[Congressional Record Volume 144, Number 146 (Wednesday, October 14, 1998)]
[Senate]
[Pages S12491-S12492]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     OREGON'S ASSISTED SUICIDE LAW

  Mr. WYDEN. Mr. President and colleagues, I take the floor this 
afternoon because it is my understanding that democracy in Oregon has 
won at least a temporary victory. I have been informed that there will 
be nothing attached to the comprehensive spending bill that would 
override Oregon's assisted suicide law.
  While I intend to be very vigilant to monitor any further discussions 
that take place on this matter, I come today to talk about why this 
issue is so important not just to my constituents but to all Americans. 
And I also thank the participants in the budget negotiations for their 
willingness to leave out this matter that is so complicated and 
controversial.
  I had informed the leadership of both political parties that I was 
prepared to speak at considerable length if there had been an effort as 
part of the final budget bill to toss Oregon's ballot measure on 
assisted suicide into the trash can. I was prepared to do this in spite 
of the fact that I have personal reservations about assisted suicide. I 
was prepared to do this because I believe that nothing is more 
important than the people's right to govern themselves.
  When the people of our States have made difficult decisions, 
difficult moral decisions about matters that have historically been 
within the purview of the State governments, it is out and out wrong 
for the Congress to butt in and override those decisions of voters in 
the States.
  The voters of my State have spoken clearly. In two separate 
referendums, the verdict was clear: Physician-assisted suicide should, 
under limited circumstances, be legal in the State of Oregon. If the 
Congress of the United States, meeting 3,000 miles away, had tossed 
those decisions aside, in a last-minute backroom deal, it would have 
been a great insult to the people of Oregon and in my view would have 
contributed mightily to skepticism and cynicism about Government.
  It would have been a mistake because there were many questions raised 
about the measure drafted by the Senator from Oklahoma who, it seems to 
me, is very sincere about his interest in this subject. In addition to 
overriding the popular will of the people of my State, his measure 
would have also set back considerably the cause of better pain 
management for patients in end-of-life care.
  That would have had serious consequences for the treatment of 
patients in severe pain across this country. His measure would have 
great implications not just for the people of Oregon, but for the 
people of all our States. More than 55 groups representing the medical 
community, many of whom oppose physician-assisted suicide, joined 
together in an unprecedented coalition to oppose the legislation of the 
Senator from Oklahoma because of their fear that doctors and other 
medical providers would be hampered. They feared that the cause of 
providing pain care to their patients would be set back by the way the 
legislation by the Senator from Oklahoma was written. I thank all of 
these groups for their commitment to humane care and for their hard 
work on this issue.
  The key groups that led the coalition were: The Americans for Better 
Care of the Dying, the American Geriatrics Society, the American 
Pharmaceutical Association, the National Hospice Organization, the 
American College of Physicians-American Society of Internal Medicine, 
and the American Medical Association.
  One of the reasons that so many of these groups worked so hard with 
respect to keeping out of the spending bill legislation that would 
overturn Oregon's law was their sincere belief that the legislation by 
Senator Nickles would have harmed the effort to promote good pain 
management.
  The Nickles legislation would have given the Drug Enforcement 
Administration new authority to look at every prescription of a 
controlled substance to determine for what it was intended. In 
addition, doctors and pharmacists under this legislation have had to be 
mind readers about what their patients were going to do with one of the 
drugs that was used under the Controlled Substances Act. Was the 
patient going to take a medication as prescribed for pain management, 
or would they have sought to use it to kill themselves?
  There is ample scientific evidence that pain management is not 
performed as well as it might be at this time. And to add further 
complexities and a broader role for an agency like the Drug Enforcement 
Administration to step into an area where it has never been before 
would have, in my view, added additional barriers and complexities to 
the effort to promote hospice care, palliative care, comfort care, and 
advance the science of pain management.
  Recently, the findings of a study in Oregon done in 1997 were 
published that show that families reported relatively constant levels 
of moderate to severe pain during their loved one's final week of life. 
During the final months in 1997, families reported higher rates of 
moderate to severe pain for those dying in acute care hospitals. There 
was one exception, which was when a loved one died in an acute care 
hospital in late 1997. An important study showed a statewide trend 
indicating that there were in so many cases moderate to severe pain for 
these individuals in the last week of life who would have required a 
physician and others to step in and advocate for those patients.
  I have received many letters and a great deal of e-mail from chronic 
pain patients. These stories are heartbreaking. They point out that it 
could be any one of us or any one of our loved ones or constituents who 
finds themselves in chronic, excruciating pain as a result of an 
accident or through the development of some painful, chronic disease.
  Unfortunately, pain patients in the current regulatory environment 
feel in many instances--and they have told me--as if they are treated 
like junkies, and that their providers are extremely nervous about how 
to use pain management in a climate where, had the Nickles legislation 
been adopted, certainly you would have had the Federal Government 
looking over the shoulders of doctors and pharmacists with respect to 
their motivation in prescribing drugs for those who are suffering these 
acute health and chronic ailments.
  We need to do a great deal more. We can do it on a bipartisan basis 
to advance the cause of pain management. I have had a number of 
discussions on this matter with Senator Mack, who has done, in my view, 
excellent work on a number of health issues. Senator Smith of my State 
is greatly interested in these matters. I believe we ought to work 
together so that early next year we can bring before the health 
committees--and I see our friend from the State of Texas, the chairman 
of the Subcommittee on Health Care, is here; he has a great interest in 
these issues --a bipartisan package to promote good pain management 
before the Senate next year. We do need to do more to help the dying 
and those who suffer from chronic pain.
  I believe that the mere threat of legislation would put the Drug 
Enforcement Administration into such an intrusive role that physicians, 
pharmacists, and other health providers would be reluctant to use these 
medications and future medications that promote pain management, 
comfort care, and hospice care. The mere threat of this legislation 
would be a real setback to the kind of health care services that the 
vast majority of Americans want to see expanded.
  Certainly Americans can have differences of opinion on the issue of 
assisted suicide. I voted against our ballot measure once. I voted for 
the repeal of it the second time. I voted against Federal funding of 
assisted suicide. My reservations with respect to this topic are clear. 
But I think it is wrong for the Federal Government to butt in and 
override the voters of my State, on a matter that has historically been 
left to the States. It is especially wrong to do it in a way that is 
going to allow the Federal Government, particularly through the Drug 
Enforcement Administration, to play such an intrusive role that 
doctors, pharmacists, and other health providers will feel 
uncomfortable and reluctant to assist their patients who are suffering 
chronic and extraordinary pain.
  We have heard reports in Oregon from hospices where doctors have been 
reluctant to prescribe needed amounts of pain medication because they 
were

[[Page S12492]]

frightened about the implications of being visited by a Government 
agency that would second-guess them.
  I am very pleased that the Nickles legislation will not be included 
in the comprehensive spending bill. I intend to remain vigilant 
throughout the remaining hours of the negotiations. I wanted to come to 
the floor this afternoon to talk about why this issue is so important 
not to just the people of my State, but to the people of this country.
  Finally, I am under no illusion that there will not be further 
discussions on the floor of the U.S. Senate about this topic. I know 
that the Senator from Oklahoma feels very strongly and sincerely about 
this issue. I know that there will be an effort to bring forward that 
proposal, and others like it, next year. I am aware that there are a 
number of Members of the U.S. Senate who would be willing to see 
Oregon's law set aside.
  I ask all of my colleagues to think just for a few moments over the 
next few months about their reaction if their State passed a law on a 
matter that the States have historically led on, and then a Member of 
the U.S. Senate sought to step in and lay that aside. That is, in 
effect, what some in the U.S. Senate are trying to tell the people of 
Oregon. I think that is a mistake. I think that Senators who would be 
willing to toss aside a vote of the people of Oregon ought to think 
about the implications of the precedent they will be setting that will 
have their voters and the popular will of their States set aside if 
this Senate, in the future, tosses aside the Oregon law.
  There is a better way. The better way is the approach that Senator 
Mack, Senator Smith and Members of the House, such as Congresswoman 
Darlene Hooley, and I are talking about. The better way is to say that 
there will be differences of opinion in our country about assisted 
suicide, but let us come together on that broad swath of policy that we 
all can agree on--which is to promote better hospice care, pain 
management, and comfort care in the use of advanced directives.
  Many of these services in many of our communities are utilized very 
rarely. So there is much we can do that will bring our citizens 
together, that will help us improve the conditions of our patients, 
reduce their suffering, without setting a dangerous precedent of 
overriding a law passed by the voters of my State that could redound to 
the detriment of other States and our citizens.
  Mr. President, I thank the negotiators who are dealing with the 
omnibus appropriations bill. I am pleased that it was not necessary for 
me to speak at length on the omnibus appropriations bill. Our voice 
will be heard when we are challenged in Oregon. We will be heard each 
time our rights are challenged.
  I will conclude my remarks. I see the Senator from Oklahoma here. He 
has been very gracious to this Senator in terms of discussing this 
matter and keeping me apprised of his intentions. We do have a 
difference of opinion on this issue and, at the same time, he has made 
it clear that he wants to work with this Senator, Senator Mack, and 
others, on a variety of issues that we can agree on relating to pain 
management. I know that we will be back on this Senate floor debating 
this topic in the future. But I want the Senator from Oklahoma to know 
that not only do I appreciate his courtesy in keeping me apprised of 
his intentions, but of my desire to work with him on a variety of 
issues relating to this topic where I think we can agree.
  Mr. President, I yield the floor.
  Mr. NICKLES addressed the Chair.
  The PRESIDING OFFICER. The Senator from Texas has the floor.
  Mr. GRAMM. Mr. President, I ask unanimous consent that the Senator 
from Oklahoma might speak, and that at the conclusion of his remarks, I 
be recognized.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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