[Congressional Record Volume 144, Number 146 (Wednesday, October 14, 1998)]
[Senate]
[Pages S12492-S12494]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         USING FEDERALLY CONTROLLED DRUGS FOR ASSISTED SUICIDE

  Mr. NICKLES. Mr. President, I thank my colleague from Texas. I want 
to make a couple of comments in regard to the legislation that my 
colleague and friend, Senator Wyden, alluded to dealing with assisted 
suicide.
  Mr. President, I introduced legislation to correct a mistake that 
Attorney General Reno made in June of this year when she overruled the 
Drug Enforcement Act and its interpretation that controlled substances 
could not be used for assisted suicide.
  Let me make sure that everybody understands the picture of this. The 
Controlled Substance Act is a Federal law. It is not a State law; it is 
a Federal law. It is a Federal law that controls very strong drugs--
drugs that are illegal, drugs that can kill, drugs that are very 
addictive. They are controlled by Federal law. They can't be used 
except for legitimate medical purposes. That is what is defined in the 
Federal law in the Controlled Substance Act. They can only be used for 
legitimate medical purposes.
  What constitutes a legitimate medical purpose? History has it that a 
legitimate medical purpose is, or can be, the alleviation of pain, to 
reduce pain, give comfort. It can be used for palliative care, but it 
is never--let me restate this--the Drug Enforcement Agency, which is in 
charge of enforcing this act, has never been used for assisted suicide. 
These drugs are strong drugs. If they are abused, used in heavy 
quantities, they kill people.
  Unfortunately, some people want to use these drugs for assisted 
suicide. The Drug Enforcement Administrator, Mr. Constantine, a year 
ago, in November, wrote a letter to Congress and said that assisted 
suicide is not a legitimate medical purpose.
  Mr. President, I ask unanimous consent that at the conclusion of my 
statement a letter from Mr. Constantine, Administrator of the Drug 
Enforcement Agency, be printed in the Record.
  The PRESIDING OFFICER (Mr. Burns). Without objection, it is so 
ordered.
  (See Exhibit 1.)
  Mr. NICKLES. Mr. President, the letter says they have reviewed it, 
and assisted suicide is never a legitimate medical purpose. These drugs 
can only be used for a legitimate medical purpose.
  The State of Oregon, by referendum, passed a law that says assisted 
suicide is OK. They had a couple of them. The State of Oregon can do 
what it wants, but that doesn't overturn Federal law. What if the State 
of Massachusetts said they were going to legalize heroin? That is a 
controlled substance. Does that make it legal? No. There is a reason 
why we have a Federal law dealing with these very strong drugs, and it 
is called the Controlled Substance Act. And just because one State has 
a referendum or petition or the legislature passes a bill, it doesn't 
overturn Federal drug law, period.
  For some unknown reason, the Attorney General--and I still don't know 
why--gave one of the most absurd rulings in June, where she said, well, 
we still believe we have control of the Federal Controlled Substance 
Act, so assisted suicide is illegal for some States, except for those 
which have legalized it. Now, that is an absurd conclusion. I guess if 
you take that to its conclusion, any State can do whatever they want on 
these substances. That is absurd. Why have a Federal law? Why have a 
Federal law in any way, shape, or form.

  Now we have several States--and Oregon is the pioneer in this--like 
Michigan and other States that are saying they want assisted suicide. I 
just beg to differ. I don't think that should be the purpose. The whole 
purpose of these drugs is to alleviate pain. For those organizations 
that say we are not sure if we support this bill because maybe it would 
have a chilling impact on pain, that is false. They haven't read the 
bill. If they want us to help write it in a stronger way--we put very 
clearly in the bill that these drugs can be used to alleviate pain. We 
encourage use of these drugs for the alleviation of pain, for 
palliative care. But they are licensed by the Federal Government and 
should not be used to kill people. They should not be used for assisted 
suicide. These are federally controlled drugs.
  Are we going to give that kind of license? What happens if somebody 
does it? Tradition has it and history has had it that the Drug 
Enforcement Agency, if somebody misuses these drugs--one, they have to 
get a Federal license to distribute the drug, and if they misuse them, 
they lose that license. I think it is only appropriate to do so. They

[[Page S12493]]

should not have the ability to distribute these drugs if they are going 
to use these drugs for assisted suicide.
  So I say to my colleagues and anybody who has an interest in this 
that I want to work this out. I met with the Secretary of Health and 
Human Services today, Secretary Shalala, and we talked about this. We 
need to make sure that these drugs can be used for palliative care. We 
also need to make sure that they are controlled by the Federal 
Government. They should not be used for assisted suicide.
  Mr. President, let me make a couple of general comments. This is 
about this administration, and it is about life in general, or maybe 
their lack of respect for life.
  On two or three issues, I think this administration seems quite bent 
on devaluating life. I am talking about unborn children, where the 
administration has been eagerly trying to bring forth the distribution 
of RU486, an abortion pill that aborts fetuses up to 9 or 10 weeks, 
where there is a beating heart; they want to legalize that. There 
wasn't a pharmaceutical company in the country that wanted to make the 
drug, and the administration bent over backwards trying to recruit this 
drug coming into the country.
  Now, you find the administration, through the Attorney General, 
coming up with a ruling that is totally contrary to the Drug 
Enforcement Agency's history of controlling controlled substances and 
saying, oh, well, we think assisted suicide is OK. Even though the 
President of the United States says he is against it, his 
administration and the Attorney General say maybe it is OK if the State 
says it is even though the drugs are controlled by the Federal 
Government. So you have the administration recruiting people to bring 
in abortion drugs for young people--an administration that wants to 
fund and subsidize abortion for unborn children, and then an 
administration now that, through the Attorney General's ruling, says we 
think these drugs that have been controlled by the Federal Government, 
under Federal law--we think it is OK if States want to legalize the use 
of these federally controlled drugs for assisted suicide. I don't think 
that makes sense.
  I think it is pathetic when you think that the Federal Government's 
purpose should be to protect people, and they are actually trying to 
bring in drugs that will kill unborn children. And, then, also at the 
same time, ``Oh, yes. You can use these very strong drugs to kill 
senior citizens.'' It is hard to believe that they would take that 
position. That is the position of this administration. They are wrong. 
Hopefully, this Congress will vote.
  I might mention that this is not the first issue that we have had 
with this. We passed legislation in the last Congress. We passed it 
unanimously through the Senate. It was my bill, or my language, that 
said no Federal funds were to be used for assisted suicide. Now we have 
people saying, ``Well, we want to use Federal drugs for assisted 
suicide.'' I think not.
  We are going to vote on it. We are going to have significant debate 
on it. I look forward to that debate. I regret we are out of time to 
get a significant debate on it this year.
  I look forward to working with my colleague from Oregon. I understand 
trying to represent one's State. I believe very strongly in States 
rights. But I don't believe so strongly in States rights that if the 
State of Oklahoma wanted to legalize heroin, or other controlled 
substances--I don't think that supersedes Federal law.
  I would tell my colleague from Oregon that if the State of Oklahoma 
said, ``We think we want to legalize assisted suicide and have it be 
public,'' I say that is fine, you can do it with any drug that is 
controlled by the State, but not drugs controlled by the Federal 
Government, because we don't want Federal Government policy to be that 
we are going to basically acquiesce in assisted suicide. That should 
not be Federal policy.
  Again, there is a Federal Controlled Substance Act. It is not State. 
The State could do whatever they want. But not with Federal law, not 
with Federal drugs, not with the Federal Drug Enforcement 
Administration, which controls the licenses and controls the use of 
these substances. The act is written OK. The act says these substances 
can only be used for legitimate medical purposes. I agree with that. If 
anybody thinks that legitimate medical purpose is assisted suicide, I 
disagree with that. That is not in the law. The Attorney General's 
reading of the law is totally contrary to that of the Drug Enforcement 
Administration. I believe she is wrong.
  We will give all Members of this body a chance to vote on it in the 
not-too-distant future--if not this Congress, certainly the next 
Congress.
  I thank my colleagues, particular my colleague from Texas, for 
allowing me to proceed to respond to my colleague from Oregon.
  I yield the floor.
                                       U.S. Department of Justice,


                              Drug Enforcement Administration,

                                 Washington, DC, November 5, 1997.
     Hon. Henry J. Hyde,
     House of Representatives,
     Washington, DC.
       Dear Congressman Hyde: Thank you for your letter of July 
     29, 1997. In that letter, you requested the Drug Enforcement 
     Administration's (DEA) view as to ``whether delivering, 
     distributing, dispensing, prescribing, filling a 
     prescription, or administering a controlled substance with 
     the deliberate intent of assisting in a suicide would violate 
     the Controlled Substance Act (CSA), applicable regulations, 
     rulings, or other federal law subject to DEA enforcement, 
     notwithstanding the enactment of a state law such as Oregon's 
     Measure 16 which rescinds state penalties against such 
     prescriptions for patients with a life expectancy of less 
     than six months.''
       I apologize for the delay in responding to you. As you 
     know, the CSA authorizes DEA to revoke the registration of 
     physicians who dispense controlled substances without a 
     legitimate medical purpose. Historically, DEA's experience 
     with the phrase ``without a legitimate medical purpose'' has 
     focused on cases involving physicians who have provided 
     controlled substances to drug addicts and abusers. The 
     application of this phrase to cases involving physician-
     assisted suicide presented DEA with a new issue to review.
       Since receiving your inquiry, my staff has carefully 
     reviewed a number of cases, briefs, law review articles and 
     state laws relating to physician-assisted suicide, including 
     the documents referenced in your letter. In addition, my 
     staff has conducted a thorough review of prior administrative 
     cases in which physicians have dispensed controlled 
     substances for other than a ``legitimate medical purpose.'' 
     Based on that review, we are persuaded that delivering, 
     dispensing or prescribing a controlled substance with the 
     intent of assisting a suicide would not be under any current 
     definition a ``legitimate medical purpose.'' As a result, the 
     activities that you described in your letter to us would be, 
     in our opinion, a violation of the CSA.
       Because physician-assisted suicide would be a new and 
     different application of the CSA, a number of issues remain 
     unresolved. For example, suspicious or unnatural deaths 
     require a medico-legal investigation. The first priority in 
     such an investigation would be a comprehensive forensic 
     inquiry by a state or local law enforcement agency, which is 
     traditionally supported by the efforts of a medical examiner, 
     forensic pathologist, and/or coroner. At the conclusion of 
     this stage of the inquiry, the evidence often is submitted to 
     a grand jury or similar process for a determination of 
     potential criminal liability of the person who assisted in 
     the death.
       This initial determination as to the cause of death is not 
     DEA's responsibility. Rather, DEA would have to rely on the 
     evidence supplied to us by state and local law enforcement 
     agencies and prosecutors. If the information or evidence 
     presented to DEA indicates that a physician has delivered, 
     distributed, dispensed, prescribed or administered a 
     controlled substance with the deliberate intent of assisting 
     in a suicide, then DEA could initiate revocation proceedings 
     on the grounds that the physician has acted ``without a 
     legitimate medical purpose.''
       In addition to moving to revoke a physician's registration 
     for dispensing controlled substances ``without a legitimate 
     medical purpose,'' please also be aware that the CSA provides 
     a number of other grounds upon which DEA might revoke the 
     registration of a physician who assisted in a suicide. For 
     example, DEA will revoke the registration of any physician 
     whose state license to practice medicine has been revoked for 
     assisting suicide. Similarly, DEA has authority to revoke the 
     registration of any physician whose acts in assisting a 
     suicide result in a conviction under state controlled 
     substances laws.
       DEA must examine the facts on a case-by-case basis to 
     determine whether a physician's actions conflict with the 
     CSA. If the facts indicate that a physician has acted as set 
     forth in your letter, however, then DEA would have a 
     statutory basis to initiate revocation proceedings.
       I trust that this response addresses your inquiry. If you 
     have any further questions, please feel free to contact me.
           Sincerely,
                                            Thomas A. Constantine,
                                                    Administrator.

  Mr. GRAMM addressed the Chair.
  The PRESIDING OFFICER. The Senator from Texas.
  Mr. GRAMM. Mr. President, I understand the Senator from Wyoming has 
cleared a bill. Knowing how hard it is

[[Page S12494]]

in the waning hours to do that, without losing my right to the floor 
and my full time when he is finished, I would like to yield him 5 
minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The Senator from Wyoming.
  Mr. THOMAS. Thank you, very much.
  I thank the Senator from Texas. I have several bills that will be 
concluded.

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