[Congressional Record Volume 143, Number 42 (Thursday, April 10, 1997)]
[House]
[Pages H1397-H1405]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            ASSISTED SUICIDE FUNDING RESTRICTION ACT OF 1997

  Mr. BLILEY. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1003) to clarify Federal law with respect to restricting the 
use of Federal funds in support of assisted suicide, as amended.
  The Clerk read as follows:

                               H.R. 1003

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Assisted 
     Suicide Funding Restriction Act of 1997''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings and purpose.
Sec. 3. Restriction on use of Federal funds under health care programs.
Sec. 4. Restriction on use of Federal funds under certain grant 
              programs under the Developmental Disabilities Assistance 
              and Bill of Rights Act.
Sec. 5. Restriction on use of Federal funds by advocacy programs.
Sec. 6. Restriction on use of other Federal funds.
Sec. 7. Clarification with respect to advance directives.
Sec. 8. Application to District of Columbia.
Sec. 9. Conforming amendments.
Sec. 10. Relation to other laws.
Sec. 11. Effective date.
Sec. 12. Suicide prevention (including assisted suicide).

     SEC. 2. FINDINGS AND PURPOSE.

       (a) Findings.--Congress finds the following:
       (1) The Federal Government provides financial support for 
     the provision of and payment for health care services, as 
     well as for advocacy activities to protect the rights of 
     individuals.
       (2) Assisted suicide, euthanasia, and mercy killing have 
     been criminal offenses throughout the United States and, 
     under current law, it would be unlawful to provide services 
     in support of such illegal activities.
       (3) Because of recent legal developments, it may become 
     lawful in areas of the United States to furnish services in 
     support of such activities.
       (4) Congress is not providing Federal financial assistance 
     in support of assisted suicide, euthanasia, and mercy killing 
     and intends that Federal funds not be used to promote such 
     activities.
       (b) Purpose.--It is the principal purpose of this Act to 
     continue current Federal policy by providing explicitly that 
     Federal funds may not be used to pay for items and services 
     (including assistance) the purpose of which is to cause (or 
     assist in causing) the suicide, euthanasia, or mercy killing 
     of any individual.

     SEC. 3. RESTRICTION ON USE OF FEDERAL FUNDS UNDER HEALTH CARE 
                   PROGRAMS.

       (a) Restriction on Federal Funding of Health Care 
     Services.--Subject to subsection (b), no funds appropriated 
     by Congress for the purpose of paying (directly or 
     indirectly) for the provision of health care services may be 
     used--
       (1) to provide any health care item or service furnished 
     for the purpose of causing, or for the purpose of assisting 
     in causing, the death of any individual, such as by assisted 
     suicide, euthanasia, or mercy killing;
       (2) to pay (directly, through payment of Federal financial 
     participation or other matching payment, or otherwise) for 
     such an item or service, including payment of expenses 
     relating to such an item or service; or
       (3) to pay (in whole or in part) for health benefit 
     coverage that includes any coverage of such an item or 
     service or of any expenses relating to such an item or 
     service.
       (b) Construction and Treatment of Certain Services.--
     Nothing in subsection (a), or in any other provision of this 
     Act (or in any amendment made by this Act), shall be 
     construed to create apply to or to affect 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.
       (c) Limitation on Federal Facilities and Employees.--
     Subject to subsection (b), with respect to health care items 
     and services furnished--
       (1) by or in a health care facility owned or operated by 
     the Federal government, or
       (2) by any physician or other individual employed by the 
     Federal government to provide health care services within the 
     scope of the physician's or individual's employment,

     no such item or service may be furnished for the purpose of 
     causing, or for the purpose of assisting in causing, the 
     death of any individual, such as by assisted suicide, 
     euthanasia, or mercy killing.
       (d) List of Programs to Which Restrictions Apply.--
       (1) Federal health care funding programs.--Subsection (a) 
     applies to funds appropriated under or to carry out the 
     following:
       (A) Medicare program.--Title XVIII of the Social Security 
     Act.
       (B) Medicaid program.--Title XIX of the Social Security 
     Act.
       (C) Title xx social services block grant.--Title XX of the 
     Social Security Act.
       (D) Maternal and child health block grant program.--Title V 
     of the Social Security Act.
       (E) Public health service act.--The Public Health Service 
     Act.
       (F) Indian health care improvement act.--The Indian Health 
     Care Improvement Act.
       (G) Federal employees health benefits program.--Chapter 89 
     of title 5, United States Code.
       (H) Military health care system (including tricare and 
     champus programs).--Chapter 55 of title 10, United States 
     Code.
       (I) Veterans medical care.--Chapter 17 of title 38, United 
     States Code.
       (J) Health services for peace corps volunteers.--Section 
     5(e) of the Peace Corps Act (22 U.S.C. 2504(e)).
       (K) Medical services for federal prisoners.--Section 
     4005(a) of title 18, United States Code.
       (2) Federal facilities and personnel.--The provisions of 
     subsection (c) apply to facilities and personnel of the 
     following:
       (A) Military health care system.--The Department of Defense 
     operating under chapter 55 of title 10, United States Code.
       (B) Veterans medical care.--The Veterans Health 
     Administration of the Department of Veterans Affairs.
       (C) Public health service.--The Public Health Service.
       (3) Nonexclusive list.--Nothing in this subsection shall be 
     construed as limiting the application of subsection (a) to 
     the programs specified in paragraph (1) or the application of 
     subsection (c) to the facilities and personnel specified in 
     paragraph (2).

     SEC. 4. RESTRICTION ON USE OF FEDERAL FUNDS UNDER CERTAIN 
                   GRANT PROGRAMS UNDER THE DEVELOPMENTAL 
                   DISABILITIES ASSISTANCE AND BILL OF RIGHTS ACT.

       Subject to section 3(b) (relating to construction and 
     treatment of certain services), no funds appropriated by 
     Congress to carry out part B, D, or E of the Developmental 
     Disabilities Assistance and Bill of Rights Act may be used to 
     support or fund any program or service which has a purpose of 
     assisting in procuring any item, benefit, 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. 5. RESTRICTION ON USE OF FEDERAL FUNDS BY ADVOCACY 
                   PROGRAMS.

       (a) In General.--Subject to section 3(b) (relating to 
     construction and treatment of certain services), no funds 
     appropriated by Congress may be used to assist in, to 
     support, or to fund any activity or service which has a 
     purpose of assisting in, or to bring suit or provide any 
     other form of legal assistance for the purpose of--
       (1) securing or funding any item, benefit, program, or 
     service furnished for the purpose of causing, or the purpose 
     of assisting in causing, the suicide, euthanasia, or mercy 
     killing of any individual;
       (2) compelling any person, institution, governmental entity 
     to provide or fund any item, benefit, program, or service for 
     such purpose; or
       (3) asserting or advocating a legal right to cause, or to 
     assist in causing, the suicide, euthanasia, or mercy killing 
     of any individual.
       (b) List of Programs to Which Restrictions Apply.--
       (1) In general.--Subsection (a) applies to funds 
     appropriated under or to carry out the following:
       (A) Protection and advocacy systems under the developmental 
     disabilities assistance and bill of rights act.--Part C of 
     the Developmental Disabilities Assistance and Bill of Rights 
     Act.
       (B) Protection and advocacy systems under the protection 
     and advocacy for mentally ill individuals act.--The 
     Protection and Advocacy for Mentally Ill Individuals Act of 
     1986.
       (C) Protection and advocacy systems under the 
     rehabilitation act of 1973.--Section 509 of the 
     Rehabilitation Act of 1973 (29 U.S.C. 794e).
       (D) Ombudsman programs under the older americans act of 
     1965.--Ombudsman programs under the Older Americans Act of 
     1965.
       (E) Legal assistance.--Legal assistance programs under the 
     Legal Services Corporation Act.
       (2) Nonexclusive list.--Nothing in this subsection shall be 
     construed as limiting the application of subsection (a) to 
     the programs specified in paragraph (1).

     SEC. 6. RESTRICTION ON USE OF OTHER FEDERAL FUNDS.

       (a) In General.--Subject to section 3(b) (relating to 
     construction and treatment of certain services) and 
     subsection (b) of this

[[Page H1398]]

     section, no funds appropriated by the Congress shall be used 
     to provide, procure, furnish, or fund any item, good, 
     benefit, activity, or service, furnished or performed for the 
     purpose of causing, or assisting in causing, the suicide, 
     euthanasia, or mercy killing of any individual.
       (b) Nonduplication.--Subsection (a) shall not apply to 
     funds to which section 3, 4, or 5 applies, except that 
     subsection (a), rather than section 3, shall apply to funds 
     appropriated to carry out title 10, United States Code (other 
     than chapter 55), title 18, United States Code (other than 
     section 4005(a)), and chapter 37 of title 28, United States 
     Code.

     SEC. 7. CLARIFICATION WITH RESPECT TO ADVANCE DIRECTIVES.

       Subject to section 3(b) (relating to construction and 
     treatment of certain services), sections 1866(f) and 1902(w) 
     of the Social Security Act shall not be construed--
       (1) 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; or
       (2) to apply to or to affect any requirement with respect 
     to a portion of an advance directive that directs the 
     purposeful causing of, or the purposeful assisting in 
     causing, the death of any individual, such as by assisted 
     suicide, euthanasia, or mercy killing.

     SEC. 8. APPLICATION TO DISTRICT OF COLUMBIA.

       For purposes of this Act, the term ``funds appropriated by 
     Congress'' includes funds appropriated to the District of 
     Columbia pursuant to an authorization of appropriations under 
     title V of the District of Columbia Self-Government and 
     Governmental Reorganization Act and the term ``Federal 
     government'' includes the government of the District of 
     Columbia.

     SEC. 9. CONFORMING AMENDMENTS.

       (a) Medicare Program.--
       (1) Funding.--Section 1862(a) of the Social Security Act 
     (42 U.S.C. 1395y(a)) is amended--
       (A) by striking ``or'' at the end of paragraph (14);
       (B) by striking the period at the end of paragraph (15) and 
     inserting ``; or''; and
       (C) by inserting after paragraph (15) the following new 
     paragraph:
       ``(16) in the case in which funds may not be used for such 
     items and services under the Assisted Suicide Funding 
     Restriction Act of 1997.''.
       (2) Advance directives.--Section 1866(f) of such Act (42 
     U.S.C. 1395cc(f)) is amended by adding at the end the 
     following new paragraph:
       ``(4) For construction relating to this subsection, see 
     section 7 of the Assisted Suicide Funding Restriction Act of 
     1997 (relating to clarification respecting assisted suicide, 
     euthanasia, and mercy killing).''.
       (b) Medicaid Program.--
       (1) Funding.--Section 1903(i) of the Social Security Act 
     (42 U.S.C. 1396b(i)) is amended--
       (A) by striking ``or'' at the end of paragraph (14);
       (B) by striking the period at the end of paragraph (15) and 
     inserting ``; or''; and
       (C) by inserting after paragraph (15) the following new 
     paragraph:
       ``(16) with respect to any amount expended for which funds 
     may not be used under the Assisted Suicide Funding 
     Restriction Act of 1997.''.
       (2) Advance directives.--Section 1902(w) of such Act (42 
     U.S.C. 1396a(w)) is amended by adding at the end the 
     following new paragraph:
       ``(5) For construction relating to this subsection, see 
     section 7 of the Assisted Suicide Funding Restriction Act of 
     1997 (relating to clarification respecting assisted suicide, 
     euthanasia, and mercy killing).''.
       (c) Title XX Block Grant Program.--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);
       (2) by striking the period at the end of paragraph (9) and 
     inserting ``; or''; and
       (3) by adding at the end the following:
       ``(10) in a manner inconsistent with the Assisted Suicide 
     Funding Restriction Act of 1997.''.
       (d) Maternal and Child Health Block Grant Program.--Section 
     501(a) of the Social Security Act (42 U.S.C. 701(a)) is 
     amended by adding at the end the following:

     ``Funds appropriated under this section may only be used in a 
     manner consistent with the Assisted Suicide Funding 
     Restriction Act of 1997.''.
       (e) Public Health Service Act.--Title II of the Public 
     Health Service Act (42 U.S.C. 201 et seq.) is amended by 
     adding at the end thereof the following new section:

     ``SEC. 246. RESTRICTION ON USE OF FUNDS FOR ASSISTED SUICIDE, 
                   EUTHANASIA, AND MERCY KILLING.

       ``Appropriations for carrying out the purposes of this Act 
     shall not be used in a manner inconsistent with the Assisted 
     Suicide Funding Restriction Act of 1997.''.
       (f) Indian Health Care Improvement Act.--Title II of the 
     Indian Health Care Improvement Act (25 U.S.C. 1621 et seq.) 
     is amended by adding at the end the following new section:


                      ``limitation on use of funds

       ``Sec. 225. Amounts appropriated to carry out this title 
     may not be used in a manner inconsistent with the Assisted 
     Suicide Funding Restriction Act of 1997.''.
       (g) Federal Employees Health Benefit Program.--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 for which 
     funds may not be used under the Assisted Suicide Funding 
     Restriction Act of 1997.''.
       (h) Military Health Care Program.--Section 1073 of title 
     10, United States Code, is amended by adding at the end the 
     following: ``This chapter shall be administered consistent 
     with the Assisted Suicide Funding Restriction Act of 1997.''.
       (i) Veterans' Medical Care Program.--
       (1) In general.--Subchapter I of chapter 17 of title 38, 
     United States Code, is amended by adding at the end the 
     following new section:

     ``Sec. 1707. Restriction on use of funds for assisted 
       suicide, euthanasia, or mercy killing

       ``Funds appropriated to carry out this chapter may not be 
     used for purposes that are inconsistent with the Assisted 
     Suicide Funding Restriction Act of 1997.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item relating to section 1706 the following new item:

``1707. Restriction on use of funds for assisted suicide, euthanasia, 
              or mercy killing.''.

       (j) Health Care Provided for Peace Corps Volunteers.--
     Section 5(e) of the Peace Corps Act (22 U.S.C. 2504(e)) is 
     amended by adding at the end the following: ``Health care may 
     not be provided under this subsection in a manner 
     inconsistent with the Assisted Suicide Funding Restriction 
     Act of 1997.''.
       (k) Medical Services for Federal Prisoners.--Section 
     4005(a) of title 18, United States Code, is amended by 
     inserting ``and to the extent consistent with the Assisted 
     Suicide Funding Restriction Act of 1997'' after ``Upon 
     request of the Attorney General''.
       (l) Developmental Disabilities and Bill of Rights Act.--
       (1) State plans regarding developmental disabilities 
     councils.--Section 122(c)(5)(A) of the Developmental 
     Disabilities Assistance and Bill of Rights Act (42 U.S.C. 
     6022(c)(5)(A)) is amended--
       (A) in clause (vi), by striking ``and'' after the semicolon 
     at the end;
       (B) in clause (vii), by striking the period at the end and 
     inserting ``; and''; and
       (C) by adding at the end the following clause:
       ``(viii) such funds will be used consistent with the 
     section 4 of the Assisted Suicide Funding Restriction Act of 
     1997.''.
       (2) Legal actions by protection and advocacy systems.--
     Section 142(h) of such Act (42 U.S.C. 6042(h)) is amended by 
     adding at the end the following new paragraph:
       ``(3) Limitation.--The systems may only use assistance 
     provided under this chapter consistent with section 5 of the 
     Assisted Suicide Funding Restriction Act of 1997.''.
       (3) University affiliated programs.--Section 152(b)(5) of 
     such Act (42 U.S.C. 6062(b)(5)) is amended by adding at the 
     end the following: ``Such grants shall not be used in a 
     manner inconsistent with section 4 of the Assisted Suicide 
     Funding Restriction Act of 1997.''.
       (4) Grants of national significance.--Section 162(c) of 
     such Act (42 U.S.C. 6082(c)) is amended--
       (A) by striking ``and'' at the end of paragraph (4),
       (B) by striking the period at the end of paragraph (5) and 
     inserting ``; and'', and
       (C) by adding at the end the following new paragraph:
       ``(6) the applicant provides assurances that the grant will 
     not be used in a manner inconsistent with section 4 of the 
     Assisted Suicide Funding Restriction Act of 1997.''.
       (m) Protection and Advocacy for Mentally Ill Individuals 
     Act of 1986.--Section 105(a) of the Protection and Advocacy 
     for Mentally Ill Individuals Act of 1986 (42 U.S.C. 10805(a)) 
     is amended--
       (1) in paragraph (8), by striking ``and'' at the end;
       (2) in paragraph (9), by striking the period and inserting 
     ``; and''; and
       (3) by adding at the end thereof the following new 
     paragraph:
       ``(10) not use allotments provided to a system in a manner 
     inconsistent with section 5 of the Assisted Suicide Funding 
     Restriction Act of 1997.''.
       (n) Protection and Advocacy Systems Under the 
     Rehabilitation Act of 1973.--Section 509(f) of the 
     Rehabilitation Act of 1973 (29 U.S.C. 794e(f)) is amended--
       (1) in paragraph (6), by striking ``and'' after the 
     semicolon at the end;
       (2) in paragraph (7), by striking the period at the end and 
     inserting ``; and''; and
       (3) by adding at the end the following paragraph:
       ``(8) not use allotments provided under this section in a 
     manner inconsistent with section 5 of the Assisted Suicide 
     Funding Restriction Act of 1997.''.
       [(o) Older Americans Act of 1965.--Title VII of the Older 
     Americans Act of 1965 is amended by adding at the end the 
     following new section:

     [``SEC. 765. FUNDING LIMITATION.

       [``Funds provided under this title may not be used in a 
     manner inconsistent with the Assisted Suicide Funding 
     Restriction Act of 1997.''.]

[[Page H1399]]

       [(p)] (o) Legal Services Program.--Section 1007(b) of the 
     Legal Services Corporation Act (42 U.S.C. 2996f(b)) is 
     amended--
       (1) by striking ``or'' at the end of paragraph (9);
       (2) by striking the period at the end of paragraph (10) and 
     inserting ``; or''; and
       (3) by adding after paragraph (10) the following:
       ``(11) to provide legal assistance in a manner inconsistent 
     with the Assisted Suicide Funding Restriction Act of 1997.''.
       [(q)] (p) Construction on Conforming Amendments.--The fact 
     that a law is not amended under this section shall not be 
     construed as indicating that the provisions of this Act do 
     not apply to such a law.

     SEC. 10. RELATION TO OTHER LAWS.

       The provisions of this Act supersede other Federal laws 
     (including laws enacted after the date of the enactment of 
     this Act) except to the extent such laws specifically 
     supersede the provisions of this Act.

     SEC. 11. EFFECTIVE DATE.

       (a) In General.-- The provisions of this Act (and the 
     amendments made by this Act) take effect upon its enactment 
     and apply, subject to subsection (b), to Federal payments 
     made pursuant to obligations incurred after the date of the 
     enactment of this Act for items and services provided on or 
     after such date.
       (b) Application to Contracts.--Such provisions shall apply 
     with respect to contracts entered into, renewed, or extended 
     after the date of the enactment of this Act and shall also 
     apply to a contract entered into before such date to the 
     extent permitted under such contract.

     SEC. 12. SUICIDE PREVENTION (INCLUDING ASSISTED SUICIDE).

       (a) Purpose.--The purpose of this section is to reduce the 
     rate of suicide (including assisted suicide) among persons 
     with disabilities or terminal or chronic illness by 
     furthering knowledge and practice of pain management, 
     depression identification and treatment, and issues related 
     to palliative care and suicide prevention.
       (b) Research and Demonstration Projects.--Section 781 of 
     the Public Health Service Act (42 U.S.C. 295) is amended--
       (1) by redesignating subsection (e) as subsection (f); and
       (2) by inserting after subsection (d) the following new 
     subsection:
       ``(e) Research and Demonstration Projects on Suicide 
     Prevention (Including Assisted Suicide).--
       ``(1) Research.--The Secretary may make grants to and enter 
     into contracts with public and private entities for 
     conducting research intended to reduce the rate of suicide 
     (including assisted suicide) among persons with disabilities 
     or terminal or chronic illness. The Secretary shall give 
     preference to research that aims--
       ``(A) to assess the quality of care received by patients 
     with disabilities or terminal or chronic illness by measuring 
     and reporting specific outcomes;
       ``(B) to compare coordinated health care (which may include 
     coordinated rehabilitation services, symptom control, 
     psychological support, and community-based support services) 
     to traditional health care delivery systems; or
       ``(C) to advance biomedical knowledge of pain management.
       ``(2) Training.--The Secretary may make grants and enter 
     into contracts to assist public and private entities, 
     schools, academic health science centers, and hospitals in 
     meeting the costs of projects intended to reduce the rate of 
     suicide (including assisted suicide) among persons with 
     disabilities or terminal or chronic illness. The Secretary 
     shall give preference to qualified projects that will--
       ``(A) train health care practitioners in pain management, 
     depression identification and treatment, and issues related 
     to palliative care and suicide prevention;
       ``(B) train the faculty of health professions schools in 
     pain management, depression identification and treatment, and 
     issues related to palliative care and suicide prevention; or
       ``(C) develop and implement curricula regarding disability 
     issues, including living with disabilities, living with 
     chronic or terminal illness, attendant and personal care, 
     assistive technology, and social support services.
       ``(3) Demonstration projects.--The Secretary may make 
     grants to and enter into contracts with public and nonprofit 
     private entities for the purpose of conducting demonstration 
     projects that will--
       ``(A) reduce restrictions on access to hospice programs; or
       ``(B) fund home health care services, community living 
     arrangements, and attendant care services.
       ``(4) Palliative medicine.--The Secretary shall emphasize 
     palliative medicine among its funding and research 
     priorities.''.
       (c) Report by General Accounting Office.--Not later than 1 
     year after the date of enactment of this Act, the Comptroller 
     General of the United States shall submit to the Congress a 
     report providing an assessment of programs under subsection 
     (e) of section 781 of the Public Health Service Act (as added 
     by subsection (b) of this section) to conduct research, 
     provide training, and develop curricula and of the curricula 
     offered and used by schools of medicine and osteopathic 
     medicine in pain management, depression identification and 
     treatment, and issues related to palliative care and suicide 
     prevention. The purpose of the assessment shall be to 
     determine the extent to which such programs have furthered 
     knowledge and practice of pain management, depression 
     identification and treatment, and issues related to 
     palliative care and suicide prevention.

  The SPEAKER pro tempore (Mr. Smith of Michigan). Pursuant to the 
rule, the gentleman from Virginia [Mr. Bliley] and the gentleman from 
Ohio [Mr. Brown] will each control 20 minutes.
  The Chair recognizes the gentleman from Virginia [Mr. Bliley].
  Mr. BLILEY. Mr. Speaker, I yield myself 3 minutes.
  Mr. Speaker, I am very pleased to bring this bill before the full 
House today, H.R. 1003, the Assisted Suicide Funding Restriction Act of 
1997. It is an important and forward-looking piece of legislation. H.R. 
1003 is our response to Dr. Jack Kevorkian, who last Friday said, ``If 
you want to stop something,'' and I'm quoting, ``pass a law.''
  Today, just 6 days later, we are doing exactly that. Too often 
Congress acts only in response to problems after they have already 
taken their toll on the American people. Today we address a serious 
threat to the lives of many Americans before that threat becomes a 
widespread reality. In the States of Oregon, Washington, New York, and 
Florida, lawsuits have been filed seeking to legalize physician-
assisted suicide. Two of those cases are before the Supreme Court right 
now. If any of these actions result in the legalization of assisted 
suicide, Federal funds could be used to pay for it. That is right, the 
money we currently devote to such programs as Medicare and Medicaid, 
programs devoted to improving the health and extending the lives of 
elderly, disabled, and low-income Americans, could be used instead for 
health care services intended to cause death.
  This is an issue with shattering implications for the Nation, for its 
most vulnerable patients, for individuals with disabilities, for senior 
citizens, and for the millions of Americans who devote their lives to 
improving the health of their patients.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, the legislation before us today prohibits Federal 
funding for assisting an individual with suicide. The bill's rhetorical 
nature implies the taxpayers may be paying for something to which they 
strongly object, and that citizens should fear some insidious incursion 
into their pocketbooks for a wholesale tax-funded Kevorkian-like 
scheme.
  However, there is little basis either for this fear or for the 
rhetoric that drives it. Nothing in current law prohibits Federal 
funding of suicide, including assisted suicide. Nothing in Federal law 
permits Federal funding of suicide. Tax dollars are not used for this 
purpose today, and there is no intention to change that longstanding 
policy.
  The Government already prohibits Federal funding of any physician-
assisted suicide through Medicare, through Medicaid, through Indian 
Health Services, through the Veterans Administration. In short, this 
bill essentially prohibits nothing.
  It is typical, Mr. Speaker, of the last two Republican Congresses, 
legislating a solution in search of a problem. In a hearing before the 
Subcommittee on Health and Environment of the Committee on Commerce, 
religious leaders, health care professionals, and patient advocates 
testified about the seriousness of this discussion and debate.
  Their testimony made clear to all of us who heard it that what we do 
has profound implications for people whose lives are already nearly 
intolerable because they are suffering from severe disability or 
incapacitating illness and the psychological trauma and depression that 
often accompany the realization that death is near.
  All of the witnesses suggested that the medical profession needed to 
do more to train physicians and health care providers to recognize and 
treat those very factors that cause suicide. The Committee on Commerce 
should have adopted an amendment offered during the committee's 
deliberation on this bill. That amendment was simple. It simply 
required medical school training programs in those medical schools that 
receive Federal grants to include training in the care of dying people. 
Admittedly, it would have been a small step, but it would have been 
effective in prompting needed changes in health provider training.
  In other words, Mr. Speaker, we had an opportunity to do something 
real

[[Page H1400]]

with this bill, but instead it is nothing more than a hollow exercise, 
probably designed to fill a massive hole in the do-nothing 105th 
Congress.
  Mr. Speaker, I intend to vote for this bill, but then again, why not? 
A vote for this bill merely means that we agree with the system that 
has been in place for many years. Assisted suicide is not now nor has 
it ever been financed by the Federal Government.
  Mr. Speaker, let me conclude by saying that this Congress has failed 
to seize that opportunity to reduce the tragic conditions that often 
lead to suicide in our country. People with disabilities, frail 
seniors, and people seriously ill and in great pain deserve quality of 
life at the end of their lives. We had a chance to take some small 
steps to make that happen. It would have been good public policy. It 
would have been the right thing to do. That is the way to achieve what 
should have been the purpose of this legislation: to prevent assisted 
suicide by preventing conditions that cause it. It is too bad this 
Congress, Mr. Speaker, has failed to do that.
  Mr. Speaker, I yield 4 minutes to my colleague, the gentleman from 
Texas [Mr. Hall].
  (Mr. HALL of Texas asked and was given permission to revise and 
extend his remarks.)
  Mr. HALL of Texas. Mr. Speaker, I rise today, of course, in support 
of H.R. 1003.
  Mr. Speaker, I enjoyed the presentation of the gentleman from Ohio 
[Mr. Brown], and I appreciate getting to work with him in the 
committee, both the subcommittee and in the full committee. The part of 
his speech that I listened to more closely than any was that he voted 
for this on both occasions, and he intends to vote for it today.
  I am grateful for that, because we need this support. We would like 
to have a resounding vote and send it over to the Senate, and say to 
the world, to poor people, to hardworking people, we do not want to 
spend your tax dollars helping people commit suicide.
  Mr. Speaker, I think the bill does not in any way affect the sanctity 
of the doctor-patient relationship or the right of the patient to 
receive pain medication or reject or discontinue any medical treatment. 
It does not do anything. It does one simple thing: It says to the 
people of this country, we are not going to spend tax dollars to help 
people kill themselves. I keep coming back to that and coming back to 
that. It is a simple message. This bill could have been one sentence: 
``There ain't going to be any tax dollars spent for assisted suicide.'' 
But in an abundance of caution we put a lot of other things on it. We 
listed those specific things it could not be used for.
  Today's vote is very important in light of recent decisions by the 
Federal courts of appeal that rule that assisted suicide is a 
constitutional right. There is a danger here. The Court lurks over 
there, right today, waiting to render. They heard arguments January 8 
of this year. I think there is certainly need for this legislation. It 
is proactive in that it would preempt the use of Federal funding, 
regardless of how the Court rules.
  They get last guess, Mr. Speaker, as to what the law is. If they 
guess wrong on this, you can open up the Treasury to every Dr. 
Kevorkian all across the country, every crossroads in Rockwall County, 
TX, and all the other 254 counties of Texas would have a Dr. Kevorkian 
there, because it gives them a chance to get their hand into the 
Medicare funds that are needed, the Medicaid funds that are needed. It 
would say to this country that while we are trying to help people, poor 
people live, that we are going to spend a lot of their money helping 
people die. That just absolutely does not make sense.
  Mr. Speaker, I think it has been said that the nobility of a culture 
is marked by how it treats its weakest members. That cries out to us 
here. There is a lesson to this. Where does it take us? Where does it 
lead?
  The Netherlands report presents some alarming facts. In 1990 alone, 
2,300 people were killed by doctors in The Netherlands in their 
euthanasia program. Even more shocking, Mr. Speaker, in the same year 
more than 1,300 people were euthanized without their consent; 140 of 
these cases involved fully competent people who were never given a 
choice. That is a clear and present danger.
  I hope the Supreme Court listens to this argument today, and I hope 
they listen to the argument and the speeches that the President of the 
United States sent to them, his brief. I hope they listen to the 
Wirthlin report, where 87 percent of the people said they were opposed 
to assisted suicide. I hope they will listen to the American people. I 
hope they will listen to this Congress. Mr. Speaker, I urge the Members 
to support this bill.
  Mr. BLILEY. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from 
Florida [Mr. Stearns], a member of the committee.
  Mr. STEARNS. Mr. Speaker, the question I hear is, Congressman, this 
bill is not necessary because assisted suicide is not currently funded. 
This is a solution in search of a problem.
  Mr. Speaker, let me answer that question, because I think it is 
fundamental to this debate. Current Federal law uses broad and general 
language. For example, Medicare pays for items and services 
``reasonable and necessary for the diagnosis or treatment of illness or 
injury.''
  If assisted suicide is legalized by the Supreme Court, or any 
individual State, all it would take is one district court judge to rule 
that assisted suicide fits under the Medicare statutes guidelines. We 
need to make sure that this does not happen today by clarifying the 
Federal law.
  This bill is also very important because it will send a clear message 
to States and insurance carriers. As has happened in many cases, State 
and private coverage is often modeled after Federal law. For example, 
when Congress extends Medicare or Medicaid coverage to address a 
particular health condition, States and private plans frequently adopt 
the same changes.
  Mr. Speaker, by banning Federal funding for assisted suicide, we will 
serve as an example for States and private carriers to follow, thereby 
reducing the number of suicides and promoting better end-of-life care 
and suicide prevention.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 3 minutes to the gentleman 
from California [Mr. Stark].
  (Mr. STARK asked and was given permission to revise and extend his 
remarks.)
  Mr. STARK. Mr. Speaker, the bill before us states that assisted 
suicide, euthanasia, and mercy killing have been criminal offenses 
throughout the United States and under current law would be unlawful, 
and this, in other words, makes this bill totally unnecessary.
  Mr. Speaker, Medicare does only cover medically necessary services. 
It does not pay for suicide. No one can bill for suicide. No matter 
what some State may decide to do about suicide, Medicare would not pay 
for it. It is not now covered and it will not be. This bill is a facade 
for a Congress that is doing nothing.
  There are a lot of reasons people in our society are driven to 
suicide. This bill does not deal with those. This bill does nothing to 
provide mental health counseling. This bill does not require that 
insurers offer mental health services that could prevent suicide. It 
does not provide for health insurance for children to ease the fears 
and frustrations of parents. It does not stop managed care companies 
and for-profit HMO's from denying health care that can lead to death 
and disability. It does not stop the gag rules that cause managed care 
doctors to mistreat patients. The Consortium for Citizens with 
Disability says prohibiting people from using Federal funds to end 
their lives is not worth much.
  Why do we not provide public and private assistance so they can live 
their lives? If we want to help, why do we not ensure that Americans, 
regardless of income, have access to quality care; have home health 
care so they can live in their communities rather than in institutions; 
ensure that untreated depression is no longer mistaken as a desire to 
die.
  We can enhance the quality of life, Mr. Speaker. Any public policy in 
the area of physician-assisted suicide should include a proposal to 
fund mental health services and anti-pain services necessary for decent 
basic living. Mr. Speaker, this bill does nothing. It just addresses a 
problem that does not exist. It eases some pseudo-religious wackos. It 
does nothing to address the

[[Page H1401]]

real problems in our society that cause people to seek suicide or 
assisted death.

                              {time}  1045

  It is a sham. It is a shame. We are a sad, sad Congress if we pass 
this bill.
  Mr. BLILEY. Mr. Speaker, I yield 1 minute to the gentleman from New 
York [Mr. Paxon], a member of the committee.
  Mr. PAXON. Mr. Speaker, I rise today in support of H.R. 1003. As a 
cosponsor of this legislation, when I came before the Committee on 
Commerce, I am very pleased to see that such quick action has been 
taken on this important measure. I particularly commend the gentleman 
from Virginia [Mr. Bliley], the chairman, for his leadership in 
bringing this bill to the floor in such an expeditious fashion.
  Mr. Speaker, I say to my colleagues that it is imperative that this 
Congress send a clear signal to the Nation that all human life is 
valued, even those who face disabilities or disease. The overwhelming 
majority of Americans are strongly opposed to doctor-assisted suicide. 
This legislation will ensure that American taxpayers will never be 
forced to support this abhorrent activity.
  Mr. Speaker, I urge all my colleagues to support this important 
legislation today on the House floor.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 3 minutes to the gentlewoman 
from Colorado [Ms. DeGette].
  Ms. DeGETTE. Mr. Speaker, when I learned that this Congress would be 
considering legislation on physician-assisted suicide, I foresaw a 
lengthy discussion on the complex moral, legal, and ethical issues 
surrounding the issue because I am still examining this issue myself. 
But in fact, none of that has occurred because the legislation being 
considered does nothing.
  This bill is a solution in search of a problem. Let me be clear 
again. Physician-assisted suicide is not legal today. No Federal 
dollars are being used for this purpose and, in fact, the agencies that 
give money to doctors and hospitals specifically prohibit the use of 
Federal funds for this purpose. So by simply considering a ban on 
moneys that are already prohibited, we are ignoring the truly sensitive 
ethical and cultural issues raised by physician-assisted suicide.
  We are leaving unanswered the most pressing questions in this debate. 
Should individuals be entitled to choose for themselves how and when 
they may end their lives? Is there a constitutional right to privacy or 
equal protection which warrants such a policy? Are health care 
providers obligated to help mentally competent and terminally ill 
patients end their lives?
  Today instead of exploring these tough questions and learning from 
providers like Hospice on the front lines of end-of-life care, we are 
considering an empty piece of legislation. As I said, I do not have a 
position on Federal regulation of physician-assisted suicide, but I 
think that Congress could play an important role in looking at humane 
and palliative end-of-life care and how do we best educate doctors.
  Now, let me say, if the courts do allow physician-assisted suicide, 
let us look at legislation then. But in the meantime, Congress should 
be in the business of encouraging broad public discussion, not cutting 
off debate in this Chamber or, worse, wasting our time and our money 
enacting a solution that is in search of a problem and giving the 
public the false belief that we are actually doing something on this 
issue.
  I intend to oppose this legislation. I urge my colleagues to do the 
same.
  Mr. BLILEY. Mr. Speaker, I yield 1 minute to the gentleman from 
Florida [Mr. Canady].
  Mr. CANADY of Florida. Mr. Speaker, I rise in strong support of the 
Assisted Suicide Funding Restriction Act. I want to thank the gentleman 
from Virginia [Mr. Bliley] and the gentleman from Texas [Mr. Hall] for 
their outstanding leadership on this important issue.
  As chairman of the House Judiciary Subcommittee on the Constitution, 
I held hearings on the subject of assisted suicide a year ago. 
Witnesses warned us against following the policy in the Netherlands 
which began as assisted suicide for the terminally ill and now includes 
euthanasia for mental suffering and even nonvoluntary euthanasia.
  The Dutch medical association's official ``Guidelines for 
Euthanasia'' specifically require that a patient voluntarily request 
assisted suicide, but a study confirmed that nonvoluntary euthanasia 
was being widely performed. In 1990, there were more than 1,000 cases 
in which physicians terminated patients' lives without their consent. 
Fourteen percent of the patients who were killed without consent were 
fully competent, and 11 percent were partially competent.
  The Dutch experience vividly shows how permitting of assisted suicide 
for the terminally ill can easily lead to the nightmare of 
nonconsensual termination of human life. An individual's so-called 
right to die, over time, can be transformed into a demand by society 
that certain individuals have a need to die. We should not go down this 
road.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentlewoman 
from California [Ms. Eshoo].
  Ms. ESHOO. Mr. Speaker, the bill before us makes a clear statement 
that Congress does not support the use of Federal funds to directly or 
indirectly support assisted suicide. We heard testimony in the Health 
and Environment Subcommittee in support of this view and certainly in 
the full committee. In fact, the bill is a restatement of present 
Federal policy. Not a penny of Federal dollars is spent in support of 
assisted suicide. I think it is very important for the American people 
to understand this. We are not correcting something. We are simply 
restating Federal policy here today.
  However, in the committee we also heard clear testimony that the 
current state of dying and care for the dying is inadequate. Pain 
management is insufficient. Palliative care generally is lacking. The 
American Medical Association gave testimony and even announced that 
they have launched a new initiative to better educate their doctors on 
care of the terminally ill in their final days.
  During the full committee consideration of the legislation, I offered 
an amendment to address this problem based on the testimony that we had 
received. It simply stated that Federal health programs should have 
guidelines in place for appropriate palliative and pain management care 
of terminally ill beneficiaries. Unfortunately, the amendment failed.
  It is my hope that the vision of death described by the religious 
leaders that testified before our subcommittee in which we are 
surrounded by loved ones and at peace with God would be the case for 
every American. Unfortunately, it is not the case for too many today.
  I am not endorsing assisted suicide. No one is. I am saying that 
there is much more to this debate that the Congress can bring to it. 
There is much more that we can do to lessen the prevalence of assisted 
suicide or those that wish to commit suicide because pain management is 
simply not addressed in America today the way it should be.
  This bill before us is a small step. We could have done much more.
  Mr. BLILEY. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
New York [Mrs. Kelly].
  Mrs. KELLY. Mr. Speaker, I rise today in strong support of H.R. 1003, 
the Assisted Suicide Funding Restriction Act.
  I ardently believe that the issue of euthanasia must be taken 
seriously, without encroaching on patients' rights to oversee their 
treatment and refuse to be placed on life support. However, there is a 
balance to be had when dealing with the humane treatment of the 
terminally ill. Given physicians the legal protection of assisting 
suicide, in my view, tips that balance.
  I would like to spend a minute to discuss what this bill does not do. 
It does not get in the way of a patient's wish to refuse medical 
treatment, nutrition, or hydration. It does not get in the way of a 
doctor's responsibility to relieve pain, even if doing so increases the 
likelihood of death. Last, this bill only applies to those programs, 
agencies, and organizations that receive Federal funds and limits a 
practice that has already been deemed a criminal offense.
  I applaud my colleagues, the gentleman from Virginia [Mr. Bliley], 
the chairman, and the gentleman from Texas [Mr. Hall] as well as the 
leadership for bringing this responsible bill to the House floor. 
Please join me in supporting this measure.

[[Page H1402]]

  Mr. BLILEY. Mr. Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 1 minute to the gentlewoman 
from Oregon [Ms. Furse].
  Ms. FURSE. Mr. Speaker, I will yield to the gentleman from Virginia 
[Mr. Bliley] for the purpose of engaging in a colloquy.
  Is it his understanding that no provision of this legislation is 
intended to prohibit States or other entities from providing services 
or items related to physician-assisted suicide with non-Federal funds?
  Mr. BLILEY. Mr. Speaker, will the gentlewoman yield?
  Ms. FURSE. I yield to the gentleman from Virginia.
  Mr. BLILEY. Mr. Speaker, that is correct.
  Ms. FURSE. Mr. Speaker, furthermore, is it the gentleman's 
understanding that no provision of this legislation is intended to 
prohibit Federal funding for health coverage that includes services or 
items related to physician-assisted suicide, provided the portion of 
the health coverage providing such services or items are paid for with 
State funds or other non-Federal funding?
  Mr. BLILEY. Mr. Speaker, if the gentlewoman will continue to yield, 
that is correct.
  Ms. FURSE. Mr. Speaker, I thank the gentleman. I appreciate his 
attention.
  Mr. BLILEY. Mr. Speaker, I yield 3 minutes to the gentleman from 
Texas, Mr. Sam Johnson, a member of the Committee on Ways and Means.
  Mr. SAM JOHNSON of Texas. Mr. Speaker, I thank the gentleman from 
Virginia for yielding me the time.
  Today we are dealing with one of the most serious matters that could 
come before this Congress. It is unbelievable to me that anybody would 
want to spend any kind of tax money on this, but it is literally an 
issue of life and death.
  The question is whether or not Federal tax dollars should be used to 
pay for assisted suicide and euthanasia and whether Federal facilities 
like veterans hospitals, for example, are to be in the business of 
providing euthanasia as though it were just another type of medical 
treatment.
  On March 18, the Committee on Ways and Means Subcommittee on Health 
favorably reported this bill to the full committee by voice vote. Under 
normal circumstances, the full committee would meet to consider the 
bill. However, in order to expedite consideration of this extremely 
important legislation, the Committee on Ways and Means agreed to send 
the bill straight to the floor.
  This bill bars Medicare, Medicaid, military and Federal employee 
plans from paying doctors to help terminal ill patients to end their 
lives. The legislation does not affect the withholding of medical 
treatment or services and does not address the ethical or legal issues 
surrounding assisted suicide. It only bars American taxpayer dollars 
from funding such action.
  Can Members imagine someone providing an individual with the means to 
commit suicide and billing Medicare for the services? This sounds far-
fetched but without this legislation, it sure could happen. This bill 
was introduced in response to a recent court ruling in favor of 
assisted suicide.
  In 1994, a ballot initiative in Oregon made assisted suicide legal. 
This law could mean that Oregon's Medicaid Program as well as other 
Federal programs could be used to fund assisted suicide. No one can 
have anything but compassion and sympathy for those who are faced with 
health situations so difficult that they seriously consider suicide. 
The question is, how can we help and how should we respond to that cry 
for help? I firmly believe we should give help and comfort, not the 
financial means to end their lives.
  According to a Wirthlin poll taken last election day, 87 percent of 
the American people say tax dollars should not be spent to pay for 
assisted suicide and euthanasia. Let us listen to our constituents 
across the country. I urge a ``yes'' vote on this bill.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentleman 
from Washington [Mr. McDermott].
  (Mr. McDERMOTT asked and was given permission to revise and extend 
his remarks.)
  Mr. McDERMOTT. Mr. Speaker, I listened to my colleagues here on the 
floor talk about this issue. I have the feeling that they have never 
put themselves in the shoes of a physician or a family dealing with a 
terminally ill patient. This bill has no definitions in it for what 
suicide is or what is assisting a suicide. Yet doctors are continually 
faced with the problem of a patient who wants to die for a variety of 
reasons.
  First of all, Medicare does not give parity to the funding for 
psychiatric services to counsel them out of it so that is the first way 
in which this is a hypocritical bill. If we are really serious, we 
would deal with the mental health funding for Medicare.

                              {time}  1100

  But if someone wants to die and says to the doctor, ``I would like 
you not to do anything and just give me pain medication,'' now, is that 
assisting somebody in committing suicide, if they are lying in bed and 
saying they do not want hydration, they do not want to have intravenous 
feedings, just give them some pain medication?
  We all know, if we do a little study, that Demerol or morphine 
depresses respirations and, ultimately, the physician is depressing 
respirations and leading to death. Now, is that assisting someone at a 
time when they want to die?
  Well, this bill is very unclear. The problem with this bill, it is 
very simpleminded. It is simply, as my colleague from Texas says, 
driven by a poll, when we ask people are they for physician-assisted 
suicide. Nobody on this floor is for physician-assisted suicide, none 
of us, not even me. But this is not any help in that debate.
  What we should be talking about is living wills and what real 
definitions we want to put in here if we want to try and make it so 
people can actually have the assistance of the medical profession while 
they choose to end their life. We have to be very careful in what we 
write. I am going to vote against it.
  Mr. BLILEY. Mr. Speaker, I yield 3 minutes to the gentleman from 
Florida [Mr. Bilirakis], chairman of the Subcommittee on Health and 
Environment.
  Mr. BILIRAKIS. Mr. Speaker, I thank the gentleman for yielding me 
this time.
  I am an original cosponsor of this bill. I strongly support it and 
supported it certainly when it was considered by my committee, as it 
was approved by the committee resoundingly.
  Let me state emphatically that most Americans do not want their tax 
dollars to pay for assisted suicide. This legislation was written to 
respond to the desires of the American people, something that we should 
be emphasizing, because something like 85 to 90 percent of the American 
people are very much against assisted suicide.
  The bill anticipates a troublesome issue which could result from the 
legal battles across the Nation on this matter. The question we should 
be raising is, what is the purpose of the legislation? Well, that is 
the purpose, because there are legal battles out there.
  Currently, courts in the State of Florida and Oregon and a couple of 
other States are considering this issue, and, in addition, the U.S. 
Supreme Court is deliberating cases arising from lawsuits brought in 
New York and Washington State on assisted suicides. If any of these 
court cases result in a ruling legalizing assisted suicide, Federal 
funding may be used to pay for this procedure.
  Federal dollars appropriated for programs such as Medicaid and 
Medicare could be used to promote death instead of what we should be 
concentrating on, preserving life. I might add also, in the State of 
Oregon, that their Medicaid director, I am not sure what his full title 
is, has indicated he feels Medicaid Federal funds are available to use 
for assisted suicide in Oregon. Another reason why we have to have this 
legislation.
  The bill would address this important issue by clarifying that 
Federal funds cannot be used for assisted suicide. It also prohibits 
federally owned facilities from providing or encouraging assisted 
suicide.
  I want to make it clear, the bill does not ban or restrict assisted 
suicide nor does it prevent the use of State or private dollars to pay 
for assisted suicide. It also does not affect a patient's right to 
reject or restrict assisted suicide.
  Finally, the bill does not interfere in any way with the doctor-
patient relationship. Instead, the bill achieves only

[[Page H1403]]

one objective, but it is a very important objective, and that is the 
assurance that Federal tax dollars will not be used to assist in a 
suicide of any American.
  During our subcommittee hearing, Mr. Speaker, a number of 
organizations expressed their support for this legislation. The groups 
included almost every organized religion in America; a wide range of 
provider groups, including the AMA, experts on pain management, 
depression, and medical ethics; and, most importantly, older Americans 
and those with disabilities, including chronic and terminal illnesses.
  I want to commend my colleague in closing, Mr. Speaker, the gentleman 
from Texas, Ralph Hall, for his efforts in bringing this legislation to 
the House floor. It is a measure which I believe protects the interests 
of the American people and what the people have already said they 
really want, and I strongly urge my colleagues to support this bill.
  Mr. BROWN of Ohio. Mr. Speaker, how much time does each side have?
  The SPEAKER pro tempore (Mr. Smith of Michigan). The gentleman from 
Ohio [Mr. Brown] has 3 minutes remaining, and the gentleman from 
Virginia [Mr. Bliley] has 8 minutes remaining.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself the balance of my 
time.
  We have listened in the course of this debate to several speakers say 
that we must stop Federal funds from being used for assisted suicide. I 
would reiterate, Mr. Speaker, that nothing in current law permits 
Federal funding of suicide, including assisted suicide. Tax dollars are 
not used for this purpose. There is no intention from anyone in this 
body, there is no intention to change that long-standing policy.
  In short, this bill prohibits absolutely nothing. Medicare, Medicaid, 
Veterans, Indian Health Service, in each case money to be spent for 
assisted suicide are prohibited.
  Even in the committee report, Mr. Speaker, I would quote from it 
briefly: Medicare statute limits Medicare coverage to items and 
services that are reasonable and necessary for the diagnosis or 
treatment of illness or injury, or to improve the functioning of a 
malformed body member. Physician-assisted suicide, even if allowed 
under State law, does not meet these statutory criteria. As such, the 
program is prohibited from making payment for it under existing law.
  Mr. Speaker, I am disappointed that in this rush to actually do 
something in this session of Congress, that Congress today has missed a 
golden opportunity to help very sick, terminally ill patients. We 
missed an opportunity to reduce the tragic conditions that often lead 
to suicide in this country: People that are especially ill, people that 
are frail, people with disabilities who are in great pain.
  People who are seriously ill deserve quality of life at the end of 
their lives. We had a chance today, Mr. Speaker, to take steps to make 
that happen. We had a chance to say to medical schools in this country, 
``Yes, you should teach better pain management; you should teach your 
young medical students more about treatment of depression to help those 
people in those last days of their lives, in their most difficult days 
of their lives, so that they do not have the desire to commit suicide, 
to ask their doctor for some sort of assistance.''
  It would have been good policy; it would have been the right thing to 
do. That was the way, Mr. Speaker, we could have achieved the purpose 
of this legislation: To prevent assisted suicide by preventing the 
conditions that cause it.
  Mr. Speaker, I ask for support of the bill. I also ask, Mr. Speaker, 
that we think more seriously about this issue in terms of doing the 
right thing, this issue in terms of making sure that our medical 
schools do the right thing, train their medical students in helping 
those people in the sickest and most painful days of their lives.
  Mr. Speaker, I yield back the balance of my time.
  Mr. BLILEY. Mr. Speaker, I yield the balance of my time to the 
gentleman from Texas, Mr. Ralph Hall, the principal author of the bill 
and a member of the committee.
  Mr. HALL of Texas. Mr. Speaker, first I want to thank the gentleman 
from Virginia [Mr. Bliley] for his support and for bringing this bill 
to an early hearing, and I certainly thank the ranking minority leader, 
the gentleman from Ohio [Mr. Brown] for his good words.
  I think when the gentleman from Ohio says that we could have done 
more, perhaps he is correct. I go back to my initial statement, though: 
Read the bill. The bill simply says no tax dollars shall be spent for 
assisted suicide.
  The gentleman from California [Mr. Stark] who is certainly an 
authority on health matters and a man I greatly admire and respect, 
went to great length to say what this bill does not do, and perhaps he 
is correct, but, once again, if he will read the bill, it simply says 
no tax dollars are going to be spent. No hard-earned tax dollars are 
going to be spent for assisted suicide.
  If we listened to the gentlewoman from California, [Ms. Eshoo] she 
says she, of course, does not endorse assisted suicide. Of course she 
does not, and neither does this bill, nor does this bill preclude 
assisted suicide if States want to pay for it or families want to pay 
for it.
  The gentleman from Washington, [Mr. McDermott] talks about the lack 
of definitions. And yes, thank goodness we are not hampered down with 
definitions here, because it is so simple. It simply says no tax 
dollars will be spent for assisted suicide.
  He speaks of doctors' positions. Let me talk a moment or so about the 
physician's position. Where are the physicians on this? The American 
Medical Association, the American Nurses Association, the American 
Psychiatric Association, and at least 30 other professional health care 
givers, Mr. Speaker, these groups have filed briefs with the Supreme 
Court in opposition to physician-assisted suicide. They say, by their 
briefs, no tax dollars should be spent for assisted suicide.
  Certainly the AMA believes and has stated in their testimony before 
our committee that physician-assisted suicide is unethical and 
fundamentally inconsistent with the pledge that physicians make to 
devote themselves to healing and to life and not to death.
  I think we might also question whether or not there is a danger that 
Federal funds might be spent if we do nothing. Current Federal law uses 
broad and general language. For example, Medicare pays for items and 
services which are, quote, reasonable and necessary for the diagnosis 
or treatment of illness or injury.
  If assisted suicide is legalized by the Supreme Court or in any 
individual State, all it would take, Mr. Speaker, is for one district 
court judge to rule that assisted suicide fits under the State's 
Medicare guidelines. We need to make sure that this does not happen by 
clarifying Federal law.
  President Clinton often calls for Congress to spend taxpayers' 
dollars in a manner that reflects values. We ask the same thing. This 
bill does exactly that. According to a recent poll, 87 percent of 
Americans opposed federally funded suicide. They say what this bill 
says: No tax dollars shall be spent for assisted suicide.
  This bill honors a value central to all of our heritage, central to 
our society, that all people are created equal and all people are 
deserving of protection and assistance. That means that no matter how 
ill they are, no matter how disabled they are, no matter how elderly 
they are, no matter how frail they are or how depressed a person is, 
that we will never allow Federal funds to be used to kill them. 
Instead, we will continue to devote our effort and our resources to 
improving the health and prolonging the lives of our patients.

  This bill simply says, as I close, no hard-earned tax dollars shall 
be spent for assisted suicide.
   Mr. Speaker, I yield back the balance of my time.
  Mr. DOYLE. Mr. Speaker, I rise today in support of this measure, H.R. 
1003, the Assisted Suicide Funding Restriction Act. This legislation 
simply clarifies current Federal policy and practice in this area, 
prohibiting the use of Federal funds for activities explicitly involved 
with assisted suicide.
  Often when we think of protecting human life, we think of protecting 
the unborn. However, every life deserves that same protection. Our 
efforts must be refocused on helping people alleviate their suffering, 
not by ending their lives, but by increasing our understanding of 
medicine and mental health to give these individuals a better 
alternative than death.

[[Page H1404]]

  While H.R. 1003 prohibits Federal support of assisted suicide, it 
also works to solve some of the problems associated with depression and 
other conditions that can move someone to consider taking their own 
life. The bill authorizes the Department of Health and Human Services 
to increase its efforts on this front. Funds for this initiative would 
come from existing resources within the agency and would fund 
activities aimed at reducing the rate of suicide, including assisted 
suicide, among all segments of our society. Some of the activities 
these funds could support include training for health care 
professionals in pain management techniques and identifying depression 
in patients as well as activities related to mental health and suicide 
prevention.
  There are many people across the Nation suffering from medical or 
mental health conditions who are in need of assistance, but I do not 
believe that suicide assistance is the help that the Federal Government 
should be promoting. Once again, I reiterate my support for this 
legislation, which puts our Nation on a path to truly help those in 
need.
  Mrs. EMERSON. Mr. Speaker, I rise to lend my full support to H.R. 
1003, the Assisted Suicide Funding Restriction Act. I thank Mr. Hall 
for his sponsorship of this legislation, and I urge this body to 
reaffirm our Nation's commitment to the life of each and every 
individual.
  Assisted suicide is an abominable act. Despite claims that it is a 
matter of mercy or dignity, an assisted suicide is nothing more than 
the murder of some of our most vulnerable citizens, persons who are 
ailing and sometimes unable to voice their will. These individuals 
deserve every chance at life and all the support and assistance that we 
can provide, not some misguided notion of a so-called honorable death. 
An assisted suicide must not be deemed an acceptable medical procedure, 
or the grave consequences will be the lives of our sick and elderly.
  The first and sacred rule of medicine is to preserve the life of the 
patient. That is why physician-assisted suicide is opposed by the 
American Medical Association and numerous other doctor and nurse 
associations. The House has the opportunity today to reaffirm this 
fundamental tenet of the health profession, making the law reflect what 
doctors, nurses, and most Americans already know intuitively.
  Mr. Speaker, America is a nation of justice and of compassion. Both 
justice and compassion tell us to pass H.R. 1003, and I urge my 
colleagues to give it their full support.
  Mr. PACKARD. Mr. Speaker, American tax dollars shouldn't be used to 
end a patient's life. There are far more humane ways to help those 
stricken with a terminal illness and their families.
  The Supreme Court is currently considering two cases, Washington 
versus Glucksberg and Vacco versus Quil, to determine the 
constitutionality of assisted suicide. This is a complex issue 
involving medical ethics, religion, and science. Regardless of what the 
Court decides about the constitutionality of the deed, this bill will 
make sure no Federal tax dollars will be spent on it.
  Supporters often hold up assisted suicide as the compassionate answer 
to helping someone die with dignity. A society is best judged by how it 
treats its most vulnerable members, and killing them is not 
compassionate or dignified. Researchers have found that many severely 
and terminally ill patients share a common symptom--depression brought 
on by high levels of anxiety, fear, and rejection. Hastening their 
death does nothing to identify and treat the depression that comes 
along with facing death; it is not the way to resolve a terminally ill 
patient's concerns about becoming a burden to their family and friends; 
nor is it the way to comfort or ease the pain of the terminally ill.
  Congress should not let a single tax dollar go to pay for this 
physician assisted killing--a false compassion and a perversion of 
mercy. Turning medical doctors into licensed killers of the sick, the 
handicapped, and the depressed, is not the way to empower Americans.
  Mr. CANADY of Florida. Mr. Speaker, I rise in strong support for H.R. 
1003, the Assisted Suicide Funding Restriction Act of 1997. This bill 
would prohibit the use of Federal funds to pay for assisted suicide.
  The will of the American people is clear on this issue. Thirty-five 
States have enacted statutes prohibiting assisted suicide. An 
additional eight States recognize assisted suicide as a common law 
crime. In a May 1996 Wirthlin poll, 87 percent of those polled opposed 
the use of tax dollars to pay for assisted suicide. The American people 
recognize the value of protecting human life, and the serious threat 
which assisted suicide poses to the safety of vulnerable persons.
  Why, then, is it necessary for this body to act on a subject which is 
already being addressed by the States? First, it is our responsibility 
to ensure that Federal spending reflects the values of the American 
people. Accordingly, this bill would ensure that no Federal funds would 
be spent on assisted suicide, a policy which most Americans have 
rejected.
  Second, recent Federal appeals court decisions from the ninth and 
second circuit courts invalidated State prohibitions on assisted 
suicide. With no national debate, these courts are attempting to 
implement a broad public policy that would profoundly affect the way 
Americans deal with life and death and drastically alter the role of 
physicians in our society. These appeals courts have effectively 
thwarted the will of the people as expressed through their State laws. 
The U.S. Supreme Court is currently reviewing these cases, and more 
than one Supreme Court Justice has expressed reluctance to interfere in 
what may more properly be a matter of public policy for the legislative 
branch of government to decide. I am hopeful that the Court will uphold 
the right of the States to prevent the serious abuses that would 
inevitably be associated with assisted suicide. In the meantime, 
however, it is important for this body to go on record as opposing 
assisted suicide.
  The House Judiciary Subcommittee on the Constitution, of which I am 
the chairman, held hearings on this subject a year ago. Witnesses 
warned Congress against following the policy in the Netherlands which 
began as assisted suicide and moved to active euthanasia, from 
euthanasia for the terminally ill to euthanasia for the chronically 
ill, from euthanasia for physical illness to euthanasia for mental 
suffering, and from voluntary to nonvoluntary euthanasia.
  Last September I released a report which examines this devolution of 
physician-assisted suicide policy in the Netherlands. In 1986 the Dutch 
medical association established official ``Guidelines for Euthanasia.'' 
The guidelines specifically require that a patient voluntarily request 
physician-assisted suicide or euthanasia, but a study confirmed that 
nonvoluntary euthanasia was being widely performed. In 1990 there were 
2,300 cases of euthanasia at the patient's request, 400 cases of 
physician-assisted suicide, and more than 1,000 cases in which 
physicians terminated patients' lives without their consent. Fourteen 
percent of the patients who were killed without consent were fully 
competent, and 11 percent were partially competent. These were patients 
who could have made their own decisions about whether to live or die 
but were never given the opportunity to decide for themselves.

  The Dutch experience vividly shows how permitting physician-assisted 
suicide for terminally ill patients can easily lead to the unchecked 
nightmare of nonconsensual termination of human life. And individual's 
so-called right to die, over time, can be transformed into a demand by 
society that certain individuals have a duty to die.
  We need to maintain the integrity of the medical profession as a 
profession dedicated to healing. Physicians should not become 
facilitators of death. If we break down the barriers which prohibit 
assisted suicide, we will be on the path to a society where individuals 
are killed simply because someone else decides their lives are not 
worthy to be lived. We must protect those most vulnerable in our 
society by easing the fears and alleviating the pain of terminally ill 
patients, and by providing positive and realistic solutions to the 
problems of those who are driven to despair.
  Mr. BARTON of Texas. Mr. Speaker, I would like to take this time to 
voice my strong support for the House to pass H.R. 1003, the Assisted 
Suicide Funding Restriction Act of 1997. I was an original cosponsor of 
this legislation when it was introduced in the 104th Congress. I was 
also an original cosponsor of the bill when it was reintroduced in this 
Congress. H.R. 1003 was marked up in the Commerce Committee, of which I 
am a member. It passed out of the full committee by a vote of 45 to 2. 
The bill has 118 cosponsors. I commend Congressman Ralph Hall for his 
hard work on this legislation.
  The American people's support for this legislation is evident. When 
asked on election day in 1996, ``Should tax dollars be spent to pay for 
the cost of assisting suicide and euthanasia?'' Eighty-seven percent 
said no in a national poll by Wirthlin Worldwide. Our purpose to pass 
this legislation here today is clear: the potentially imminent 
legalization of assisted suicide and euthanasia could lead to the 
spending of Federal tax dollars to subsidize them. The U.S. Supreme 
Court is currently reviewing decisions of the second and ninth circuit 
court of appeals that have declared a new constitutional right to 
assisted suicide. If the Supreme Court decides this summer to uphold 
the decisions of the lower courts, this decision would legalize 
assisted suicide. This would immediately bring up the question of 
whether or not Federal tax funds should be used to subsidize assisted 
suicide. That is why we must address this issue now, by passing this 
bill and sending it to the Senate.
  The Federal Government should not be in the business of paying for 
people to end their lives. But more importantly, the American people, 
who have indicated that they are opposed to this, should not be 
compelled to provide

[[Page H1405]]

funds so that Federal health programs like Medicare or Medicaid may 
provide assistance to patients in efforts to end their lives.
  My father passed away December 7, 1996. He suffered from diabetes, 
prostate cancer, and stomach ulcers. He did not go out of his way to 
prolong his life, yet he also did not go out of his way to artificially 
end his life. The fundamental belief that we should preserve life is 
one that people of all religious denominations can agree on. Again, I 
urge my colleagues to vote ``yes'' today on the Assisted Suicide 
Funding Restriction Act of 1997.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Virginia [Mr. Bliley] that the House suspend the rules 
and pass the bill, H.R. 1003, as amended.
  The question was taken.
  Mr. BLILEY. Mr. Speaker, I object to the vote on the ground that a 
quorum is not present and make the point of order that a quorum is not 
present.
  The SPEAKER pro tempore. Evidently a quorum is not present.
  The Sergeant at Arms will notify absent Members.
  The vote was taken by electronic device, and there were--yeas 398, 
nays 16, not voting 18, as follows:

                             [Roll No. 75]

                               YEAS--398

     Abercrombie
     Ackerman
     Aderholt
     Allen
     Andrews
     Archer
     Armey
     Bachus
     Baesler
     Baker
     Baldacci
     Barcia
     Barr
     Barrett (NE)
     Barrett (WI)
     Bartlett
     Barton
     Bass
     Bateman
     Bentsen
     Bereuter
     Berman
     Berry
     Bilbray
     Bilirakis
     Bishop
     Blagojevich
     Bliley
     Blumenauer
     Blunt
     Boehlert
     Boehner
     Bonilla
     Bonior
     Borski
     Boswell
     Boucher
     Boyd
     Brady
     Brown (CA)
     Brown (FL)
     Brown (OH)
     Bryant
     Bunning
     Burr
     Burton
     Buyer
     Callahan
     Calvert
     Camp
     Campbell
     Canady
     Cannon
     Cardin
     Castle
     Chabot
     Chambliss
     Chenoweth
     Christensen
     Clay
     Clayton
     Clement
     Clyburn
     Coble
     Coburn
     Collins
     Combest
     Condit
     Cook
     Cooksey
     Costello
     Cox
     Coyne
     Cramer
     Crane
     Crapo
     Cubin
     Cummings
     Cunningham
     Danner
     Davis (FL)
     Davis (IL)
     Davis (VA)
     Deal
     DeFazio
     Delahunt
     DeLauro
     DeLay
     Deutsch
     Diaz-Balart
     Dicks
     Dingell
     Dixon
     Doggett
     Dooley
     Doyle
     Dreier
     Duncan
     Dunn
     Edwards
     Ehlers
     Ehrlich
     Emerson
     Engel
     English
     Ensign
     Eshoo
     Etheridge
     Evans
     Everett
     Ewing
     Farr
     Fattah
     Fawell
     Fazio
     Flake
     Foglietta
     Foley
     Forbes
     Ford
     Fowler
     Fox
     Franks (NJ)
     Frelinghuysen
     Frost
     Furse
     Gallegly
     Ganske
     Gejdenson
     Gekas
     Gephardt
     Gibbons
     Gilchrest
     Gillmor
     Gilman
     Gonzalez
     Goode
     Goodlatte
     Goodling
     Gordon
     Goss
     Graham
     Granger
     Green
     Greenwood
     Gutierrez
     Gutknecht
     Hall (OH)
     Hall (TX)
     Hamilton
     Hansen
     Harman
     Hastert
     Hastings (FL)
     Hastings (WA)
     Hayworth
     Hefley
     Herger
     Hill
     Hilleary
     Hilliard
     Hinchey
     Hinojosa
     Hobson
     Hoekstra
     Holden
     Hooley
     Horn
     Hostettler
     Houghton
     Hoyer
     Hulshof
     Hunter
     Hutchinson
     Hyde
     Inglis
     Istook
     Jackson-Lee (TX)
     Jefferson
     Jenkins
     John
     Johnson (CT)
     Johnson (WI)
     Johnson, E.B.
     Johnson, Sam
     Jones
     Kanjorski
     Kaptur
     Kasich
     Kelly
     Kennedy (MA)
     Kennedy (RI)
     Kennelly
     Kildee
     Kim
     Kind (WI)
     King (NY)
     Kingston
     Kleczka
     Klink
     Klug
     Knollenberg
     Kolbe
     Kucinich
     LaFalce
     LaHood
     Lampson
     Lantos
     Largent
     Latham
     LaTourette
     Lazio
     Leach
     Levin
     Lewis (CA)
     Lewis (GA)
     Lewis (KY)
     Linder
     Lipinski
     Livingston
     LoBiondo
     Lofgren
     Lowey
     Lucas
     Luther
     Maloney (CT)
     Maloney (NY)
     Manton
     Manzullo
     Markey
     Martinez
     Mascara
     Matsui
     McCarthy (MO)
     McCarthy (NY)
     McCollum
     McCrery
     McDade
     McGovern
     McHale
     McHugh
     McInnis
     McIntosh
     McIntyre
     McKeon
     McNulty
     Meehan
     Meek
     Menendez
     Metcalf
     Mica
     Millender-McDonald
     Miller (FL)
     Minge
     Mink
     Molinari
     Moran (KS)
     Moran (VA)
     Morella
     Murtha
     Myrick
     Neal
     Nethercutt
     Neumann
     Ney
     Northup
     Norwood
     Nussle
     Oberstar
     Obey
     Olver
     Ortiz
     Owens
     Oxley
     Packard
     Pallone
     Pappas
     Parker
     Pascrell
     Pastor
     Paul
     Paxon
     Payne
     Pease
     Pelosi
     Peterson (PA)
     Petri
     Pickering
     Pickett
     Pitts
     Pombo
     Portman
     Poshard
     Price (NC)
     Pryce (OH)
     Quinn
     Rahall
     Ramstad
     Rangel
     Regula
     Reyes
     Riggs
     Riley
     Rivers
     Roemer
     Rogan
     Rogers
     Rohrabacher
     Ros-Lehtinen
     Rothman
     Roukema
     Roybal-Allard
     Royce
     Rush
     Ryun
     Sabo
     Salmon
     Sanchez
     Sanders
     Sandlin
     Sanford
     Sawyer
     Saxton
     Schaefer, Dan
     Schumer
     Sensenbrenner
     Serrano
     Sessions
     Shadegg
     Shaw
     Shays
     Sherman
     Shimkus
     Shuster
     Sisisky
     Skaggs
     Skeen
     Skelton
     Slaughter
     Smith (MI)
     Smith (NJ)
     Smith (OR)
     Smith (TX)
     Smith, Adam
     Smith, Linda
     Snowbarger
     Snyder
     Solomon
     Souder
     Spence
     Spratt
     Stabenow
     Stearns
     Stenholm
     Stokes
     Strickland
     Stump
     Stupak
     Sununu
     Talent
     Tanner
     Tauscher
     Tauzin
     Taylor (MS)
     Taylor (NC)
     Thomas
     Thompson
     Thornberry
     Thune
     Thurman
     Tiahrt
     Tierney
     Torres
     Towns
     Traficant
     Turner
     Upton
     Velazquez
     Vento
     Visclosky
     Walsh
     Wamp
     Watkins
     Watt (NC)
     Weldon (FL)
     Weldon (PA)
     Weller
     Wexler
     Weygand
     White
     Whitfield
     Wicker
     Wise
     Wolf
     Woolsey
     Wynn
     Young (AK)
     Young (FL)

                                NAYS--16

     Becerra
     Conyers
     DeGette
     Dellums
     Frank (MA)
     Jackson (IL)
     Kilpatrick
     McDermott
     McKinney
     Miller (CA)
     Nadler
     Scott
     Stark
     Waters
     Waxman
     Yates

                             NOT VOTING--18

     Ballenger
     Bono
     Capps
     Carson
     Dickey
     Doolittle
     Filner
     Hefner
     Moakley
     Mollohan
     Peterson (MN)
     Pomeroy
     Porter
     Radanovich
     Scarborough
     Schaffer, Bob
     Schiff
     Watts (OK)

                              {time}  1137

  Ms. KILPATRICK. Ms. WATERS, Mr. MILLER of California, and Mr. NADLER 
changed their vote from ``yea'' to ``nay.''
  Mr. OLVER changed his vote from ``nay'' to ``yea.''
  So (two-thirds having voted in favor thereof) the rules were 
suspended, and the bill, as amended, was passed.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.

                          ____________________