[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
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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
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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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