[Congressional Record Volume 143, Number 18 (Wednesday, February 12, 1997)]
[Senate]
[Pages S1300-S1305]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

       By Mr. DORGAN (for himself, Mr. Ashcroft, Mr. Nickles, Mr. 
     Ford, Mr. Abraham, Mr. Allard, Mr. Biden, Mr. Bond, Mr. 
     Breaux, Mr. Brownback, Mr. Burns, Mr. Coats, Mr. Craig, Mr. 
     DeWine, Mr. Enzi, Mr. Faircloth, Mr. Grassley, Mr. Gregg, Mr. 
     Helms, Mr. Hutchinson, Mr. Inhofe, Mr. Lieberman, Mr. Lott, 
     Mr. Mack, Mr. McConnell, Mr. Murkowski, Mr. Sessions, Mr. 
     Smith of Oregon, Mr. Smith of New Hampshire, and Mr. 
     Thurmond):
  S. 304. A bill to clarify Federal law with respect to assisted 
suicide, and for other purposes; to the Committee on Finance.


              THE ASSISTED SUICIDE FUNDING RESTRICTION ACT

  Mr. DORGAN. Mr. President, I rise today to introduce legislation, 
along with Senator Ashcroft and 28 of our colleagues from both sides of 
the aisle, that will prohibit Federal funds from being used to pay for 
the costs associated with assisted suicide.
  I want to say right off that the Dorgan-Ashcroft bill does not 
attempt to address the broad and complex issue of whether there is a 
constitutional right to die. That job belongs to the Supreme Court, and 
as you all know, the High Court is expected to issue a decision later 
this year to answer this fundamental question.
  It is the job of Congress, however, to determine how our Federal 
resources will be allocated. I do not believe Congress ever intended 
for Federal funding to be used for assisted suicide, and my bill will 
ensure that such funding does not occur.
  I understand that the decisions that confront individuals and their 
families when a terminal illness strikes are among the most difficult a 
family will ever have to make. At times like this, each of us must rely 
on our own religious beliefs and conscience to guide us.
  But regardless of one's personal views about assisted suicide, I feel 
strongly that Federal tax dollars should not be used for this 
controversial practice, and the vast majority of Americans agree with 
me. In fact, when asked in a poll in November of last year whether tax 
dollars should be spent for assisting suicide, 87 percent of Americans 
feel tax money should not be spent for this purpose.
  The Assisted Suicide Funding Restriction Act prevents any Federal 
funding from being used for any item or service which is intended to 
cause, or assist in causing, the suicide, euthanasia, or mercy killing 
of any individual.
  This bill does make some important exceptions. First, this bill 
explicitly provides that it does not limit the withholding or 
withdrawal of medical treatment or of nutrition or hydration from 
terminally ill patients who have decided that they do not want their 
lives sustained by medical technology. Most people and States recognize 
that there are ethical, moral, and legal distinctions between actively 
taking steps to end a patient's life and withholding or withdrawing 
treatment in order to allow a patient to die naturally. Every State now 
has a law in place governing a patient's right to lay out in advance, 
through an advanced directive, living will, or some other means, his or 
her

[[Page S1301]]

wishes related to medical care at the end of life. Again, this 
legislation would not interfere with the ability of patients and their 
families to make clear and carry out their wishes regarding the 
withholding or withdrawal of medical care that is prolonging the 
patient's life.
  This bill also makes clear that it does not prevent Federal funding 
for any care or service that is intended to alleviate a patient's pain 
or discomfort, even if the use of this pain control ultimately hastens 
the patient's death. Large doses of medication are often needed to 
effectively reduce a terminally ill patient's pain, and this medication 
may increase the patient's risk of death. I think we all would agree 
that the utmost effort should be made to ensure that terminally ill 
patients do not spend their final days in pain and suffering.
  Finally, while I think Federal dollars ought not be used to assist a 
suicide, this bill does not prohibit a State from using its own dollars 
for this purpose. However, I do not think taxpayers from other States, 
who have determined that physician-assisted suicide should be illegal, 
should be forced to pay for this practice through the use of Federal 
tax dollars.
  I realize that the legality of assisted suicide has historically been 
a State issue. There are 35 States, including my State of North Dakota, 
which have laws prohibiting assisted suicide and at least 8 other 
States consider this practice to be illegal under common law. Only one 
State, Oregon, has a law legalizing assisted suicide.
  However, two circumstances have changed that now make this an issue 
of Federal concern. First, the Supreme Court's decisions in Washington 
versus Glucksberg and Quill versus Vacco could have enormous 
consequences on our public policy regarding assisted suicide. In these 
two cases, the Federal Ninth Second Circuit Courts of Appeal have 
struck down Washington and New York State statutes outlawing assisted 
suicide. Although the circuit courts varied in their legal reasoning, 
both recognized a constitutional right to die.
  Second, we are on the brink of a situation where Federal Medicaid 
dollars may soon be used to reimburse physicians who help their 
patients die. In another case, Lee versus Oregon, a Federal district 
court judge has ruled that Oregon's 1994 law allowing assisted suicide 
is unconstitutional and he has blocked its implementation. However, his 
decision has been appealed to the Ninth Circuit Court of Appeals, which 
has already recognized a constitutional right to die.
  Once the legal challenges to Oregon's law have been resolved, the 
State's Medicaid director has already stated that Oregon will begin 
using its Federal Medicaid dollars to reimburse physicians for their 
costs associated with assisting in suicide. Should this occur, Congress 
will not have considered this issue. I do not think it was Congress' 
intention for Medicaid or other Federal dollars to be used to assist in 
suicide, and I hope we will take action soon to stop this practice 
before it starts.
  It is important to point out that the Supreme Court decisions will 
not resolve the important issue of funding for assisted suicides. Even 
if the Supreme Court finds that there is not a constitutional right to 
assisted suicide, the ruling likely will not negate Oregon's statute 
permitting assisted suicide. As a result, the Ninth Circuit Court could 
well uphold the Oregon statute and Oregon could, in turn, bill Medicaid 
for the costs associated with assisted suicide. If Congress does not 
act to disallow Federal funding, a few States, or a few judges, may 
very well take this decision out of our hands.
  The National Conference of Catholic Bishops and the National Right to 
Life Committee have endorsed this legislation. The American Medical 
Association and the American Nurses Association have issued position 
statements opposing assisted suicide, and President Clinton has also 
indicated his opposition to assisted suicide.
  I hope you agree with me and the vast majority of Americans who 
oppose using scarce Federal dollars to pay for assisted suicide. I 
invite you to join me, Senator Ashcroft and 28 of our colleagues in 
this effort by cosponsoring the Assisted Suicide Funding Restriction 
Act.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 304

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Assisted Suicide Funding 
     Restriction Act of 1997''.

     SEC. 2. GENERAL PROHIBITION ON USE OF FEDERAL ASSISTANCE.

       Notwithstanding any other provision of law, no funds 
     appropriated by the Congress shall be used to provide, 
     procure, furnish, fund, or support, or to compel any 
     individual, institution, or government entity to provide, 
     procure, furnish, fund, or support, any item, good, benefit, 
     program, or service, the purpose of which is to cause, or to 
     assist in causing, the suicide, euthanasia, or mercy killing 
     of any individual.

     SEC. 3. RULE OF CONSTRUCTION.

       Nothing in this Act, or in an amendment made by this Act, 
     shall be construed to create any limitation relating to--
       (1) the withholding or withdrawing of medical treatment or 
     medical care;
       (2) the withholding or withdrawing of nutrition or 
     hydration;
       (3) abortion; or
       (4) the use of an item, good, benefit, or service furnished 
     for the purpose of alleviating pain or discomfort, even if 
     such use may increase the risk of death, so long as such 
     item, good, benefit, or service is not also furnished for the 
     purpose of causing, or the purpose of assisting in causing, 
     death, for any reason.

     SEC. 4. PROHIBITION OF FEDERAL FINANCIAL PARTICIPATION UNDER 
                   MEDICAID FOR ASSISTED SUICIDE OR RELATED 
                   SERVICES.

       (a) In General.--Section 1903(i) of the Social Security Act 
     (42 U.S.C. 1396b(i)) is amended--
       (1) by striking ``or'' at the end of paragraph (14);
       (2) by striking the period at the end of paragraph (15) and 
     inserting ``; or''; and
       (3) by inserting after paragraph (15) the following:
       ``(16) with respect to any amount expended for any item or 
     service furnished for the purpose of causing, or the purpose 
     of assisting in causing, the death of any individual, such as 
     by assisted suicide, euthanasia, or mercy killing.''.
       (b) Treatment of Advance Directives.--Section 1902(w) of 
     the Social Security Act (42 U.S.C. 1396a(w)) is amended by 
     adding at the end the following:
       ``(5) Nothing in this subsection shall be construed to 
     create any requirement with respect to a portion of an 
     advance directive that directs the purposeful causing, or the 
     purposeful assisting in causing, of the death of any 
     individual, such as by assisted suicide, euthanasia, or mercy 
     killing.
       ``(6) Nothing in this subsection shall be construed to 
     require any provider or organization, or any employee of such 
     a provider or organization, to inform or counsel any 
     individual regarding any right to obtain an item or service 
     furnished for the purpose of causing, or the purpose of 
     assisting in causing, the death of the individual, such as by 
     assisted suicide, euthanasia, or mercy killing.''.

     SEC. 5. RESTRICTING TREATMENT UNDER MEDICARE OF ASSISTED 
                   SUICIDE OR RELATED SERVICES.

       (a) Prohibition of Expenditures.--Section 1862(a) of the 
     Social Security Act (42 U.S.C. 1395y(a)) is amended--
       (1) by striking ``or'' at the end of paragraph (14);
       (2) by striking the period at the end of paragraph (15) and 
     inserting ``; or''; and
       (3) by inserting after paragraph (15) the following:
       ``(16) where such expenses are for any item or service 
     furnished for the purpose of causing, or the purpose of 
     assisting in causing, the death of any individual, such as by 
     assisted suicide, euthanasia, or mercy killing.''.
       (b) Treatment of Advance Directives.--Section 1866(f) of 
     the Social Security Act (42 U.S.C. 1395cc(f)) is amended by 
     adding at the end the following:
       ``(4) Nothing in this subsection shall be construed to 
     create any requirement with respect to a portion of an 
     advance directive that directs the purposeful causing, or the 
     purposeful assisting in causing, of the death of any 
     individual, such as by assisted suicide, euthanasia, or mercy 
     killing.
       ``(5) Nothing in this subsection shall be construed to 
     require any provider of services or prepaid or eligible 
     organization, or any employee of such a provider or 
     organization, to inform or counsel any individual regarding 
     any right to obtain an item or service, furnished for the 
     purpose of causing, or the purpose of assisting in causing, 
     the death of the individual, such as by assisted suicide, 
     euthanasia, or mercy killing.''.

     SEC. 6. PROHIBITION AGAINST USE OF BLOCK GRANTS TO STATES FOR 
                   SOCIAL SERVICES TO PROVIDE ITEMS OR SERVICES 
                   FOR THE PURPOSE OF INTENTIONALLY CAUSING DEATH.

       Section 2005(a) of the Social Security Act (42 U.S.C. 
     1397d(a)) is amended--
       (1) by striking ``or'' at the end of paragraph (8);

[[Page S1302]]

       (2) by striking the period at the end of paragraph (9) and 
     inserting ``; or''; and
       (3) by adding at the end the following:
       ``(10) for the provision of any item or service furnished 
     for the purpose of causing, or the purpose of assisting in 
     causing, the death of any individual, such as by assisted 
     suicide, euthanasia, or mercy killing.''.

     SEC. 7. INDIAN HEALTH CARE.

       Section 201(b) of the Indian Health Care Improvement Act 
     (25 U.S.C. 1621(b)) is amended by adding at the end the 
     following:
       ``(3) Funds appropriated under the authority of this 
     section may not be used for the provision of any item or 
     service (including treatment or care) furnished for the 
     purpose of causing, or the purpose of assisting in causing, 
     the death of any individual, such as by assisted suicide, 
     euthanasia, or mercy killing.''.

     SEC. 8. MILITARY HEALTH CARE SYSTEM.

       (a) Members and Former Members.--Section 1074 of title 10, 
     United States Code, is amended by adding at the end the 
     following:
       ``(d) Under joint regulations prescribed by the 
     administering Secretaries, a person may not furnish any item 
     or service under this chapter (including any form of medical 
     care) for the purpose of causing, or the purpose of assisting 
     in causing, the death of any individual, such as by assisted 
     suicide, euthanasia, or mercy killing.''.
       (b) Prohibited Health Care for Dependents.--Section 1077(b) 
     of title 10, United States Code, is amended by adding at the 
     end the following:
       ``(4) Items or services (including any form of medical 
     care) furnished for the purpose of causing, or the purpose of 
     assisting in causing, the death of any individual, such as by 
     assisted suicide, euthanasia, or mercy killing.''.
       (c) Prohibited Health Care Under CHAMPUS.--
       (1) Spouses and children of members.--Section 1079(a) of 
     title 10, United States Code, is amended by adding at the end 
     the following:
       ``(18) No contract for the provision of health-related 
     services entered into by the Secretary may include coverage 
     for any item or service (including any form of medical care) 
     furnished for the purpose of causing, or the purpose of 
     assisting in causing, the death of any individual, such as by 
     assisted suicide, euthanasia, or mercy killing.''.
       (2) Other covered beneficiaries.--Section 1086(a) of title 
     10, United States Code, is amended--
       (A) by inserting ``(1)'' after ``(a)'' the first place it 
     appears; and
       (B) by adding at the end the following:
       ``(2) No contract for the provision of health-related 
     services entered into by the Secretary may include coverage 
     for any item or service (including any form of medical care) 
     furnished for the purpose of causing, or the purpose of 
     assisting in causing, the death of any individual, such as by 
     assisted suicide, euthanasia, or mercy killing.''.

     SEC. 9. FEDERAL EMPLOYEES HEALTH BENEFIT PLANS.

       Section 8902 of title 5, United States Code, is amended by 
     adding at the end the following:
       ``(o) A contract may not be made or a plan approved which 
     includes coverage for any benefit, item or service that is 
     furnished for the purpose of causing, or the purpose of 
     assisting in causing, the death of any individual, such as by 
     assisted suicide, euthanasia, or mercy killing.''.

     SEC. 10. HEALTH CARE PROVIDED FOR PEACE CORPS VOLUNTEERS.

       Section 5(e) of the Peace Corps Act (22 U.S.C. 2504(e)) is 
     amended--
       (1) by inserting ``(1)(A)'' after ``(e)'';
       (2) by striking ``Subject to such'' and inserting the 
     following:
       ``(2) Subject to such''; and
       (3) by adding at the end of paragraph (1) (as so designated 
     by paragraph (1)), the following:
       ``(B) Health care provided under this subsection to 
     volunteers during their service to the Peace Corps shall not 
     include any item or service furnished for the purpose of 
     causing, or the purpose of assisting in causing, the death of 
     any individual, such as by assisted suicide, euthanasia, or 
     mercy killing.''.

     SEC. 11. MEDICAL SERVICES FOR FEDERAL PRISONERS.

       Section 4005(a) of title 18, United States Code, is 
     amended--
       (1) by inserting ``(1)'' after ``(a)''; and
       (2) by adding at the end the following:
       ``(2) Services provided under this subsection shall not 
     include any item or service furnished for the purpose of 
     causing, or the purpose of assisting in causing, the death of 
     any individual, such as by assisted suicide, euthanasia, or 
     mercy killing.''.

     SEC. 12. PROHIBITING USE OF ANNUAL FEDERAL PAYMENT TO 
                   DISTRICT OF COLUMBIA FOR ASSISTED SUICIDE OR 
                   RELATED SERVICES.

       (a) In General.--Title V of the District of Columbia Self-
     Government and Governmental Reorganization Act is amended by 
     adding at the end the following:


    ``ban on use of funds for assisted suicide and related services

       ``Sec. 504. None of the funds appropriated to the District 
     of Columbia pursuant to an authorization of appropriations 
     under this title may be used to furnish any item or service 
     for the purpose of causing, or the purpose of assisting in 
     causing, the death of any individual, such as by assisted 
     suicide, euthanasia, or mercy killing.''.
       (b) Clerical Amendment.--The table of sections of the 
     District of Columbia Self-Government and Governmental 
     Reorganization Act is amended by adding at the end of the 
     items relating to title V the following:

``Sec. 504. Ban on use of funds for assisted suicide and related 
              services.''.

       (c) Effective Date.--The amendments made by this section 
     shall apply to payments to the District of Columbia for 
     fiscal years beginning with fiscal year 1998.

  Mr. ASHCROFT. Mr. President, I am grateful for this opportunity to 
speak to my colleagues and to the American public about an item which 
is important and which demands our attention. It is an item of urgency. 
And because it is, I think it is important that we develop a sense of 
cooperation and that we act expeditiously.
  A lot of comment is being heard these days about bipartisanship, the 
need to cooperate and to be partners and participants rather than being 
opponents and partisans. The measure about which I will speak today is 
one that has broad bipartisan support, and I think is something upon 
which cooperation is not only taking place, but one which will provide 
the basis for the ultimate passage of the legislation.
  Members on both sides of the aisle agree that Federal health programs 
such as Medicare and Medicaid should provide a means to care for and to 
protect our citizens--not become vehicles for the destruction or 
impairment of our citizens.
  The Declaration of Independence reads: ``We hold these truths to be 
self-evident, that all men are created equal, that they are endowed by 
their Creator with certain unalienable Rights, that among these are 
Life, Liberty and the pursuit of Happiness.'' It is Congress' 
responsibility to defend the foremost of our inalienable rights--that 
of life.
  In this spirit and understanding, I rise today to introduce with 
Senators Dorgan, Nickles, Ford, and others, the Assisted Suicide 
Funding Restriction Act of 1997, a modest and a timely response to the 
threat that taxes paid by American citizens would be used to finance 
assisted suicide. What this bill simply says is that Federal tax 
dollars shall not be used to pay for and promote assisted suicide or 
euthanasia. We introduced such a bill in the 104th Congress, and have 
wide bipartisan support for this legislation, with 30 Members of the 
U.S. Senate as original cosponsors on the bill.
  This bill is urgently needed to preserve the intent of our Founding 
Fathers and the integrity of Federal programs that serve the elderly 
and the seriously ill, programs which were intended to support and 
enhance human health and life, not to promote the destruction of human 
life.
  Government's role in our culture should be to call us to our highest 
and best, to expand our capacity to take advantage of the opportunities 
of life, and to build our capacity for achievement. I do not believe 
that Government has a place in hastening Americans to their graves.
  Our court system is, however, on the brink of allowing Federal-
taxpayer-assisted suicide funding. This bill is intended to preempt and 
to prevent proactively such a morally contemptible practice as taking 
tax money from one American and using it to assist in the suicide of 
another American.
  Let me be clear that this bill only affects Federal funding for 
actions whose direct purpose is to cause or to assist in causing 
suicide--actions that are clearly condemned as unethical by the 
American Medical Association and illegal in the vast majority of 
States. Again, this bill simply prohibits any Federal funding for 
medical actions that assist suicide.
  Some might ask why we need such a law. It is because two Federal 
courts of appeals recently contradicted the positions of 49 States when 
they found that there is a Federal constitutional ``right'' to 
physician-assisted suicide. These cases involved New York and 
Washington State laws which prohibit physician-assisted suicide.
  The State of Oregon recently passed Measure No. 16. That was the 
first law in the country that authorized the dispensing of lethal drugs 
to terminally ill patients to assist in suicide. Although a Federal 
court in Oregon struck down that law, the case has been to the ninth 
circuit, one of the appeals courts that has already signaled a strong 
indication that there is a constitutional right to assisted suicide.

[[Page S1303]]

  Oregon's Medicaid director and the chairman of the Oregon Health 
Services Commission have both said that in the event that the ninth 
circuit would clear the way for Oregon's law to take effect, the 
federally funded Medicaid Program in Oregon would begin to pay for 
assisted suicide with public funds in that State. According to the 
Oregon authorities, the procedure would be listed on Medicaid 
reimbursement forms under the grotesque euphemism of ``comfort care.''
  Unless we pass the Assisted Suicide Funding Restriction Act, Oregon 
could soon be drawing down Federal funds through its Medicaid Program 
to help pay for assisted suicides. Neither Medicaid, nor Medicare, nor 
any other Federal health program has explicit statutory language to 
prohibit the use of Federal funds to dispense lethal drugs for suicide 
primarily because no one in the history of these programs ever thought 
that they would be used to end the lives of individuals. We have always 
focused in these programs on seeking to extend rather than end the 
lives of Americans.
  In fact, the Clinton administration's brief filed in the Supreme 
Court of the United States opposing physician-assisted suicide pointed 
out that:

       The Department of Veterans Affairs, which operates 173 
     medical centers, 126 nursing homes, and 55 inpatient 
     hospices, has a policy manual that . . . forbids ``the active 
     hastening of the moment of death.''

  ``The active hastening of the moment of death'' sounds a lot like 
assisted suicide to me.
  Such guidelines also apply to the VA's hospice program, the military 
services, the Indian Health Service, and the National Institutes of 
Health.
  Nonetheless, if the ninth circuit reinstates Oregon's Measure 16, 
Federal funds will be used for the so-called comfort care, also known 
as assisted suicide.
  I believe we would be derelict in our duty if we were to ignore this 
problem and allow a few officials in one State to decide that the 
taxpayers of the other 49 States must help subsidize a practice that 
they have never authorized and that millions of Americans find to be 
morally abhorrent.
  It is crystal clear that the American people do not want their tax 
dollars spent on assisting the suicide of individuals. Recently, a 
national Wirthlin poll showed that 87 percent of Americans oppose the 
use of public funds for this purpose. Even the voters of Oregon, who 
narrowly approved Measure 16 by a 51- to 49-percent margin, did not 
consider the question of public funding. The voters of two other west 
coast States, California and Washington, soundly defeated similar 
measures to authorize assisted suicide. Since November 1994, when 
Oregon passed its law, 15 other States have considered and rejected 
bills to legalize the practice. However, this bill does not talk about 
authorizing or prohibiting assisted suicide. It merely states that no 
Federal funds could be used to promote or assist suicide.
  Let me just say a few words about the way the legislation is crafted. 
It is very limited. It is very modest, and I think that provides the 
basis for its bipartisan support.
  It does not forbid a State to legalize assisted suicide, and it does 
not forbid using State funds for the practice. It merely prevents 
Federal funds and Federal programs from being drawn into promoting it.
  The bill also does not attempt to resolve the constitutional issue 
that the Supreme Court considered last month when it heard the cases of 
Washington versus Glucksberg and Vacco versus Quill. These are right-
to-suicide cases, and the bill does not attempt to answer this complex 
question. Nor would this legislation be affected by what the Supreme 
Court decides on the issue. Congress would still have the right to 
prevent Federal funding of such a practice even if the practice itself 
had the status of a constitutional ``right.''
  As the bill's rule of construction clearly provides, this legislation 
does not affect any other life issue that some might have strong 
feelings about. The bill does not affect abortion, or complex issues 
such as the withholding or withdrawal of life-sustaining treatment, 
even of nutrition or hydration. Nor does it affect the dispersing of 
large doses of morphine or other drugs to ease the pain of terminal 
illness, even when this may carry the risk of hastening death as a 
side-effect--a practice that is legally accepted in all 50 States, and 
ethically accepted by the medical profession and even by pro-life and 
religious organizations. This bill is focused exclusively on 
prohibiting Federal funding for assisting suicide.
  Finally, I am pleased to mention those organizations that have joined 
with us in endorsing this legislation. These include the American 
Medical Association, the Christian Coalition, the Family Research 
Council, Free Congress, the National Conference of Catholic Bishops, 
National Right to Life, and the Traditional Values Coalition. I ask 
unanimous consent to have printed in the Record a letter of support 
from the American Medical Association.
  There being no objection, the letter was ordered to be printed in the 
Record, as follows:


                                 American Medical Association,

                                   Chicago, IL, February 12, 1997.
     Hon. John Ashcroft,
     Washington, DC.
       Dear Senator Ashcroft: The American Medical Association 
     (AMA) is pleased to support the ``Assisted Suicide Funding 
     Restriction Act of 1997'' which you are introducing in 
     collaboration with Senator Dorgan. We believe that the 
     prohibition of federal funding for any act that supports 
     ``assisted suicide'' sends a strong message from our elected 
     officials that such acts are not to be encouraged or 
     condoned. The power to assist in intentionally taking the 
     life of a patient is antithetical to the central mission of 
     healing that guides physicians. While some patients today 
     regrettably do not receive adequate treatment for pain or 
     depression, the proper response is an increased effort to 
     educate both physicians and their patients as to available 
     palliative measures and multidisciplinary interventions. The 
     AMA is currently designing just such a far-reaching, 
     comprehensive effort in conjunction with the Robert Wood 
     Johnson Foundation.
       The AMA is particularly pleased to note that your bill 
     acknowledges--in its ``Rules of Construction'' section--the 
     appropriate role for physicians and other caregivers in end-
     of-life patient care. The Rules properly distinguish the 
     passive intervention of withholding or withdrawing medical 
     treatment or care (including nutrition and hydration) from 
     the active role of providing the direct means to kill 
     someone. Most important to the educational challenge cited 
     above is the Rule of Construction which recognizes the 
     medical principle of ``secondary effect,'' that is, the 
     provision of adequate palliative treatment, even though the 
     palliative agent may also foreseeably hasten death. This 
     provision assures patients and physicians alike that 
     legislation opposing assisted suicide will not chill 
     appropriate palliative and end-of-life care. Such a chilling 
     effect would, in fact, have the perverse result of increasing 
     patients' perceived desire for a ``quick way out.''
       The AMA continues to stand by its ethical principle that 
     physician-assisted suicide is fundamentally incompatible with 
     the physician's role as healer, and that physicians must, 
     instead, aggressively respond to the needs of patients at the 
     end of life. We are pleased to support this carefully crafted 
     legislative effort, and offer our continuing assistance in 
     educating patients, physicians and elected officials alike as 
     to the alternatives available at the end of life.
           Sincerely,
                                               P. John Seward, MD.

  Mr. ASHCROFT. President Jefferson wrote in words that are now 
inscribed in the Jefferson Memorial here in Washington that the ``care 
and protection of human life, and not its destruction,'' are the only 
legitimate objectives of good government. Thomas Jefferson believed 
that our rights are God given and that life is an inalienable right. 
With this understanding and belief, I urge the Congress and the 
President to support this bill. It is a modest but necessary effort to 
uphold our basic principles by forbidding the Federal funding of 
assisted suicide.
  Mr. President, I thank my colleague from North Dakota for his 
excellent work, his cooperation in this respect, and his emphasis on 
what this bill does and what it does not do. There is a narrow focus in 
this measure. We do not seek to preempt the ability of States to make 
decisions regarding their own laws, or individuals to make their own 
decisions. We are merely making reference to the fact that the Federal 
Government should not be financing assisted suicides.
  I thank him for his outstanding work and for his excellent effort in 
developing this legislation, to narrowly focus it and target it in such 
a way that makes it possible for us to work together. I commend him.
  Mr. ABRAHAM. Mr. President, I rise to express my strong support for 
the Assisted Suicide Funding Restriction Act. In so doing I side with 
the 87 percent of Americans who oppose the use

[[Page S1304]]

of tax dollars to pay for the cost of assisting suicide or euthanasia.
  I find it deeply distressing, Mr. President, that we are in the 
throes of a legal and public policy debate over whether physicians 
should be given the power to end the lives of their patients. This 
controversy raises many troublesome questions concerning the duties of 
a physician, the nature of the doctor-patient relationship, the 
possibility of coerced suicide, and the very sanctity of life.
  Some may find these questions difficult or even impossible to answer. 
But of one thing I am certain: the government has no right to use 
public moneys, the tax dollars paid by the American people, to support 
physician assisted suicide. Whatever their views on the rectitude of 
allowing doctors to assist their patients in ending their lives, I hope 
my colleagues will join with me in saying that such a controversial 
practice, which so many Americans find morally troubling, should not be 
the object of Federal largesse.
  I congratulate my friends the Senator from North Dakota and the 
Senator from Missouri on their courage and conviction in submitting 
this bill, and urge my colleagues to join them in its support.
  Mr. BURNS. Mr. President, as an original cosponsor of the Assisted 
Suicide Funding Restriction Act of 1997, I rise in strong support of 
this bill.
  Mr. President, this bill simply prohibits Federal tax funds from 
being used to pay for or promote assisted suicide or euthanasia. 
Specifically, the bill will prevent Federal funding for items or 
services ``the purpose of which is to cause, or assist in causing, the 
suicide, euthanasia, or mercy killing of any individual.'' The 
prohibition will encompass Medicare, Medicaid, the Federal Employees 
Health Program, medical services for prisoners, and the military health 
care system.
  This bill does not create any limitation with regard to the 
withholding or withdrawing of medical treatment or of nutrition or 
hydration, or affect funding for abortion or for alleviating pain or 
discomfort for patients.
  The American people oppose taxpayer funding of assisted suicide by an 
overwhelming margin. In addition, the American Medical Association has 
endorsed this bill. Yet States are free to legalize assisted suicide, 
as Oregon has by referendum, and this raises the prospect of Federal 
Medicaid dollars being used to facilitate suicide. The Federal 
Government must not be in the business of promoting death. Let's listen 
to the American people and settle the question of publicly funding 
assisted suicide once and for all. I urge my colleague to join us in 
supporting the Assisted Suicide Funding Restriction Act of 1997.
 Mr. HUTCHINSON. Mr. President, I am pleased to express my 
support of the Assisted Suicide Funding Restriction Act of which I am a 
cosponsor. This bill would ensure that no Federal tax dollars are used 
to pay for or promote assisted suicide or euthanasia. In addition, it 
identifies those Federal programs which may not be sued to pay for 
assisted suicide. These programs include Medicare, Medicaid, Federal 
Employees Health Benefits plans, medical services for Federal 
prisoners, and the military health care system.
  This bill also makes clear that Federal law will not require health 
care facilities, in States where assisted suicide has been legalized, 
to advise patients at the time of admission about their ``right'' to 
get lethal drugs for suicide.
  This legislation is needed due to recent Federal court rulings which 
have declared a constitutional right to assisted suicide. The U.S. 
Supreme Court heard oral arguments in two cases on January 8 of this 
year to determine the constitutionality of those rulings. In addition, 
some States, such as Oregon, have legalized assisted suicide by 
referendum. These States may be tempted to consider using Federal funds 
and facilities to pay for these procedures. For this reason, we must 
send a clear message. The American people do not want their tax dollars 
used to pay for assisted suicides. In fact, a majority of Americans are 
strongly opposed to the very notion of assisted suicide. Counted among 
those in opposition are the American Medical Association whose 
physician members would be asked to play the role of moral arbitrator 
in the decision to end one's life.
  The purpose of this bill and its guidelines are concise and clear. No 
limitations will be placed on the withholding or withdrawing of medical 
treatment. In addition, it does not affect funding for alleviating 
patient pain or discomfort.
  An overwhelming majority of the American people believe their taxes 
should not be used to pay for assisted suicide or euthanasia. A 
national Wirthlin poll taken in November 1996 found that 87 percent of 
Americans did not believe their tax dollars should be used to pay for 
these procedures.
  I ask my colleagues to join me in supporting this bill which 
guarantees every American that their tax dollars will not be used to 
pay for or promote assisted suicide or euthanasia.
  Mr. NICKLES. Mr. President, I rise today, and begin with these words: 
``We hold these Truths to be self-evident, that all Men are created 
equal, that they are endowed by their Creator with certain unalienable 
Rights, that among these are Life, Liberty, and the Pursuit of 
Happiness.''
  These profound words are possibly the most known words from our 
Declaration of Independence. They state a principle that is fundamental 
to who we are as a nation; life itself is a gift from our Creator, and 
it is a right that can not be taken away. We are a nation whose core 
philosophy is to care for its people.
  As public servants, we deal with issues that affect the lives of 
people every day. Caring for people is the underlying aspect of almost 
every piece of legislation dealt with in the Senate, and nearly every 
issue we confront as a country.
  But while we work to build up America, something is at work in the 
country, eating away at fundamentals we used to take for granted: in 
this case, the sanctity of life. It is no secret that I place a high 
value on life at its conception. But a disturbing trend has developed 
over the past few years, a devaluation of life as it nears its end.
  Two years ago, I offered legislation banning the use of Medicaid and 
Medicare funds for assisted suicide in the 1995 balanced budget act. 
Unfortunately the President vetoed this legislation.
  Today, I am proud to be a cosponsor of the legislation offered by 
Senators Ashcroft and Dorgan, which prohibits any Federal funds from 
being used for assisted suicide, euthanasia or mercy killing. This 
means that hospitals, medical institutions, or health care providers 
are not required to participate in procedures they morally or ethically 
oppose.
  The large majority of people oppose assisted suicide. In a Wirthlin 
poll taken November 5, 1996, 87 percent of the people asked said tax 
dollars should not be spent to pay for the cost of assisting suicide or 
euthanasia. A recent study by the Dana-Farber Cancer Institute in 
Boston, found that seriously ill cancer patients in severe pain are 
unlikely to ``approve of, or desire'' euthanasia or physician-assisted 
suicide, instead they desire ``only relief from their pain''.
  Even the medical profession is opposed to assisted suicide. An amicus 
brief filed by the American Medical Association to the Supreme Court on 
November 12, 1996, contends assisted suicide ``will create profound 
danger for many ill persons with undiagnosed depression and 
inadequately treat pain, for whom assisted suicide rather than good 
palliative care could become the norm. At greatest risk would be those 
with the least access to palliative care--the poor, the elderly and 
members of minority groups.'' The brief concludes, ``Although, for some 
patients it might appear compassionate to hasten death, 
institutionalizing physician-assisted suicide as a medical treatment 
would put many more patients at serious risk for unwanted and 
unnecessary death.''
  Dr. Joanne Lynn, board member of the American Geriatrics Society and 
director of the Center to Improve Care of the Dying at George 
Washington University said--Health Line, Jan. 8, 1997--``No one needs 
to be alone or in pain or beg a doctor to put an end to misery. Good 
care is possible.''
  As Tracy Miller, former head of the New York Task Force on Life and 
Law said, ``It is far easier to assist patients in killing themselves 
than it is to care for them at life's end.''

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  The bill before us today is a major step in continuing to provide the 
care our elderly, poor, and seriously ill need and deserve. The bill 
would assure that the programs designed to support human life and 
health would not be transformed into implements of death. I commend the 
work of Senator Ashcroft and Senator Dorgan in writing this 
legislation, compliment them upon its introduction today, and pledge to 
work with them to see it to passage in the 105th Congress. Our country 
deserves no less.
                                 ______