Gayle Osterberg, spokesperson for Senator Nickles.

The bill has a long list of supporters, including the American Medical Association, the American Academy of Pain Management and the Hospice Association of America, along with Republican presidential nominee George W. Bush and Green party candidate Ralph Nader.

Nickle's spokesperson said some states have already taken the lead on the issue.

"We've seen some states where they've passed similar laws, where the use of morphine, for example, has gone up as a result of that type of legislation," said Osterberg. "We're hopeful this will have the same effect throughout the country, that patients will have better end-of-life care and pain management as a result," she said.

The House version of the bill, sponsored by Rep. Henry Hyde (R-IL), was approved in October, 1999. The Senate bill is not only racing against time this year; it also has stiff opposition from lawmakers and special interest groups who object to the effective ban on doctor-assisted suicide. Sen. Ron Wyden (D-OR) supports doctor-assisted suicide, reflecting the majority of Oregon voters who passed a ballot initiative in 1994 legalizing the practice.

Wyden, who has reportedly threatened a filibuster of the Nickles bill, has his own competing bill, called the Conquering Pain Act. Both bills direct tax dollars to research and education in pain management.

"Senator Wyden feels that [the Nickles bill] would allow the Drug Enforcement Administration criminal experts, not health care experts, to come in and dissect the intent of physicians when they prescribe pain medication to alleviate suffering for people," said Lisa Finkel, spokesperson for Wyden.

Nickles argues that doctors are already afraid of the DEA and that his bill would, to the contrary, make doctors less afraid. "A lot of these substances can be very useful in treating pain and are often under-prescribed by doctors, partly because a lot of them are lethal if given in large doses," said Osterberg.

"There's a little bit of fear in prescribing something in large quantities and having it hasten death and there being a physician's decision being called into question by state medical boards and the DEA," she said.

Tom Miller, Director of Health Policy Studies for the Cato Institute, denies he is an advocate of doctor-assisted suicide but shares some of Wyden's concerns about the Nickles plan.

"You don't want to institutionalize [doctor-assisted suicide] as a standard of care and be reimbursed by Medicare," said Miller. On the other hand, Miller doubts that policy- makers will be able to write a law that, in the real world, distinguishes between prescriptions that ease pain and those intended to assist with suicide.

"They don't know how to draw that line," said Miller. "What are you going to have," he asked, "a 24 hour camera with attendant witnesses?"

"Part of [the purpose of Nickle's bill] is trying to have it both ways: seeming compassionate but making sure you hold up a stop sign when someone has gone over the edge," said Miller. "There's a whole human side to what's a very difficult time, that you're never going to be able to do anything other than put in some clumsy controls that make you more likely to hit the wrong innocent party than the right guilty party," said Miller.