[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 2151 Reported in Senate (RS)]





                                                       Calendar No. 607

105th CONGRESS

  2d Session

                                S. 2151

_______________________________________________________________________

                                 A BILL

To clarify Federal law to prohibit the dispensing or distribution of a 
   controlled substance for the purpose of causing, or assisting in 
 causing, the suicide, euthanasia, or mercy killing of any individual.

_______________________________________________________________________

                           September 24, 1998

        Reported with an amendment and an amendment to the title





                                                       Calendar No. 607
105th CONGRESS
  2d Session
                                S. 2151

To clarify Federal law to prohibit the dispensing or distribution of a 
   controlled substance for the purpose of causing, or assisting in 
 causing, the suicide, euthanasia, or mercy killing of any individual.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              June 9, 1998

 Mr. Nickles (for himself, Mr. Lott, Mr. Coats, Mr. Inhofe, Mr. Helms, 
   Mr. Murkowski, Mr. Grams, Mr. Faircloth, Mr. Bond, Mr. Enzi, Mr. 
  Sessions, Mr. Hagel, Mr. Coverdell, Mr. Smith of New Hampshire, Mr. 
  Lieberman, Mr. Brownback, Mr. Craig, Mr. Abraham, Mr. Santorum, Mr. 
    Allard, Mr. Grassley, Mr. DeWine, Mr. Kyl, and Mr. Hutchinson) 
introduced the following bill; which was read twice and referred to the 
                       Committee on the Judiciary

                           September 24, 1998

 Reported by Mr. Hatch, with an amendment and an amendment to the title
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
To clarify Federal law to prohibit the dispensing or distribution of a 
   controlled substance for the purpose of causing, or assisting in 
 causing, the suicide, euthanasia, or mercy killing of any individual.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Lethal Drug Abuse 
Prevention Act of 1998''.</DELETED>

<DELETED>SEC. 2. FINDINGS; PURPOSES.</DELETED>

<DELETED>    (a) Findings.--Congress finds that--</DELETED>
        <DELETED>    (1) the use of certain narcotics and other 
        dangerous drugs is generally prohibited under the Controlled 
        Substances Act;</DELETED>
        <DELETED>    (2) under the Controlled Substances Act and 
        implementing regulations, an exception to this general 
        prohibition permits the dispensing and distribution of certain 
        controlled substances by properly registered physicians for 
        legitimate medical purposes;</DELETED>
        <DELETED>    (3) the dispensing or distribution of controlled 
        substances to assist suicide is not a legitimate medical 
        purpose and should not be construed to be permissible under the 
        Controlled Substances Act;</DELETED>
        <DELETED>    (4) the dispensing or distribution of certain 
        controlled substances for the purpose of relieving pain and 
        discomfort is a legitimate medical purpose under the Controlled 
        Substances Act and physicians should not hesitate to dispense 
        or distribute them for that purpose when medically indicated; 
        and</DELETED>
        <DELETED>    (5) for the reasons set forth in section 101 of 
        the Controlled Substances Act (21 U.S.C. 801), the dispensing 
        and distribution of controlled substances for any purpose, 
        including that of assisting suicide, affects interstate 
        commerce.</DELETED>
<DELETED>    (b) Purposes.--The purposes of this Act are--</DELETED>
        <DELETED>    (1) to provide explicitly that Federal law is not 
        intended to license the dispensing or distribution of a 
        controlled substance with a purpose of causing, or assisting in 
        causing, the suicide, euthanasia, or mercy killing of any 
        individual; and</DELETED>
        <DELETED>    (2) to encourage physicians to prescribe 
        controlled substances as medically appropriate in order to 
        relieve pain and discomfort, by reducing unwarranted concerns 
        that their registration to prescribe controlled substances will 
        thereby be put at risk, if there is no intent to cause a 
        patient's death.</DELETED>

<DELETED>SEC. 3. LETHAL DRUG ABUSE PREVENTION.</DELETED>

<DELETED>    (a) Denial of Registration.--Section 303 of the Controlled 
Substances Act (21 U.S.C. 823) is amended by adding at the end the 
following:</DELETED>
<DELETED>    ``(i) Denial of Registration.--The Attorney General shall 
determine that registration of an applicant under this section is 
inconsistent with the public interest if--</DELETED>
        <DELETED>    ``(1) during the 5-year period immediately 
        preceding the date on which the application is submitted under 
        this section, the registration of the applicant under this 
        section was revoked under section 304(a)(4); or</DELETED>
        <DELETED>    ``(2) the Attorney General determines, based on 
        clear and convincing evidence, that the applicant is applying 
        for the registration with the intention of using the 
        registration to take any action that would constitute a 
        violation of section 304(a)(4).''.</DELETED>
<DELETED>    (b) Suspension or Revocation of Registration.--</DELETED>
        <DELETED>    (1) In general.--Section 304(a) of the Controlled 
        Substances Act (21 U.S.C. 824(a)) is amended--</DELETED>
                <DELETED>    (A) by redesignating paragraphs (4) and 
                (5) as paragraphs (5) and (6), respectively; 
                and</DELETED>
                <DELETED>    (B) by inserting after paragraph (3) the 
                following:</DELETED>
        <DELETED>    ``(4) has intentionally dispensed or distributed a 
        controlled substance with a purpose of causing, or assisting in 
        causing, the suicide, euthanasia, or mercy killing of any 
        individual, except that this paragraph does not apply to the 
        dispensing or distribution of a controlled substance for the 
        purpose of relieving pain or discomfort (even if the use of the 
        controlled substance may increase the risk of death), so long 
        as the controlled substance is not also dispensed or 
        distributed for the purpose of causing, or assisting in 
        causing, the death of an individual for any 
        reason;''.</DELETED>
        <DELETED>    (2) Conforming amendment.--Section 304(a)(5) of 
        the Controlled Substances Act (21 U.S.C. 824(a)(5)) (as 
        redesignated by paragraph (1) of this subsection) is amended by 
        inserting ``other'' after ``such''.</DELETED>
<DELETED>    (c) Pain Relief.--Section 304(c) of the Controlled 
Substances Act (21 U.S.C. 824(c)) is amended--</DELETED>
        <DELETED>    (1) by striking ``(c) Before'' and inserting the 
        following:</DELETED>
<DELETED>    ``(c) Procedures.--</DELETED>
        <DELETED>    ``(1) Order to show cause.--After any hearing 
        under paragraph (2), and before''; and</DELETED>
        <DELETED>    (2) by adding at the end the following:</DELETED>
        <DELETED>    ``(2) Medical review board on pain relief.--
        </DELETED>
                <DELETED>    ``(A) In general.--The Attorney General 
                shall by regulation establish a board to be known as 
                the Medical Review Board on Pain Relief (referred to in 
                this subsection as the `Board').</DELETED>
                <DELETED>    ``(B) Membership.--The Attorney General 
                shall appoint the members of the Board--</DELETED>
                        <DELETED>    ``(i) from among individuals who, 
                        by reason of specialized education or 
                        substantial relevant experience in pain 
                        management, are clinical experts with knowledge 
                        regarding standards, practices, and guidelines 
                        concerning pain relief; and</DELETED>
                        <DELETED>    ``(ii) after consultation with the 
                        American Medical Association, the American 
                        Academy of Hospice and Palliative Medicine, the 
                        National Hospice Organization, the American 
                        Geriatrics Society, and such other entities 
                        with relevant expertise concerning pain relief, 
                        as the Attorney General determines to be 
                        appropriate.</DELETED>
                <DELETED>    ``(C) Duties of board.--</DELETED>
                        <DELETED>    ``(i) Hearing.--If an applicant or 
                        registrant claims that any action (or, in the 
                        case of a proposed denial under section 
                        303(i)(2), any potential action) that is a 
                        basis of a proposed denial under section 
                        303(i), or a proposed revocation or suspension 
                        under subsection (a)(4) of this section, is an 
                        appropriate means to relieve pain that does not 
                        constitute a violation of subsection (a)(4) of 
                        this section, the applicant or registrant may 
                        seek a hearing before the Board on that 
                        issue.</DELETED>
                        <DELETED>    ``(ii) Findings.--Based on a 
                        hearing under clause (i), the Board shall make 
                        findings regarding whether the action at issue 
                        is an appropriate means to relieve pain that 
                        does not constitute a violation of subsection 
                        (a)(4). The findings of the Board under this 
                        clause shall be admissible in any hearing 
                        pursuant to an order to show cause under 
                        paragraph (1).''.</DELETED>

<DELETED>SEC. 4. CONSTRUCTION.</DELETED>

<DELETED>    (a) In General.--Nothing in this Act or the amendments 
made by this Act shall be construed to imply that the dispensing or 
distribution of a controlled substance before the date of enactment of 
this Act for the purpose of causing, or assisting in causing, the 
suicide, euthanasia, or mercy killing of any individual is not a 
violation of the Controlled Substances Act (21 U.S.C. 801 et 
seq.).</DELETED>
<DELETED>    (b) Incorporated Definitions.--In this section, the terms 
``controlled substance'', ``dispense'', and ``distribute'' have the 
meanings given those terms in section 102 of the Controlled Substances 
Act (21 U.S.C. 802).</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Lethal Drug Abuse Prevention Act of 
1998''.

SEC. 2. FINDINGS; PURPOSES.

    (a) Findings.--Congress finds that--
            (1) the use of certain narcotics and other drugs or 
        substances with a potential for abuse is strictly regulated 
        under the Controlled Substances Act;
            (2) the dispensing and distribution of certain controlled 
        substances only by properly registered practitioners only for 
        legitimate medical purposes are permitted under the Controlled 
        Substances Act and implementing regulations;
            (3) the dispensing or distribution of controlled substances 
        to assist suicide or euthanasia are not legitimate medical 
        purposes and are not permissible under the Controlled 
        Substances Act;
            (4) the dispensing or distribution of certain controlled 
        substances for the purpose of relieving pain and discomfort are 
        legitimate medical purposes and are permissible under the 
        Controlled Substances Act;
            (5) inadequate treatment of pain, especially for chronic 
        diseases, irreversible diseases such as cancer, and end-of-life 
        care, is a serious public health problem affecting hundreds of 
        thousands of patients every year; physicians should not 
        hesitate to dispense or distribute controlled substances when 
        medically indicated for those conditions; and
            (6) for the reasons set forth in section 101 of the 
        Controlled Substances Act (21 U.S.C. 801), the dispensing and 
        distribution of controlled substances for any purpose, 
        including that of assisting suicide or euthanasia, affect 
        interstate commerce.
    (b) Purposes.--The purposes of this Act are--
            (1) to provide explicitly that Federal law is not intended 
        to allow the dispensing or distribution of any controlled 
        substance with the purpose of causing, or assisting in causing, 
        the suicide or euthanasia, of any individual; and
            (2) to encourage practitioners to prescribe, dispense, 
        distribute, and administer controlled substances as medically 
        appropriate in order to relieve pain and discomfort, by 
        reducing unwarranted concerns that their registration to 
        prescribe controlled substances will thereby be put at risk, if 
        there is no intent to assist in causing a patient's death.

SEC. 3. LETHAL DRUG ABUSE PREVENTION.

    (a) Additional Ground for Denial of Registration.--Section 303 of 
the Controlled Substances Act (21 U.S.C. 823) is amended by adding at 
the end the following:
    ``(i) The Attorney General shall determine that registration of an 
applicant under this section is inconsistent with the public interest 
if--
            ``(1) during the 5-year period immediately preceding the 
        date on which the application is submitted under this section, 
        the registration of the applicant under this section was 
        suspended or revoked under section 304(a)(4); or
            ``(2) the Attorney General determines, based on clear and 
        convincing evidence, that the applicant is applying for the 
        registration with the intention of using the registration to 
        take any action that would constitute a violation of section 
        304(a)(4).''.
    (b) Suspension or Revocation of Registration.--
            (1) In general.--Section 304(a) of the Controlled 
        Substances Act (21 U.S.C. 824(a)) is amended--
                    (A) by redesignating paragraphs (4) and (5) as 
                paragraphs (5) and (6), respectively; and
                    (B) by inserting after paragraph (3) the following:
            ``(4) has intentionally dispensed or distributed a 
        controlled substance with the purpose of causing, or assisting 
        in causing, the suicide or euthanasia of any individual, except 
        that this paragraph does not apply to the dispensing or 
        distribution of a controlled substance--
                    ``(A) for the purpose of alleviating pain or 
                discomfort (even if the use of the controlled substance 
may increase the risk of death), so long as the controlled substance is 
not also dispensed or distributed for the purpose of causing, or 
assisting in causing, the death of an individual for any reason; or
                    ``(B) for the purpose of carrying out a sentence of 
                death under Federal or State law;''.
            (2) Conforming amendment.--Section 304(a)(5) of the 
        Controlled Substances Act (21 U.S.C. 824(a)(5)) (as 
        redesignated by paragraph (1) of this subsection) is amended by 
        inserting ``other'' after ``such'' the first place the term 
        appears.
    (c) Pain Relief.--Section 304(c) of the Controlled Substances Act 
(21 U.S.C. 824(c)) is amended--
            (1) by striking ``(c) Before'' and inserting the following:
    ``(c) Procedures.--
            ``(1) Order to show cause.--Before''; and
            (2) by adding at the end the following:
            ``(2) Assisted suicide.--
                    ``(A) Findings.--
                            ``(i) In general.--Prior to any proceeding 
                        under paragraph (1), where an order to show 
                        cause may be based on subsection (a)(4) for 
                        denial, revocation, or suspension of 
                        registration, the Attorney General shall make a 
                        finding that the applicant or registrant--
                                    ``(I) has dispensed or distributed 
                                a specific controlled substance that 
                                was directly responsible for the death 
                                of an individual; and
                                    ``(II) did not dispense or 
                                distribute the specific controlled 
                                substance as medically indicated.
                            ``(ii) Consultation.--In making any finding 
                        under clause (i)(II), the Attorney General may 
                        consult with the Secretary of Health and Human 
                        Services, as the Attorney General, in 
                        consultation with the Secretary, determines to 
                        be appropriate.
                    ``(B) Burden of proof.--At any proceeding under 
                paragraph (1), where the order to show cause is based 
                on subsection (a)(4) for denial, revocation, or 
                suspension of registration, the Attorney General shall 
                have the burden of proving, by clear and convincing 
                evidence, that the practitioner's intent was to 
                dispense or distribute a controlled substance with a 
                purpose of causing, or assisting in causing, the 
                suicide or euthanasia of any individual. In meeting 
                such burden, it shall not be sufficient to prove that 
                the registrant knew that the use of controlled 
                substance may increase the risk of death.
                    ``(C) Request for review by medical advisory board 
                on pain relief.--At any proceeding under paragraph (1), 
                where the order to show cause is based on subsection 
                (a)(4) for denial, revocation, or suspension of 
                registration, the practitioner may request, within 30 
                days after the receipt of the order to show cause, that 
                the Medical Advisory Board on Pain Relief review, in 
                accordance with paragraph (3), the administrative 
                record of such proceeding as it relates to subsection 
                (a)(4).
            ``(3) Medical advisory board on pain relief.--
                    ``(A) In general.--The Secretary of Health and 
                Human Services, in consultation with the Attorney 
                General, shall by regulation establish a board to be 
                known as the Medical Advisory Board on Pain Relief 
                (referred to in this subsection as the `Board').
                    ``(B) Membership.--
                            ``(i) In general.--Subject to clause (ii), 
                        the Secretary of Health and Human Services, in 
                        consultation with the Attorney General, shall 
                        appoint the members of the Board--
                                    ``(I) from among individuals who by 
                                reason of specialized education or 
                                substantial relevant experience in pain 
                                management, are clinical experts with 
                                knowledge regarding standards, 
                                practices, and guidelines concerning 
                                pain relief; and
                                    ``(II) after consultation with the 
                                American Medical Association, the 
                                American Academy of Pain Medicine, the 
                                American Pain Society, the American 
                                Academy of Hospice and Palliative 
                                Medicine, the National Hospice 
                                Organization, the American Geriatrics 
                                Society, and such other entities with 
                                relevant expertise concerning pain 
                                relief, as the Attorney General 
                                determines to be appropriate.
                            ``(ii) Prohibition.--No member of the Board 
                        may be an officer or employee of the Federal 
                        Government.
                    ``(C) Duties of board.--If, in accordance with 
                paragraph (2)(B), an applicant or registrant requests a 
                review by the Board of the record of a proceeding under 
                paragraph (1), the Board shall review the 
                administrative record of such proceeding as it relates 
                to subsection (a)(4) and issue to the Secretary of 
                Health and Human Services and the Attorney General an 
                advisory opinion as to whether the dispensing or 
                distribution of the controlled substance at issue in 
                the proceeding was for the purpose of alleviating pain 
                or discomfort in a manner that does not constitute a 
                violation of subsection (a)(4). The opinion of the 
                Board under this subparagraph shall be part of the 
                administrative record and shall be considered by the 
                Attorney General in determining whether to deny, 
                revoke, or suspend the registration involved.
                    ``(D) Compsensation of members.--Each member of the 
                Board shall be compensated at a rate equal to the daily 
                equivalent of the annual rate of basic pay prescribed 
                for level IV of the Executive Schedule under section 
                5315 of title 5, United States Code, for each day 
                (including travel time) during which such member is 
                engaged in the performance of the duties of the Board.
            ``(4) No additional investigative authority.--Nothing in 
        section 303(i), subsection (a)(4) of this section, or this 
        subsection may be construed to provide the Attorney General 
        with any additional investigative authority in any State, to 
        the extent that the law of the State prohibits assisted suicide 
        or euthanasia.''.

SEC. 4. DESIGNATION OF LIAISON.

    Not later than 30 days after the date of enactment of this Act, the 
Secretary of Health and Human Services shall designate an officer of 
the Department of Health and Human Services to serve as a liaison 
between the Secretary of Health and Human Services and the Attorney 
General in carrying out this Act and the amendments made by this Act.

SEC. 5. DIVERSION CONTROL FEE ACCOUNT.

    Notwithstanding any other provision of law, for purposes of section 
111(b) of the Departments of Commerce, Justice, and State, the 
Judiciary, and Related Agencies Appropriations, Act, 1993 (21 U.S.C. 
886a), the operation of the diversion control program of the Drug 
Enforcement Administration shall be construed to include carrying out 
section 303(i) of the Controlled Substances Act (21 U.S.C. 823(i)), as 
added by this Act, and subsections (a)(4), (c)(2), and (c)(3) of 
section 304 of the Controlled Substances Act (21 U.S.C. 824), as 
amended by this Act.

SEC. 6 APPLICABILITY; CONSTRUCTION.

    (a) Applicability.--The amendments made by this Act shall apply 
with respect to any controlled substance dispensed or distributed on or 
after the date of enactment of this Act.
     (b) Construction.--Nothing in this Act or amendments made by this 
Act shall be construed to imply that the dispensing or distribution of 
a controlled substance before the date of enactment of this Act for the 
purpose of causing, or assisting in causing, the suicide or euthanasia 
of any individual is or is not a violation of the Controlled Substances 
Act (21 U.S.C. 801 et seq.).
    (c) Incorporated Definitions.--In this section, the terms 
``controlled substance'', ``dispense'', and ``distribute'' have the 
meanings given those terms in section 102 of the Controlled Substances 
Act (21 U.S.C. 802).
            Amend the title so as to read: ``To clarify Federal law to 
        prohibit the dispensing or distribution of a controlled 
        substance for the purpose of causing, or assisting in causing, 
        the suicide or euthanasia of any individual.''.