[Congressional Record Volume 143, Number 45 (Wednesday, April 16, 1997)]
[Senate]
[Pages S3258-S3266]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            ASSISTED SUICIDE FUNDING RESTRICTION ACT OF 1997

  The Senate continued with the consideration of the bill.
  Mr. NICKLES. Mr. President, I rise in support of the legislation 
pending before us, a bill to prohibit Federal funds being used to 
assist in suicides.
  I wish to compliment my colleague, Senator Ashcroft, and also my 
colleague, Senator Dorgan, for their leadership. I am happy to 
cosponsor this legislation. I think it is important that we pass this 
legislation today. I am pleased that the House passed it overwhelmingly 
by a vote of 398 to 16. It is not often that we find such an 
overwhelming vote.
  Frankly, I can't see how anyone would vote against this legislation. 
This legislation makes sense. It is needed. Some may ask, ``Why is it 
needed?"
  You might be aware of the fact that the Supreme Court held hearings 
earlier this year on whether or not there is a legal right for assisted 
suicide. I have read the Constitution many times. I don't find that 
right in there. That doesn't mean the Supreme Court might not, nor does 
it mean that some other judge might say yes, you have a constitutional 
right for assisted suicide, and someone else say yes, that is a 
constitutional right; therefore, it should be covered by Medicare or 
Medicaid, and, therefore, be paid for by the Federal Government.
  So maybe this is a preemptive strike. It is unfortunate to think it 
might even be needed. But it is needed. We want to make sure it doesn't 
happen. We want to make sure that we don't have more Dr. Kevorkians 
running around the country saying, ``You have a legal right to kill 
yourself, and therefore, we will help you; and, oh, yes, we want the 
taxpayers to pay for it.'' We don't want the taxpayers to pay for it. 
We want to send a signal to Dr. Kevorkian that we don't agree with him.
  Dr. Kevorkian made a statement which was reported in the New York 
Times on April 5 talking about the fact that he publicly burned a cease 
and desist order from the State. He said, ``If you want to stop 
something, pass a law.''
  That is what we are trying to do today. We are trying to make it very 
clear that the Congress of the United States overwhelmingly believes 
that you should not use Federal funds to assist in something like 
suicides, something that is as deadly as suicide.
  This would clarify the law. If assisted suicide is legalized by the 
Supreme Court, or in any individual State, all it would take is one 
district court judge to rule that assisted suicide fits under the 
Medicare statute's guidelines. On January 8, 1997, the Supreme Court 
heard oral arguments in two cases in which the Federal courts of 
appeals have declared a constitutional right to assisted suicide.
  Mr. President I think we want to send a very clear signal. I might 
mention that this Congress has already passed a ban. In 1995, I offered 
legislation banning the use of Medicaid and Medicare funds for assisted 
suicide in the balanced budget amendment which passed this Congress. 
Unfortunately, President Clinton vetoed the legislation. But he didn't 
veto the legislation because of this.
  An amicus brief, filed by the American Medical Association, to the 
Supreme Court on November 12, 1996, contends that assisted suicide 
``will create profound danger for many ill persons with undiagnosed 
depression and inadequately treated 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.''
  Acting Solicitor Gen. Walter Dellinger recently said in opposing the 
idea of a right to assisted suicide, ``The systemic dangers are 
dramatic . . . the least costly treatment for any illness is lethal 
medication.'' That is reported in the New York Times on January 9 of 
this year.

  We are a nation built on the principle that human life is sacred, to 
be honored and cherished. As public servants, we deal with issues that 
affect the lives of people every day. Caring for people is the 
underlying aspect of nearly every piece of legislation dealt with in 
this Senate.
  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, ``No one needs to be alone or in pain or 
beg a doctor to put an end to misery. Good care is possible.''
  Cardinal Joseph Bernardin, while dying last November, took the time 
to write the Supreme Court on assisted suicide, saying,

       There can be no such thing as a ``right to assisted 
     suicide'' because there can be no legal and moral order which 
     tolerates the killing of innocent human life, even if the 
     agent of death is self-administered. Creating a new ``right'' 
     to assisted suicide will endanger society and send a false 
     signal that a less than ``perfect'' life is not worth living.

  There are a lot of groups and a lot of individuals who have endorsed 
this legislation.
  The American Medical Association said,

       The power to assist in intentionally taking the life of a 
     patient is antithetical to the central mission of healing 
     that guides physicians. 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.

  That was signed by John Seward, executive vice president of the AMA, 
on April 15.
  Mr. President, this legislation is endorsed by not only the American 
Medical Association but also the National Conference of Catholic 
Bishops, American Academy of Hospice and Palliative Medicine, American 
Geriatrics Society, Christian Coalition, Family Research Council, Free 
Congress, National Right to Life, Physicians for Compassionate Care, 
and the Traditional Values Coalition.
  In addition, I ask unanimous consent that letters be printed in the 
Record at this point from the Catholic Health Association and also the 
Christian Coalition in support of this legislation.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                              Christian Coalition,


                                          Capitol Hill Office,

                                   Washington, DC, April 16, 1997.
       Dear Senator: As of this morning, the Majority Leader was 
     trying to work out an agreement to bring up the Assisted 
     Suicide Funding Restriction Act for a vote this afternoon.
       On behalf of the members and supporters of the Christian 
     Coalition, we urge you to vote for the Assisted Suicide 
     Funding Restriction Act. This legislation overwhelmingly 
     passed the House of Representatives by a vote of 398-16.
       The Assisted Suicide Funding Restriction Act restricts the 
     use of tax dollars for the purpose of assisted suicide, 
     euthanasia, or mercy killing. The overwhelming majority of 
     American taxpayers oppose the use of tax

[[Page S3259]]

     dollars for assisted suicide and euthanasia, with 87 percent 
     of Americans opposing the use of tax dollars for these 
     purposes. This widespread support, as well as the moral 
     grounds for opposing the funding of assisted suicide, compels 
     passage of this legislation.
       This is a carefully-crafted bill and we would like to see 
     it pass in its present form. Please vote for H.R. 1003, the 
     Assisted Suicide Funding Restriction Act. Thank you for your 
     consideration of our views.
           Sincerely,
                                                     Brian Lopina,
     Director, Governmental Affairs Office.
                                                                    ____

                                       Catholic Health Association


                                         of the United States,

                                   Washington, DC, April 16, 1997.
     Senator Trent Lott,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Lott: I understand that H.R. 1003, the 
     Assisted Suicide Funding Restriction Act, will soon be 
     considered by the full Senate. On behalf of more than 1,200 
     health care facilities and organizations, the Catholic Health 
     Association of the United States (CHA) urges the Senate to 
     give this legislation swift and favorable consideration.
       As health care providers, members of CHA reject physician-
     assisted suicide as antithetical to their religious beliefs 
     and their mission as healers. Because assisted suicide 
     offends the basic moral precepts of our culture and poses a 
     grave danger to those at the margins of our society, state 
     governments have consistently outlawed its practice. 
     Unfortunately, a Florida state court and two federal Courts 
     of Appeals recently have misconstrued the Constitution to 
     ``discover'' a constitutionally protected liberty interest in 
     physician-assisted suicide.
       In response to the threat of these cases and a recent 
     referendum in Oregon, Congress should establish the principle 
     that federal tax dollars will not be expended for the 
     purposeful taking of human life. While none are being used 
     for this purpose today, judicial activism threatens to 
     undermine our long-established societal consensus against 
     assisted suicide.
       The legislative proposal before you properly distinguishes 
     between the withholding or withdrawing of burdensome and 
     ineffective medical treatment and the aiding of another in 
     purposefully taking human life. Catholic teaching and common 
     sense support this distinction.
       The most important reason to pass this legislation is to 
     send a signal to disabled persons, the elderly and other 
     vulnerable people that they are valued members of the human 
     community. They enrich rather than burden society. The late 
     Joseph Cardinal Bernardin said it best in his letter to the 
     Supreme Court: ``There can be no such thing as a `right to 
     assisted suicide' because there can be no legal or moral 
     order which tolerates the killing of innocent human life, 
     even if the agent of death is self-administered. Creating a 
     new `right' to assisted suicide will endanger society and 
     send a false signal that a less than `perfect life' is not 
     worth living.''
       CHA has a long and distinguished record of supporting the 
     goal of universal health care coverage. In addition, we 
     support meaningful efforts to improve care for the dying. 
     Yet, we do not support the views of those opposing this bill 
     on the grounds that it does not accomplish all of these 
     worthy goals in one bill. Congress should pass this bill and 
     then move on to legislation that increases health care 
     coverage and helps to provide those at the end of life with 
     the care and comfort that they deserve.
           Sincerely,
                                                   William J. Cox.
                                         Executive Vice President.

  Mr. NICKLES. Mr. President, again, I wish to thank sponsors of this 
legislation. I have had the pleasure of working with both Senators from 
Missouri. Both Senators made outstanding statements in support of this 
legislation. In addition, Senator Dorgan--we appreciate his support for 
this legislation. It has bipartisan support. We have a lot of 
cosponsors on both sides of the aisle.
  It is my hope that the Senate will pass the identical bill that the 
House passed and that we will send it to the President.
  Also, I have a statement from the administration. The Clinton 
administration issued a statement of administration policy on April 10, 
1997, which states, ``The President made it clear that he does not 
support assisted suicide. The administration, therefore, does not 
oppose enactment of H.R. 1003.''
  Mr. President, there is no reason for us to amend this legislation. 
There is no reason for us to delay this legislation. Let's pass this 
legislation and send a message to Dr. Kevorkian and others that Federal 
funding will not be tolerated and that it will not be legal to assist 
in assisted suicide.
  Mr. President, I yield the floor.
  Mr. ASHCROFT. Mr. President, thank you.
  Mr. President, I want to thank my colleague from Oklahoma for his 
excellent statement on this issue. I appreciate his leadership on this 
issue. When this legislation was initially filed last year, I was not 
aware of the fact that he had previously included it in other matters. 
But he has been a leader in respecting the will of the American people 
not to participate in the funding of assisted suicide.
  Mr. President, I might add as well that while House bill 1003 is 
largely consistent and almost totally compatible with the bill that 
Senator Dorgan and I filed here in the U.S. Senate, the House added 
some provisions which I think improve the measure. Both bills were 
narrowly and tightly drawn and focused on the fact that we didn't 
believe there should be Federal funding for assisted suicide.
  The House measure includes provisions designed 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, palliative care, and other 
issues related to suicide prevention. The bill would amend the Public 
Health Service Act to use existing Federal funds to establish research, 
training, and demonstration projects intended to help achieve the goal 
of reducing the rate of suicide. That would also, of course, include 
reducing the rate of individuals interested in assisted suicide. It 
also includes a provision directing the General Accounting Office to 
analyze the effectiveness and achievements of the grant programs that 
are authorized by the Public Health Service Act.
  So, resources now available to the public through the Public Health 
Service Act can be used in accordance with this measure to reduce the 
rate of suicide. It is important for us not just to be concerned about 
Federal funding for suicide, but where possible to help individuals 
understand the potential for hope in the situation rather than despair.
  I might just also point out that assisted suicide and the potential 
for assisted suicide or funding for assisted suicide in a culture are 
not really conducive to the development of other therapies. It is 
interesting to note that Justice Breyer pointed out a number of 
important facts during the Supreme Court's recent oral arguments 
regarding the right to assisted suicide. He indicated that supportive 
services for vulnerable patients remain undeveloped once a society has 
accepted assisted suicide as a quick and easy solution for their 
problems. In particular, he noted that in England, which prohibits 
assisted suicide, there are over 180 hospices for people who are 
terminally ill; 180 facilities designed for compassionate care to help 
these people. In a sense, each of us is terminally ill. Each of us 
ultimately will die. In the Netherlands, on the other hand, which 
allows assisted suicide, rather than having 180 hospices, they have 
only 3.

  It may be inappropriate to draw a conclusion here, but it seems to me 
that once a culture decides that the thing to do with terminally-ill 
patients is to help them die quickly, they neglect and otherwise refuse 
to develop the kinds of institutions which would help people who really 
ought to live and want to live and have many things to contribute.
  It is with that in mind that I think it is peculiarly and singularly 
important that this Congress respond to the voice of the American 
people, which with near unanimity is calling for us to prohibit Federal 
funding of assisted suicide. It is with that in mind that I urge my 
colleagues to join by voting in favor of this proposal.
  Mr. DORGAN addressed the Chair.
  The PRESIDING OFFICER. The Senator from North Dakota.
  Mr. DORGAN. Mr. President, Senator Ashcroft has just outlined a 
provision that was included in the legislation enacted by the House of 
Representatives. Frankly, I think this addition improves the 
legislation that we introduced here in the Senate. The amendment that 
was accepted by the House and is in this legislation provides for the 
prevention of suicide, including assisted suicide. It provides 
authorization for the Secretary of Health and Human Services to fund 
research and demonstration projects using existing Public Health 
Service dollars to prevent suicide among people with disabilities or 
terminal or chronic illnesses. That amendment addresses an issue that 
is very significant and serious, and I think it adds to this 
legislation.

[[Page S3260]]

  With this legislation, we are not only saying that we want to prevent 
Federal funding of assisted suicide, but also that we want to improve 
the availability of compassionate end-of-life care so that terminally 
or chronically ill individuals do not feel that assisted suicide is 
their only option for relief.
  So I think this amendment is a good amendment, and I support it.
  Mr. President, I hope we can move along to final passage on this 
legislation.
  I don't know whether there are those who intend to offer amendments. 
I see Senator Wellstone from Minnesota is on the floor. My hope is that 
we can proceed on this noncontroversial piece of legislation and finish 
it today.
  Mr. McCONNELL. Mr. President, today the U.S. Senate considers H.R. 
1003, the Assisted Suicide Funding Restriction Act of 1997. As an 
original co-sponsor of S. 304, the Senate companion to H.R. 1003, I 
rise in support of this measure's reasonable and responsible action in 
prohibiting the use of Federal funds to support physician-assisted 
suicide.
  Modern medical technology has made a significant difference in the 
health care challenges that patients and providers face today. While 
few Americans fear death from scarlet fever or cholera, a growing 
number are concerned about the potential for a slow, painful death from 
cancer or a degenerative neurological disorder. Advocates for 
physician-assisted suicide package the concept as purely an issue of 
patient choice and personal liberty in seeking relief from suffering. 
Moreover, they argue that this choice harms no one. I respectfully but 
stringently disagree. Physician-assisted suicide condones the 
intentional killing of a human being as a valid method for relieving 
pain and suffering when other means are available to address a 
patient's critical medical needs.
  Advocates for physician-assisted suicide point to secondary effect, 
the circumstance where a patient dies during treatment for pain, as a 
factor lending legitimacy to the legalization of euthanasia. Again, I 
disagree. A large number of Americans and a majority in the medical 
community identify the critical difference between the administration 
of pain medication and physician-assisted suicide. In the former, a 
physician makes a medical assessment and administers the level of 
medication necessary to relieve a patient's pain and suffering. Though 
the action is taken with the knowledge that the treatment could cause 
death, the physician's sole medical goal is helping the patient attain 
relief from suffering. In contrast, physician-assisted suicide is the 
intentional administration of a drug, not for pain relief, but to kill. 
H.R. 1003 recognizes the critical difference between secondary effect 
and physician-assisted suicide.
  While patients' rights have been raised in the debate over physician-
assisted suicide, I want to draw attention to the broader implications 
of this action on the health care community. The American Medical 
Association makes clear in its Code of Medical Ethics that the 
intentional act of killing a patient is antithetical to the central 
mission of healing that bonds the physician-patient relationship. The 
AMA fully endorses H.R. 1003's purpose to assure that the integrity of 
doctors working for Federal health care programs and in Federal health 
care facilities is not compromised by the act of physician-assisted 
suicide. Without H.R. 1003, doctors face a painful dilemma of whether 
they are expected to conduct assisted suicide as a form of medical 
treatment. The AMA rejects such a concept, and 87 percent of Americans 
agree that Federal tax dollars should not support such a questionable 
practice.

  It is clear to all that patient concerns regarding the health care 
threats of degenerative and painful disease must be addressed. This 
critical need is one of the reasons why I and other Members of the U.S. 
Senate support Federal investment in medical research. The Federal 
Government should not invest in physician-assisted suicide as a 
legitimate option for pain control however. Medicine today is capable 
of managing physical pain, but patients are forced to endure pain and 
suffering because this information is not applied uniformly. For the 
welfare of patients and families, we should focus our energies on 
correcting these failures in medical care delivery, rather than 
diverting critical attention toward the questionable promotion of 
assisted suicide.
  Mr. President, I support the right of Americans to decide whether or 
not to withdraw or withhold medical treatment. I also appreciate the 
difference between acts to relieve the pain of a dying patient and acts 
that intentionally produce pre-mature death. H.R. 1003 does the same. 
This measure makes clear that Federal funds do not and will not support 
physician-assisted suicide to the detriment of patients, families, and 
the medical community. I urge my colleagues to join in support of H.R. 
1003's intent to ensure that this vital concern for millions of 
Americans is properly addressed.
  Mr. COATS. Mr. President, I rise in support of H.R. 1003 and I urge 
my fellow Senators also to vote in favor of this legislation.
  This bill simply prohibits the use of Federal funds for the 
controversial and immoral practice of assisted suicide. It rightly 
keeps the Federal Government out of the business of killing.
  The bill prevents the use of funds to provide health care items or 
services ``furnished for the purpose of causing * * * the death of any 
individual, such as by assisted suicide, euthanasia or mercy killing.'' 
Death of the individual has been included because proponents of 
assisted suicide, mercy killing, and euthanasia often use other terms 
to describe these activities, such as physician aid in dying. In fact, 
the Oregon Death with Dignity Act, which legalizes these actions under 
certain circumstances, specifically provides that ``actions taken in 
accordance with [this law] shall not, for any purpose, constitute 
assisted suicide, mercy killing, or homicide''--even though the actions 
precisely are assisted suicide or mercy killing! The bill is very clear 
about the activity that should not receive Federal funds: an item or 
service furnished for the purpose of causing the death of any 
individual will not be funded by American taxpayers.
  Close observers will note that this broad language is used in 
sections 3, 4, and 7 of the bill, while more narrow language is used in 
sections 2, 5, and 6, where funds are prohibited for ``causing the 
suicide, euthanasia, or mercy killing of any individual. The broad 
language is used with regard to the general prohibition on health care 
funding (section 3), the prohibition on the use of funds under the 
Developmental Disabilities Assistance Act (section 4), and the Patient 
Self Determination Act (section 7) to ensure that the activities and 
actions intended not to receive Federal funds in fact do not receive 
them. The broad language is necessary because proponents often describe 
these activities in different terms; it is used without concern of 
unintended consequences because the programs covered in these instances 
are clearly and narrowly defined.
  The narrow language is used in the bill's findings and purposes 
provisions (section 2, which does not have the force of law), 
restrictions on advocacy programs (section 5), and restrictions on 
funding for mercy killing, euthanasia, and assisted suicide in national 
defense and criminal justice programs (section 6) because broad 
language, if applied to these programs, could have unintended 
consequences. For example, if the broad language were used with respect 
to criminal justice enforcement, it may have the effect of prohibiting 
capital punishment. But this bill is only about funding for assisted 
suicide--mainly in Federal health care programs, because proponents of 
assisted suicide are successfully legitimizing assisted suicide--for 
some--as a form of health or medical care.
  Assisted suicide is not health care. Or medical care. The Federal 
Government, supported by all American by all American tax payers, 
should not pay for this. This carefully crafted bill will ensure that 
that does not happen. It deserves our support.
  Some questions have arisen as to whether H.R. 1003 applies to the 
provision or withholding or withdrawing of medical treatment, medical 
care, nutrition, or hydration. My reading of the bill indicates that 
the bill does not address such situations.
  H.R. 1003 is a deliberately narrow piece of legislation. It deals 
with the issue of Federal subsidies for direct killing, as by a lethal 
injection or a lethal drug. It is not designed to address

[[Page S3261]]

or affect in any way, positively or negatively, Federal funding for the 
withholding or withdrawal of medical treatment and medical care, 
nutrition or hydration. Nor is it designed to address affect in any 
way, positively or negatively, such withholding or withdrawal in 
veterans' hospitals, military hospitals, or other Federal facilities.
  Therefore, Mr. President, no one should read into the adoption of 
this legislation any expression of blanket congressional approval for 
the practice of withholding or withdrawing of nutrition and hydration 
or, for that matter, of any lifesaving medical treatment. This Senator, 
for one, is convinced that causing a patient to die of starvation or 
dehydration is absolutely wrong. I, for one, would not have supported 
this bill as an original cosponsor if I believed that it authorized the 
use of Federal funds to withhold or withdraw nutrition and hydration 
from a patient.
  Indeed, I am convinced that every Member of this body, and I dare say 
of the other body as well, can think of at least some circumstances in 
which he or she would agree that denial of medical treatment, or of 
food and fluids, is wrong and should not be subsidized with Federal tax 
dollars. Plainly, then in voting for this legislation we do not intend 
some broad sanction for denial of nutrition, hydration, medical 
treatment and care.
  All we do in section 3(b) of H.R. 1003 is make clear the narrow scope 
of this bill: that it deals with direct killing only, and not with 
these other practices. Thus, section 3(b) should be read simply as a 
scope limitation for this legislation, and not as expressing a 
substantive policy position on withholding or withdrawing medical 
treatment, medical care, nutrition or hydration. That is a matter for 
another day.
  In conclusion, Mr. President, I want to express my firm belief that 
ours is a Nation that should direct itself to expanding the scope of 
the human community; to ensuring that all its members enjoy full access 
to the protection of life, liberty, and happiness. Our culture is one 
that increasingly commits itself to death, to killing those that some 
do not consider to be part of the human family. For years some in this 
country have treated the preborn child as unworthy of that protection. 
Recently, the President has vetoed a ban on partial-birth abortions--
has allowed the killing of a child just three inches and 3 seconds from 
full protection of the law. Now our culture is moving toward promoting 
the killing of the elderly, the handicapped, those who suffer 
desperately--instead of offering them support, resources, and hope.
  I commend the Senator from Missouri for his excellent work on this 
bill and his steadfast efforts to prevent taxpayers from being forced 
to support a culture of death. His work reclaims some of our hope that 
America can again be a beacon of light in a culture of life.
  Mr. ROCKEFELLER. Mr. President, I thought it would be helpful to 
share some thoughts about other important issues that I hope the 
Congress will address once action is taken on the bill before us to 
prohibit Federal funding for physician-assisted suicide.
  Because of my involvement in health care issues and the Medicare 
Program specifically, I have spent some time in recent months taking 
another look at the concerns and dilemmas that face patients, their 
family members, and their physicians when confronted with death or the 
possibility of dying. In almost all such difficult situations, these 
people are not thinking about physician-assisted suicide. The needs and 
dilemmas that confront them have much more to do with the kind of care 
and information that are needed, sometimes desperately.
  I am learning more and more about the importance of educating health 
care providers and the public that chronic, debilitating, terminal 
disease need not be associated with pain, major discomfort, and loss of 
control. We need to focus on the tremendous amount that can be done to 
control a wide range of symptoms associated with terminal illness, to 
assure that the highest level of comfort care is provided to those who 
are dying or have chronic, debilitating disease.
  The tremendous advances in medicine and medical technology over the 
past 30-50 years have resulted in a greatly expanded life expectancy 
for Americans, as well as vastly improved functioning and quality of 
life for the elderly and those with chronic disease. Many of these 
advances have been made possible by federally financed health care 
programs, especially the Medicare Program that assured access to high 
quality health care for all elderly Americans, as well as funding much 
of the development of technology and a highly skilled physician work 
force through support of medical education and academic medical 
centers. These advances have also created major dilemmas in addressing 
terminal or potentially terminal disease, as well as a sense of loss of 
control by many with terminal illness.
  I believe it's time for Medicare and other federally funded health 
care programs to assure that all elderly, chronically ill, and disabled 
individuals have access to compassionate, supportive, and pain-free 
care during prolonged illness and at the end of life. As we discuss 
restructuring Medicare during the present session of Congress, this 
will be one of my primary goals.
  Much of the knowledge necessary to assure individuals appropriate 
end-of-life care already exists. Much needs to be done, however, to 
assure that all health care providers have the appropriate training to 
use what is known already about such supportive care. The public must 
also be educated and empowered to discuss these issues with family 
members as well as their own physicians so that each individual's 
wishes can be respected. More research is needed to develop appropriate 
measures of quality end-of-life care and incorporate these measures 
into medical practice in all health care settings. And finally, 
appropriate financial incentives must be present within Medicare, 
especially, to allow the elderly and disabled their choice of 
appropriate care at the end of life.
  I will soon be introducing legislation that addresses the need to 
develop appropriate quality measures for end-of-life care, to develop 
models of compassionate care within the Medicare Program and to 
encourage individuals to have open communication with family members 
and health care providers concerning preferences for end-of-life care. 
These are the issues that truly need to be addressed by Congress and 
encouraged through Federal financing programs for health care, and I am 
very committed to promoting the action that Americans and their 
physicians are looking to us to help them with. By addressing end-of-
life issues in this manner, there may be a day when the divisive debate 
over physician-assisted suicide will become unnecessary.
  Mr. FRIST. Mr. President, I rise today to address the legislation 
before us which would further codify and clarify existing Federal law, 
practice, and policy on the prohibition of the use of Federal funds, 
whether directly or indirectly, for physician-assisted suicide. This 
proposal has received broad bipartisan support within the Congress, 
within the administration, and in the medical community.
  This is an issue that supersedes the politics of the present, and 
cuts to the heart of our concept of respect for life. As a physician, I 
took an oath, like physicians for centuries before me, to ``first do no 
harm.'' While there are times when the best in medical technology and 
expertise cannot save or prolong life, we should never turn those tools 
into instruments to take life, and we must preserve the sacred trust 
between physician and patient.
  I am pleased that this bill is tightly focused and disciplined in its 
approach to this controversial issue. However, I am concerned that the 
most important issue may be obscured by this debate. Physicians have a 
responsibility to ensure that patients are both comfortable and 
comforted during their last precious days on Earth. As legislators 
responsible for policy decisions impacting the federally funded health 
care programs, we also have a responsibility. We must continue to look 
for ways to support efforts to provide palliative care, as well as to 
support efforts to educate physicians, patients, and families about 
end-of-life issues.
  We have made enormous progress in treating and managing illness at 
the end of life. Over the last 50 years, life expectancy has risen 
dramatically as we have learned to manage the complications of 
illnesses which were previously considered terminal. The issue of 
physician-assisted suicide is an indication of our need to focus on 
other

[[Page S3262]]

ways of relieving suffering, while maintaining the dignity of the 
terminally ill and their families.
  While I do not believe that it is the role of the Government to 
intrude upon the relationship between a physician and patient, I do 
believe that policymakers have an obligation to create an environment 
which supports the quality of care in this country. Therefore, our 
votes in support of this bill must also be seen as our decision to take 
up a new challenge--that of finding new ways to facilitate the 
compassionate care of the dying.
  Mr. HELMS. Mr. President, when the able Senators Ashcroft and Dorgan 
invited me to cosponsor S. 304, a bill to prohibit the use of Federal 
funds for assisted suicide, I unhesitatingly accepted. Now today, I do 
hope the Senate will promptly approve H.R. 1003, now pending which is 
nearly identical to S. 304 and which was passed overwhelmingly by the 
House this past Thursday.
  The Supreme Court's tragic Roe versus Wade decision in 1973 
established that human beings--unborn children--at one end of the age 
spectrum are expendable for reasons of convenience and social policy; 
euthanasia is now the next step. Many, including this Senator who in 
1973 had just been sworn in, argued that if we can justify in our own 
minds the destruction of the lives of those whose productive years are 
yet to come, what is to prevent our destroying or agreeing to end the 
lives of men and women who can no longer pull their own weight in 
society?
  That day may arrive as early as this summer. The Supreme Court is 
currently reviewing two circuit courts of appeals decisions which, if 
upheld, will affirm the constitutional right of individuals to 
terminate their own lives with the assistance of Dr. Kevorkian or other 
like-minded physicians. But inevitably, those who demand that this 
become an acceptable right are also expecting the taxpayers to furnish 
the money for it.
  At a minimum, Mr. President, surely the Senate will reject the notion 
that tax funded programs, such as Medicaid and Medicare, should be used 
to terminate the lives of human beings. Despite anybody's looking with 
favor on euthanasia, it is absurd to suggest that the American people 
must sponsor it with their already-high taxes.
  The American people emphatically reject this idea. A poll conducted 
last year by Wirthlin Worldwide revealed that 87 percent of people 
oppose Federal funding of assisted suicide.
  So, Mr. President, the bill under consideration will not outlaw 
euthanasia. But it will forbid the use of Federal tax dollars to fund 
assisted suicides. And more importantly, the Senate will heed the 
American people's belief that paying for such a morally objectionable 
procedure is just going too far.
  Mr. DOMENICI. Mr. President, I rise today in support of the Physician 
Assisted Suicide Funding Restriction Act of 1997. This bill would 
maintain current Federal policy to prevent the use of Federal funds and 
facilities to provide and promote assisted suicide. It would not 
nullify any decision by a State to legalize assisted suicide, nor 
restrict State or privately financed assisted suicide; nor will it 
affect any living will statutes or any limitation relating to the 
withdrawal or withholding of medical treatment or care.
  The bill is urgently needed to protect Federal programs which have 
traditionally been designed to protect the health and welfare of our 
citizens. The ninth circuit recently reinstated an Oregon statute which 
provided for physician-assisted suicide through the State's Medicaid 
Program. This program is funded in part with Federal tax dollars. 
Unless we enact this statute, Federal dollars will be used to fund 
physician-assisted suicide. There is an immediate and pressing need for 
the Senate to act on this matter now. Our Nation has always been 
committed to the preservation of the lives of its citizens. The 
American people expect that tradition to continue.
  Last week, the House of Representatives acted in a decisive vote of 
398 to 16 to ban the use of Federal funds to support physician-assisted 
suicide and the President has indicated that he does not oppose this 
legislation. Mr. President, the American people do not want their tax 
dollars spent to assist individuals to commit suicide.
  This legislation simply prohibits the use of Federal funds for 
assisted suicide. It does not address the issue that is currently 
before the Supreme Court in Washington versus Glucksburg. The issue in 
that case is whether there is a liberty interest in committing suicide, 
and if so, whether that interest extends to obtaining the assistance of 
a doctor to do the same. Mr. President, nothing in this legislation 
will affect the decision that the Supreme Court will announce later 
this summer. What this bill does is maintain the longstanding Federal 
policy of preventing Federal funds from being used for this purpose. 
The American taxpayer shouldn't be forced to pay for the activities of 
Dr. Kevorkian and other physicians who may be engaged in assisting 
suicide.
  Mr. President, we are not acting prematurely by passing this 
legislation. The State of Oregon already has decided that physician-
assisted suicide is legal and that State Medicaid funds may be used for 
that purpose. The long-standing policy against the use of Federal tax 
dollars is now in jeopardy, and congressional action is now needed. Tax 
dollars ought to be used to extend life, not cause death.
  Finally, I am pleased to see that this legislation contains a 
provision to allow for research into ways we can reduce the rate of 
suicide among individuals with disabilities and chronic illnesses. 
Modern pain management techniques are improving rapidly, and it is my 
hope that this research will reduce the demand for assisted suicide, 
whether legal or illegal, in the future. We need to continue pain 
research, and make resources available to ensure that health care 
professionals are capable of administering these new treatments as they 
develop. This is a forward-looking approach and we should encourage 
this sort of research--it will improve the quality of life for those 
with debilitating diseases.
  Mr. President, I think I speak for the vast majority of the American 
people when I say that their Federal tax dollars should not be used to 
fund physician-assisted suicide. I am very pleased to support this 
bill. I commend Senator Ashcroft for bringing this issue to the 
attention of the Senate. I hope my colleagues will support the bill, 
and I yield the floor.
  Mr. BIDEN. Mr. President, I wish we were not here debating this 
legislation today--not because I don't think it is right; I do, and I 
am a cosponsor of the bill; but because I wish there was no need to 
take up a bill like this in the first place.
  Unfortunately, our hands have been forced, largely by the courts.
  In March of last year, the Ninth Circuit Court of Appeals ruled that 
a Washington State law prohibiting physician-assisted suicide was 
unconstitutional under the constitutional right of privacy.
  Then, a month later, the Second Circuit Court of Appeals struck down 
a similar New York State law, arguing that the equal protection clause 
of the Constitution gives the terminally ill the same rights to hasten 
their own death through drugs as other patients have to refuse 
artificial life support.
  Although implementation has been delayed by the courts, in 1994, 
Oregon voters approved a referendum making physician-assisted suicide 
legal in that State.
  The Supreme Court has heard oral arguments on the matter--and it is 
expected to rule before the end of this term.
  Now, if physician-assisted suicide does become legal--through the 
courts or through State referendums or by some other means--there will 
be no doubt an attempt made to have the Federal Government pay for 
this.
  I can hear the arguments already. People will demand that Medicare or 
Medicaid reimburse physicians who help people commit suicide. Mr. 
President, this is not such a farfetched notion.
  After the voters approved the Oregon referendum in 1994, Oregon 
officials actually admitted they would seek Medicaid reimbursement if 
the law were to go into effect.
  Now, truth in advertising here, Mr. President. I am opposed to 
physician-assisted suicide becoming legal in this country, period. So I 
don't want to hide under some false cloak here. I am one of those who 
does not support abortion, but I acknowledge that my personal religious 
view should not be imposed upon the rest of the world because, for

[[Page S3263]]

me, it is hard to determine and insist that my view on when there is a 
human life in being is more accurate than someone who is equally as 
religious as me, but might have a different view. But a suicide is a 
different story. There is no question that there is a human life in 
being. Physician-assisted suicide is the most dangerous slippery slope, 
in my view, that a nation can embark upon.
  So I make it clear that this has nothing to do with whether 
physician-assisted suicide should be allowed. I don't think it should 
be. But that is beside the point today. What is at issue is--if it 
becomes legal in one State, several States, or all States--is the 
Federal Government going to have to pay for it?
  To that, I hope we will emphatically say ``no,'' regardless of what 
each of us thinks about the legality or constitutionality of physician-
assisted suicide.
  No matter where you are on the issue, under no circumstances should 
the Federal Government be paying physicians to help people kill 
themselves.
  Let me say what else this debate today is not about. It is not about 
refusing to accept medical treatment. The Supreme Court has already 
ruled that individuals have a right to refuse unwanted medical 
treatment. I am not sure how a physician or a hospital would bill 
Medicare or Medicaid for not providing a treatment that the patient did 
not want. But, regardless of that, this bill explicitly states that the 
funding prohibition does not apply in such circumstances and does not 
apply to drugs given to alleviate pain.
  What we are talking about is when physicians specifically give a 
patient a drug to kill them--when there is a proactive attempt to kill 
a patient. That is what we are talking about--no Federal dollars 
allowed.
  I commend Senator Ashcroft and Senator Dorgan for their work on this 
bill. This has been a bipartisan effort from the start--going back to 
when this bill was first put together last summer.
  Mr. President, it is important that we swiftly and definitively 
resolve this issue.
  Mr. President, I yield the floor.
  Mr. SMITH of New Hampshire. Mr. President, I rise in support of H.R. 
1003, the Assisted Suicide Funding Restriction Act of 1997.
  I am pleased to be a cosponsor of S. 304, the Senate companion bill 
to H.R. 1003. As a cosponsor, I was especially gratified to learn of 
the overwhelming bipartisan vote of 398 to 16 by which H.R. 1003 passed 
the House of Representatives on April 10, 1997.
  With its resounding votes to pass both the Assisted Suicide Funding 
Restriction Act and H.R. 1122, the Partial-Birth Abortion Ban Act of 
1997, the House of Representatives has taken two major actions aimed at 
restoring respect for the sanctity of human life in our great Nation. I 
trust that in the weeks ahead, the Senate will join the House by 
passing both of these bills by large majorities and sending them to the 
President.
  Mr. President, before he passed away last November, Joseph Cardinal 
Bernadin left a moving testimony to the sanctity of life. ``I am at the 
end of my earthly life,'' Chicago's Cardinal wrote in a letter 
addressed to the U.S. Supreme Court. ``Our legal and ethical tradition 
has held consistently that suicide, assisted-suicide, and euthanasia 
are wrong because they involve a direct attack on innocent human 
life,'' Cardinal Bernadin continued. ``Creating a new `right' to 
assisted suicide,'' the Cardinal concluded, ``will . . . send a false 
signal that a less than perfect life is not worth living.''
  Mr. President, by enacting H.R. 1003, the Congress will be moving to 
defend the sanctity of human life by preventing the use of Federal 
funds and facilities to provide and promote assisted suicide. This is 
indeed a worthy goal and I am honored to be a part of this effort.
  Mr. KENNEDY. Mr. President, I support the ban on the use of Federal 
funds for assisted suicide, and I commend Senator Dorgan and Senator 
Ashcroft for their leadership on this issue.
  The disabled, the elderly, low-income and other Americans in need are 
often totally reliant on federally financed health care. Allowing 
Federal funds to be used for assisted suicide, euthanasia, or mercy 
killing could lead to situations in which terminally ill or seriously 
ill individuals are coerced into choosing assisted suicide over 
traditional medical treatments or pain management therapies. In 
addition, many seriously ill people who suffer transient depression 
could choose suicide, when, if their depression were treated, they 
would not make this irrevocable choice.
  I also support the intent of the legislation to exclude certain 
medical treatments and procedures from the provisions of the ban. 
Evidence of this intent is found in both the language of the Senate 
bill and the language contained in the House report concerning section 
3(b). This subsection clarifies the exact nature of the medical 
procedures and services which are not intended to be covered by the 
prohibition on the use of Federal funds. It is important to emphasize 
that the ban does not cover individuals who do not want their lives 
prolonged by heroic medical treatments or the other specific treatments 
identified in the language of the House report on this subsection.
  Mr. ASHCROFT. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. WELLSTONE. Madam President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER (Ms. Collins). Without objection, it is so 
ordered.
  Mr. WELLSTONE. Madam President, I am going to in a short period of 
time offer two amendments which I hope will be really noncontroversial. 
I just would like to talk about both of them in general terms and then 
I will come back in time to offer these amendments.
  One of these amendments has to do with what I think is, 
unfortunately, very germane and it has to do with our failure still to 
provide the kind of mental health services, the kind of mental health 
coverage that is so direly needed. I know my colleagues have said one 
of the things that concerns them and concerns others is that all too 
often some of the people who take their lives are people in a severe 
state of depression, people who have not been treated. And then, of 
course, you really wonder whether or not this ever should have happened 
and this is the last thing you would like to see assisted.
  So I really feel that if, in fact, we are saying we do not want to 
see this kind of assisted, physician-assisted suicide, or people taking 
their lives, that is to say, then I think we really want to make sure 
we do not get to the point where some people, some who really want to 
take their lives are taking their lives not even necessarily because 
they are in terrible pain with a terrible illness but having more to do 
with a terrible mental illness. This is an amendment we will come to in 
a little while.
  The first amendment that I will offer shortly is an amendment which 
says it is the sense of the Senate that the Senate supports firm but 
fair work requirements for low-income unemployed individuals. I do not 
think my colleagues would disagree with that. And low-income workers 
who are jobless but are unable to find a job should look for work, they 
should participate in workfare or job training programs but they should 
not be denied food stamps without these opportunities.
  Again, I am just waiting for response from a couple other Senators 
before I introduce these amendments, but just in very broad outline the 
why of this amendment.
  I am going to draw from a study which comes out from the Department 
of Agriculture February 13, 1997, which really points to the 
characteristics of childless unemployed adult food stamp and legal 
immigrant food stamp participants.
  Madam President, this is not a pretty picture. We are talking about 
the poorest of poor people. If we are going to have vehicles out in the 
Chamber and there is going to be an opportunity--and these are just 
sense-of-the-Senate amendments--to really try and get the Senate on 
record to correct some problems that have to be corrected, then I want 
to take full advantage of it. In this particular case, we are talking 
about people who are very poor, many

[[Page S3264]]

of them women, many of them minorities.
  What we are saying is, yes, work, but if there is not a workfare 
program available and someone cannot find a job, then do not cut people 
off food stamp assistance, do not say that in a 3-year period you can 
only get 3 months' worth of food stamp assistance.
  Why in the world would we want to create the very situation we are 
now creating which is you are basically taking the most vulnerable 
citizens, the poorest of poor people and you are putting them in a 
situation where they want to work, they cannot find a job, there is not 
a workfare program available, there is not a job training program 
available, they are suffering, struggling with HIV infection or dying 
from AIDS, they are struggling with mental illness, they did not even 
have a high school education, there are no opportunities for the 
training, and we are now saying that we are going to cut you off food 
stamp assistance. This was the harshest provision of the welfare bill 
that we passed.

  And so, Madam President, I come to the floor, and I will in a moment 
suggest the absence of a quorum just for a moment and then we will move 
forward with both of these amendments. But I come to the floor to 
introduce both of these amendments. These are sense-of-the-Senate 
amendments. I hope they will command widespread support. I say to my 
colleagues I am really hopeful for a very strong vote. I know they are 
anxious to have the bill come through. I do not think these 
amendments--I made them sense-of-the-Senate amendments. I think the 
language is very reasonable, and I do not mean to hold up the 
legislation at all, but on the other hand I do mean to get some 
attention focused on some areas that we really need to address.
  Madam President, just for a moment, I would suggest the absence of a 
quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. ASHCROFT. I would ask unanimous consent that the order for the 
quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ASHCROFT. The Senator from Minnesota suggests that these are 
merely sense-of-the-Senate amendments and that they would not impair 
the progress of the bill substantially. If by adding these amendments 
to the bill we send the bill to conference, we delay substantially our 
ability to move this legislation to the President of the United States 
for his signature.
  Throughout our comments and remarks, I think it has been clear we are 
simply at present awaiting judicial decisions which might authorize on 
a momentary basis Federal funding of assisted suicide, so that it is 
crucial we not delay this process. And sending this measure to 
conference would in fact delay the process.
  Second, I should indicate that this is not a measure which is 
designed to prohibit assisted suicide. Some suggestions seem to have 
been made that this is a measure which would attempt to control whether 
or not States could authorize assisted suicide or whether they could 
fund it on their own or whether we would be intervening by this 
legislation in the capacity of States to determine what is appropriate 
or inappropriate for their citizens. Nothing could be further from the 
truth.
  This is not a measure that relates to the commission of suicide. It 
relates to Federal funding of assisted suicide. This bill--and many 
people think it unfortunate it would not--does not prevent Kevorkian 
from acting. That would be controlled by local jurisdictions and what 
the law in those jurisdictions is. So that the alleged relevance of 
some of the proposed amendments simply is not consistent with the 
content of the measure.
  I think it is important for us to understand we ought to act quickly. 
We are fortunate that the courts have not already authorized Federal 
payments for assisted suicide. But for the injunction of a court in 
Oregon, that would have been the case, according to the director of 
Medicaid and the Health Services Commission chair in Oregon. And now 
the Ninth Circuit Court of Appeals has overturned that lower court's 
decision and the matter is still suspended in the limbo of the legal 
proceedings. But as soon as the ninth circuit's opinion would become 
final, the Oregon officials have indicated they intend to call for 
Federal resources to participate in the funding of what they call 
``comfort care.'' I would be uncomfortable myself to receive the 
``comfort care'' offered there.
  But it is, in my judgment, a matter of importance that we act 
promptly, that we act with dispatch. The attempt to bring unrelated 
issues to this measure is counterproductive, particularly inasmuch as 
it is likely to send this legislation to conference and to delay 
substantially the ability to move the will of the American people into 
the law of the American people, and that will is that we not fund with 
Federal resources assisted suicide.
  Madam President, I observe the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. WELLSTONE. Madam President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  Mr. ASHCROFT. I object.
  The PRESIDING OFFICER. Objection is heard.
  The bill clerk continued with the call of the roll.
  Mr. WELLSTONE. Madam President, I ask unanimous consent that the 
order for the quorum call be rescinded.
  The PRESIDING OFFICER. Is there objection? Without objection, it is 
so ordered.
  Mr. WELLSTONE. I ask unanimous consent that Margaret Heldring have 
the privilege of the floor during the debate on this bill.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WELLSTONE. I thank the Chair. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. ASHCROFT. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ASHCROFT. Madam President, I ask unanimous consent that no 
amendments or motions be in order to the pending legislation, and that 
there be 10 minutes for debate to be equally divided in the usual form, 
to be followed by third reading and final passage of H.R. 1003.
  The PRESIDING OFFICER. Is there objection? Without objection, it is 
so ordered.
  Mr. ASHCROFT. I now ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The yeas and nays were ordered.
  Mr. ASHCROFT. For the information of all Senators, a vote will occur 
within the next 10 minutes on passage of the assisted suicide bill. I 
thank my colleagues for their cooperation.
  Mr. DORGAN addressed the Chair.
  The PRESIDING OFFICER. The Senator from North Dakota.
  Mr. DORGAN. Madam President, I ask unanimous consent to have printed 
in the Record a statement of administration policy on H.R. 1003, 
including a letter to Senator Trent Lott by the Assistant Attorney 
General, Andrew Fois.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

         Executive Office of the President, Office of Management 
           and Budget,
                                   Washington, DC, April 16, 1997.

                   Statement of Administration Policy

      H.R. 1003--Assisted Suicide Funding Restriction Act of 1997

       The President has made it clear that he does not support 
     assisted suicides. The Administration, therefore, does not 
     oppose enactment of H.R. 1003, insofar as it would reaffirm 
     current Federal policy prohibiting the use of Federal funds 
     to pay for assisted suicides and euthanasia.
       However, the Department of Justice advises (in the attached 
     letter) that section 5 of the bill, which would prohibit the 
     use of any federal funds to support an activity that has a 
     purpose of ``asserting or advocating a legal right to cause, 
     or to assist in . . . the suicide . . . of any individual,'' 
     exceeds the intent of the legislation and raises concerns 
     regarding freedom of speech. Therefore, the Administration 
     urges the Senate to address

[[Page S3265]]

     this concern as the legislation moves forward, in order to 
     avoid potential constitutional challenges and implementation 
     problems.
                                                                    ____

                                       U.S. Department of Justice,


                                Office of Legislative Affairs,

                                   Washington, DC, April 16, 1997.
     Hon. Trent Lott,
     Majority Leader, U.S. Senate,
     Washington, DC.
       Dear Mr. Leader: This presents the views of the Department 
     of Justice on H.R. 1003, the ``Assisted Suicide Funding 
     Restriction Act of 1997.'' As you know, the President has 
     made it clear that he does not support assisted suicides. The 
     Administration therefore does not oppose enactment of H.R. 
     1003. We do, however, have a concern that we would like to 
     bring to your attention.
       Section 5 of H.R. 1003 provides that ``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 . . . 
     asserting or advocating a legal right to cause, or to assist 
     in causing, the suicide, euthanasia, or mercy killing or any 
     individual.'' This restriction, by its plain terms, would 
     apply without limitation to all federal funding. As a result, 
     we believe that the proposed bill would constitute a 
     constitutionally suspect extension of the type of speech 
     restriction upheld in Rust v. Sullivan, 500 U.S. 173 (1991).
       In Rust, the Supreme Court upheld a program-specific 
     funding restriction on the use of federal family planning 
     counseling funds to provide abortion-related advice. It 
     explained that the restriction constituted a permissible 
     means of furthering the government's legitimate interests in 
     ensuring program integrity and facilitating the government's 
     own speech. See id. at 187-194. The Court stressed, however, 
     that its holding was not intended ``to suggest that funding 
     by the Government, even when coupled with the freedom of the 
     fund recipients to speak outside the scope of a Government-
     funded project, is invariably sufficient to justify 
     Government control over the content of expression.'' Id. at 
     199. For example, the Court emphasized that the First 
     Amendment analysis might differ for restrictions on federally 
     funded services that were ``more all encompassing'' than the 
     limited pre-natal counselling program at issued in Rust. 
     Id. at 200. In addition, the Court explained that the 
     government's authority to place speech restrictions on the 
     use of governmental funds in ``a traditional sphere of 
     free expression,'' such as a forum created with 
     governmental funds or a government-funded university, was 
     far more limited. Id. at 200.
       The Court affirmed the limited nature of Rust in 
     Rosenberger v. Rectors and Visitors of the University of 
     Virginia, 115 S.Ct. 2510 (1995). There, the Court explained 
     that Rust applies where the government itself acts as the 
     speaker. ``When the government disburses public funds to 
     private entities to convey a governmental message,'' the 
     Court explained, ``it may take legitimate and appropriate 
     steps to ensure that its message it neither garbled nor 
     distorted by the grantee.'' Id. at 2519. The government may 
     not, however, impose viewpoint-based restrictions when it 
     ``does not itself speak or subsidize transmittal of a message 
     it favors, but instead expends funds to encourage a diversity 
     of views from private speakers.'' Id.
       Here, the bill places a speech restriction on all uses of 
     federal funds. It would move beyond speech restrictions on 
     the use of federal funds in specific, limited programs, such 
     as the one identified in Rust, to establish a viewpoint-based 
     restriction on the use of federal funds generally. As a 
     result, the bill's restriction on speech could apply to an 
     unknown number of programs that are designed to ``encourage a 
     diversity of views from private speaker, ``Rosenberger, 115 
     S.Ct. at 2519, and to which the Court has held application of 
     a viewpoint-based funding limitation unconstitutional. The 
     bill could also apply to a number of services that are ``more 
     all encompassing'' than the counselling program at issue in 
     Rust, see 500 U.S. at 200, and to which application of a 
     viewpoint-based funding restriction would be subject to 
     substantial constitutional challenge.
       Moreover, the general approach that the bill employs is 
     itself constitutionally suspect. Unlike the regulation at 
     issue in Rust, H.R. 1003 does not attempt to identify a 
     particular program, or group of programs, in which a funding 
     restriction would serve the government's legitimate interests 
     in ensuring program integrity or facilitating the effective 
     communication of a governmental message. It would instead 
     impose a broad and undifferentiated viewpoint-based 
     restriction on all uses of federal funds. As a result of the 
     unusually broad and indiscriminate nature of the proposed 
     funding restriction, the bill does not appear to be designed 
     to serve the legitimate governmental interests identified in 
     Rust. Thus, the bill is vulnerable to arguments that it 
     reflects on ``ideologically driven attempt [] to suppress a 
     particular point of view [which would be] presumptively 
     unconstitutional in funding, as in other contexts.'' 
     ``Rosenberger, 115 S.Ct. at 2517 (internal quotations 
     omitted). We therefore recommend that this provision be 
     deleted from the bill.
       Thank you for your consideration of this matter. Please do 
     not hesitate to call upon us if we may be of additional 
     assistance in connection with this or any other matter. The 
     Office of Management and Budget has advised that there is no 
     objection from the standpoint of the Administration's program 
     to the presentation of this report.
           Sincerely,
                                                      Andrew Fois,
                                       Assistant Attorney General.

  Mr. DORGAN. Madam President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. ASHCROFT. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  All time has expired. If there be no amendment to be offered, the 
question is on the third reading of the bill.
  The bill (H.R. 1003) was ordered to a third reading and was read the 
third time.
  The PRESIDING OFFICER. The bill having been read the third time, the 
question is, Shall the bill pass? The yeas and nays have been ordered. 
The clerk will call the roll.
  The assistant legislative clerk called the roll.
  Mr. NICKLES. I announce that the Senator from North Carolina [Mr. 
Faircloth] is necessarily absent.
  The PRESIDING OFFICER (Mr. Smith of Oregon). Are there any other 
Senators in the Chamber desiring to vote?
  The result was announced--yeas 99, nays 0, as follows:

                      [Rollcall Vote No. 44 Leg.]

                                YEAS--99

     Abraham
     Akaka
     Allard
     Ashcroft
     Baucus
     Bennett
     Biden
     Bingaman
     Bond
     Boxer
     Breaux
     Brownback
     Bryan
     Bumpers
     Burns
     Byrd
     Campbell
     Chafee
     Cleland
     Coats
     Cochran
     Collins
     Conrad
     Coverdell
     Craig
     D'Amato
     Daschle
     DeWine
     Dodd
     Domenici
     Dorgan
     Durbin
     Enzi
     Feingold
     Feinstein
     Ford
     Frist
     Glenn
     Gorton
     Graham
     Gramm
     Grams
     Grassley
     Gregg
     Hagel
     Harkin
     Hatch
     Helms
     Hollings
     Hutchinson
     Hutchison
     Inhofe
     Inouye
     Jeffords
     Johnson
     Kempthorne
     Kennedy
     Kerrey
     Kerry
     Kohl
     Kyl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lott
     Lugar
     Mack
     McCain
     McConnell
     Mikulski
     Moseley-Braun
     Moynihan
     Murkowski
     Murray
     Nickles
     Reed
     Reid
     Robb
     Roberts
     Rockefeller
     Roth
     Santorum
     Sarbanes
     Sessions
     Shelby
     Smith, Bob
     Smith, Gordon H.
     Snowe
     Specter
     Stevens
     Thomas
     Thompson
     Thurmond
     Torricelli
     Warner
     Wellstone
     Wyden

                             NOT VOTING--1

       
     Faircloth
       
  The bill (H.R. 1003) was passed.
  Mr. ASHCROFT. Mr. President, I move to reconsider the vote, and I 
move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  Mr. ASHCROFT. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. DOMENICI. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DOMENICI. Mr. President, parliamentary inquiry: Can I use time as 
if in morning business to introduce a bill?
  The PRESIDING OFFICER. The Senator needs consent to do that at this 
time.
  Mr. DOMENICI. That is not infringing on anything planned?
  The PRESIDING OFFICER. We have no orders at this time.
  Mr. DOMENICI. Mr. President, I ask unanimous consent that I be 
permitted to speak for up to 10 minutes on court-appointed attorney's 
fees and the taxpayers' right to know how much they are paying.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from New Mexico is recognized.
  Mr. DOMENICI. I thank the Chair.
  (The remarks of Mr. Domenici pertaining to the introduction of S. 598 
are located in today's Record under ``Statements on Introduced Bills 
and Joint Resolutions.'')
  Mr. DOMENICI. Mr. President, I suggest the absence of a quorum.

[[Page S3266]]

  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. FRIST. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Enzi). Without objection, it is so 
ordered.

                          ____________________