[Congressional Record Volume 145, Number 148 (Wednesday, October 27, 1999)]
[House]
[Pages H10868-H10876]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




PROVIDING FOR CONSIDERATION OF H.R. 2260, PAIN RELIEF PROMOTION ACT OF 
                                  1999

  Mr. LINDER. Mr. Speaker, by direction of the Committee on Rules, I 
call up House Resolution 339 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 339

       Resolved, That at any time after the adoption of this 
     resolution the Speaker may, pursuant to clause 2(b) of rule 
     XVIII, declare the House resolved into the Committee of the 
     Whole House on the state of the Union for consideration of 
     the bill (H.R. 2260) to amend the Controlled Substances Act 
     to promote pain management and palliative care without 
     permitting assisted suicide and euthanasia, and for other 
     purposes. The first reading of the bill shall be dispensed 
     with. Points of order against consideration of the bill for 
     failure to comply with clause 4(a) of rule XIII are waived. 
     General debate shall be confined to the bill and shall not 
     exceed one hour equally divided among and controlled by the 
     chairmen and ranking minority members of the Committee on 
     Commerce and the Committee on the Judiciary. After general 
     debate the bill shall be considered for amendment under the 
     five-minute rule. It shall be in order to consider as an 
     original bill for the purpose of amendment under the five-
     minute rule an amendment in the nature of a substitute 
     consisting of the bill modified by the amendments recommended 
     by the Committee on Commerce now printed in the bill. That 
     amendment in the nature of a substitute shall be considered 
     as read. No amendment to that amendment in the nature of a 
     substitute shall be in order except those printed in the 
     report of the Committee on Rules accompanying this 
     resolution. Each amendment may be offered only in the order 
     printed in the report, may be offered only by a Member 
     designated in the report, shall be considered as read, shall 
     be debatable for the time specified in the report equally 
     divided and controlled by the proponent and an opponent, and 
     shall not be subject to amendment. The Chairman of the 
     Committee of the Whole may: (1) postpone until a time during 
     further consideration in the Committee of the Whole a request 
     for a recorded vote on any amendment; and (2) reduce to five 
     minutes the minimum time for electronic voting on any 
     postponed question that follows another electronic vote 
     without intervening business, provided, that the minimum time 
     for electronic voting on the first in any series of questions 
     shall be 15 minutes. At the conclusion of consideration of 
     the bill for amendment the Committee shall rise and report 
     the bill to the House with such amendments as may have been 
     adopted. Any Member may demand a separate vote in the House 
     on any amendment adopted in the Committee of the Whole to the 
     bill or to the amendment in the nature of a substitute made 
     in order as original text. The previous question shall be 
     considered as ordered on the bill and amendments thereto to 
     final passage without intervening motion except one motion to 
     recommit with or without instructions.

  The SPEAKER pro tempore (Mr. Petri). The gentleman from Georgia (Mr. 
Linder) is recognized for 1 hour.
  Mr. LINDER. Mr. Speaker, for purposes of debate only, I yield the 
customary 30 minutes to the gentleman from Massachusetts (Mr. Moakley), 
pending which I yield myself such time as I may consume. During 
consideration of this resolution, all time yielded is for the purpose 
of debate only.
  Mr. Speaker, this is a structured rule providing for consideration of 
H.R. 2260, the Pain Relief Promotion Act of 1999. H. Res. 339 provides 
1 hour of general debate equally divided and controlled by the chairmen 
and ranking minority members of the Committee on Commerce and the 
Committee on the Judiciary.
  The rule waives clause 4(a) of Rule XIII, which requires a 3-day 
layover against consideration of the bill.
  H. Res. 339 makes in order as an original bill for the purpose of 
amendment the Committee on the Judiciary amendment in the nature of a 
substitute, as modified by the amendments recommended by the Committee 
on Commerce and printed in the bill.
  The rule provides for consideration of only the amendments printed in 
the Committee on Rules report accompanying the resolution. The rule 
further provides these amendments will be considered only in the order 
specified in the report, may be offered only by a member designated in 
the report, shall be considered as read, shall be debatable for the 
time specified in the report equally divided and controlled by the 
proponent and an opponent and shall not be subject to amendment.
  Specifically, the rule makes in order an amendment offered by the 
gentleman from Virginia (Mr. Scott) and the gentleman from Oregon (Mr. 
DeFazio) to be debated for 10 minutes and a substitute amendment 
offered by the gentlewoman from Oregon (Ms. Hooley) and the gentlewoman 
from Connecticut (Mrs. Johnson) to be debated for 40 minutes.
  The rule also allows the Chairman to postpone recorded votes and 
reduce to 5 minutes the voting time on any postponed question, provided 
the voting time on the first in any series of questions is not less 
than 15 minutes. This provision will simply facilitate consideration of 
amendments.

[[Page H10869]]

  House Resolution 339 also provides for one motion to recommit with or 
without instructions.
  Mr. Speaker, for the purpose of background, the Administrator of the 
Drug Enforcement Agency decided in late 1997 that delivering, 
dispensing, prescribing or administering a controlled substance with 
the deliberate intent of assisting in a suicide violates the Controlled 
Substance Act or applicable regulations. The regulations stated that a 
controlled substance must be issued for a legitimate medical purpose by 
an individual practitioner acting in the usual course of his 
professional practice. However, Attorney General Reno unfortunately 
decided in 1998 that such usage is now part of the ordinary practice of 
medicine in Oregon, and therefore exempt from the Controlled Substances 
Act of 1970.
  Clearly, physician-assisted suicide is a danger to society. I share 
the views of the gentleman from Illinois (Mr. Hyde), the chairman of 
the Committee on the Judiciary, that assisting in a suicide by giving a 
prescription for a controlled substance cannot be a ``legitimate 
medical purpose,'' especially when the practice is not reasonable and 
necessary to the diagnosis and treatment of disease and injury, 
legitimate health care, or compatible with the physician's role as 
healer.
  With this bill, we do want to reaffirm that the Controlled Substances 
Act does not authorize intentionally using federally regulated drugs to 
cause the death of a patient. However, this is an important bill 
because it ensures that we encourage aggressive pain relief for 
patients, while also reinforcing the current law that administering, 
dispensing, or distributing a controlled substance for the purpose of 
assisting in a suicide is not authorized by the Federal Controlled 
Substances Act.
  This legislation will promote the responsible use of these drugs for 
pain control rather than leaving the patients with the impression that 
suicide is the only option to escape from the pain of a terminal 
illness. It is unacceptable that we would permit terminally ill 
patients to think that suicide is the only option because pain relief 
options are not available to them. Today, we help make improved pain 
relief an objective in health care institutions across the country by 
authorizing the Agency for Health Care Policy and Research to develop 
and advance a scientific understanding of palliative care; authorizing 
a program for education and training in palliative care in the Health 
Resources and Services Administration of the Department of Health and 
Human Services; and authorizing additional funding for the palliative 
care award program beginning in fiscal year 2000.
  I do want to note that a previous bill in 1998 caused concerns that 
it might inhibit doctors from prescribing adequate pain relief. H.R. 
2260 has been drafted to resolve those concerns. I am very pleased that 
the interested parties have worked together over the past year and have 
crafted legislation that will not only encourage doctors to prescribe 
effective pain management but also encourage alternatives to 
euthanasia.

                              {time}  1045

  Today, the National Hospice Association states that ``this 
legislation is a step toward better awareness of effective pain 
management techniques and should ultimately change behavior to better 
serve the needs of terminally ill patients and their families.''
  The organization Aging With Dignity states that, ``improving end of 
life care is the best way to keep legalized euthanasia and assisted 
suicide away from mainstream America. Doctors can treat their patients 
and lessen their pain, and this needs to happen now. This law will help 
them do that.''
  These groups join the American Medical Association, the Coalition of 
Concerned Medical Professionals, Physicians for Compassionate Care, the 
American Academy of Pain Management, and the American Society of 
Anesthesiologists in supporting H.R. 2260.
  I want to commend the gentleman from Illinois (Mr. Hyde), the 
chairman of the Committee on the Judiciary, and the gentleman from 
Michigan (Mr. Stupak), the cosponsor, for their efforts in sponsoring 
this excellent piece of bipartisan legislation.
  Mr. Speaker, H.R. 2260 was favorably reported out of both the 
Committee on the Judiciary and the Committee on Commerce, as was the 
rule by the Committee on Rules. I urge my colleagues to support the 
rule so that we may proceed with general debate and consideration of 
the merits of this important bill.
  Mr. Speaker, I reserve the balance of my time.
  Mr. MOAKLEY. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I thank the gentleman from Georgia (Mr. Linder) for 
yielding me the time.
  Mr. Speaker, this is a restrictive rule which will allow for the 
consideration of H.R. 2260, the Pain Relief Promotion Act of 1999. As 
the gentleman from Georgia described, the rule provides 1 hour of 
general debate equally divided and controlled by the chairman and 
ranking member of the Committee on Commerce and the chairman and 
ranking member of the Committee on the Judiciary.
  Mr. Speaker, this rule permits consideration of only two amendments 
selected by the Committee on Rules. No other amendments are made in 
order. We on the Democratic side made an effort to allow amendments by 
all Members who submitted them in advance to the Committee on Rules, 
but were voted down on a party line.
  This bill prohibits doctors from using drugs for suicide and 
euthanasia. It would have the effect of overturning the Oregon State 
law permitting physician-assisted suicide.
  On the other hand, Mr. Speaker, the bill specifically permits doctors 
to provide pain reducing drugs, even if the use of those drugs 
increases the risk of death. This provision is very necessary to ensure 
that terminal patients can be given the treatment that they need so 
their suffering may be reduced.
  This bill also creates a program to study pain management and to make 
the information widely available. This program is a very meaningful way 
to improve the way health professionals treat patients suffering from 
pain.
  Mr. Speaker, I have known from personal experience the importance of 
these pain reducing drugs. Though this bill is controversial, it has 
very important features that deserve to be discussed by this entire 
body.
  Mr. Speaker, I reserve the balance of my time.
  Mr. LINDER. Mr. Speaker, I am pleased to yield 3 minutes to the 
gentleman from south Texas (Mr. Paul).
  (Mr. PAUL asked and was given permission to revise and extend his 
remarks.)
  Mr. PAUL. Mr. Speaker, I thank the gentleman from Georgia for 
yielding me this time.
  Mr. Speaker, I rise in support of the rule, but I would like to make 
a couple of comments about why I do not think we should support this 
bill.
  I am strongly pro-life. I think one of the most disastrous rulings of 
this century was Roe versus Wade. I do believe in the slippery slope 
theory. I believe that if people are careless and casual about life at 
the beginning of life, we will be careless and casual about life at the 
end. Abortion leads to euthanasia. I believe that.
  I disagree with the Oregon law. If I were in Oregon, I would vote 
against that law. But I believe the approach here is a legislative 
slippery slope. What we are doing is applying this same principle of 
Roe versus Wade by nationalizing law and, therefore, doing the wrong 
thing.
  This bill should be opposed. I think it will backfire. If we can come 
here in the Congress and decide that the Oregon law is bad, what says 
we cannot go to Texas and get rid of the Texas law that protects life 
and prohibits euthanasia. That is the main problem with this bill.
  Also, I believe it will indeed dampen the ability of doctors to treat 
dying patients. I know this bill has made an effort to prevent that, 
compared to last year, but it does not. The Attorney General and a DEA 
agent will decide who has given too much medication. If a patient is 
dying and they get too much medicine, and they die, the doctor could be 
in big trouble. They could have criminal charges filed against them. 
They could lose their license or go to jail.
  Just recently, I had a member of my family pass away with a serious 
illness and required a lot of medication. But nurses were reluctant to 
give the medicine prescribed by the doctor for fear of

[[Page H10870]]

lawsuit and fear of charges that something illegal was being done. With 
a law like this, it is going to make this problem much, much worse.
  Another thing is this sets up a new agency. For those conservative 
colleagues of mine who do not like the nationalization of medical care, 
what my colleagues are looking at here is a new agency of government 
setting up protocols, educating doctors and hospitals, and saying this 
is the way palliative care must be administered. My colleagues will 
have to answer with reports to the Federal Government.
  As bad as the Oregon law is, this is not the way we should deal with 
the problem. This bill applies the same principle as Roe versus Wade.
  I maintain that this bill is deeply flawed. I believe that nobody can 
be more pro-life than I am, nobody who could condemn the trends of what 
is happening in this country in the movement toward euthanasia and the 
chances that one day euthanasia will be determined by the national 
government because of economic conditions. But this bill does not deal 
with life and makes a difficult situation much worse.
  Mr. Speaker, the Pain Relief Promotion Act of 1999 (H.R. 2260) is 
designed for one purpose. It is to repeal the state of Oregon's law 
dealing with assisted suicide and euthanasia.
  Being strongly pro-life, I'm convinced that the Roe vs. Wade Supreme 
Court decision of 1973 is one of the worst, if not the worst, Supreme 
Court ruling of the 20th century. It has been this institutionalizing 
into our legal system the lack of respect for life and liberty that has 
and will continue to play havoc with liberty and life until it is 
changed. It has been said by many since the early 1970s that any 
legalization of abortion would put us on a slippery slope to 
euthanasia. I agree with this assessment.
  However, I believe that if we are not careful in our attempt to 
clarify this situation we also could participate in a slippery slope 
unbeknownst to us and just as dangerous. Roe vs. Wade essentially has 
nationalized an issue that should have been handled strictly by the 
states. Its repeal of a Texas State law set the stage for the wholesale 
of millions of innocent unborn. And yet, we once again are embarking on 
more nationalization of law that will in time backfire. Although the 
intention of H.R. 2260 is to repeal the Oregon law and make a statement 
against euthanasia it may well just do the opposite. If the 
nationalization of law dealing with abortion was designed to repeal 
state laws that protected life there is nothing to say that once we 
further establish this principle that the federal government, either 
the Congress or the Federal Courts, will be used to repeal the very 
laws that exist in 49 other states than Oregon that prohibit 
euthanasia. As bad as it is to tolerate an unsound state law, it's even 
worse to introduce the notion that our federal congresses and our 
federal courts have the wisdom to tell all the states how to achieve 
the goals of protecting life and liberty.
  H.R. 2260 makes an effort to delineate the prescribing of narcotics 
for alleviating pain from that of intentionally killing the patient. 
There is no way medically, legally, or morally to tell the difference. 
This law will serve to curtail the generous use of narcotics in a 
legitimate manner in caring for the dying. Claiming that this law will 
not hinder the legitimate use of drugs for medical purposes but not for 
an intentional death is wishful thinking. In fear that a doctor will be 
charged for intentionally killing a patient, even though the patient 
may have died coincidentally with an injection, this bill will provide 
a great barrier to the adequate treatment of our sick and dying who are 
suffering and are in intense pain.
  The loss of a narcotic's license, as this bill would dictate as 
punishment, is essentially denying a medical license to all doctors 
practicing medicine. Criminal penalties can be invoked as well. I would 
like to call attention to my colleagues that this bill is a lot more 
than changing the Controlled Substance Act. It is involved with 
educational and training programs to dictate to all physicians 
providing palliative care and how it should be managed. An entirely new 
program is set up with an administrator that ``shall'' carry out a 
program to accomplish the developing and the advancing of scientific 
understanding of palliative care and to disseminate protocols and 
evidence-based practices regarding palliative care.
  All physicians should be concerned about a federal government agency 
setting up protocols for medical care recognizing that many patients 
need a variation in providing care and a single protocol cannot be 
construed as being ``correct''.
  This program is designed to instruct public and private health care 
programs throughout the nation as well as medical schools, hospices and 
the general public. Once these standards are set and if any variation 
occurs and a subsequent death coincidentally occurs that physician will 
be under the gun from the DEA. Charges will be made and the doctor will 
have to defend himself and may end up losing his license. It will with 
certainty dampen the enthusiasm of the physician caring for the 
critically ill.
  Under this bill a new program of grants, cooperative agreements and 
contracts to help professional schools and other medical agencies will 
be used to educate and train health care professionals in palliative 
care. It is not explicit but one can expect that if the rules are not 
followed and an institution is receiving federal money they will be 
denied these funds unless they follow the universal protocols set up by 
the federal government. The bill states clearly that any special award 
under this new program can only be given if the applicant agrees that 
the program carried out with the award will follow the government 
guidelines. These new programs will be through the health professional 
schools, i.e. the medical schools' residency training programs and 
other graduate programs in the health professions. It will be a carrot 
and stick approach and in time the medical profession will become very 
frustrated with the mandates and the threat that funds will be 
withheld.
  The Secretary of Health and Human Services in charge of these 
programs are required to evaluate all the programs which means more 
reports to be filled out by the institutions for bureaucrats in 
Washington to study. The results of these reports will be to determine 
the effect such programs have on knowledge and practice regarding 
palliative care. Twenty four million dollars is authorized for this new 
program.
  This program and this bill essentially nationalizes all terminal care 
and opens up Pandora's box in regards to patient choices as well as 
doctor judgment. This bill, no matter how well intended, is dangerously 
flawed and will do great harm to the practice of medicine and for the 
care of the dying. This bill should be rejected.
  Mr. MOAKLEY. Mr. Speaker, I yield 5 minutes to the gentleman from New 
Jersey (Mr. Rothman).
  (Mr. ROTHMAN asked and was given permission to revise and extend his 
remarks.)
  Mr. ROTHMAN. Mr. Speaker, I rise in support of the rule, but I join 
the gentleman from Texas (Mr. Paul) in opposing the bill. Make no 
mistake about it, the bill in question deals with pain, excrutiating, 
horrible pain, the kind of pain that afflicts literally tens of 
millions of Americans, chronic pain, terminally-ill pain.
  What is the difference? Well, what is the story here in America with 
regards to providing pain medication to those tens of millions of 
Americans who so desperately need the pain medication? Well, there is a 
consensus in the United States, Democrats, Republicans, liberals, 
conservatives, everyone agrees. There is an undertreatment of pain in 
the United States of America.
  Why? Primarily we are told because doctors feel intimidated if they 
give too much pain medication to those patients in terrible pain who 
are asking for it, they do not want to die, they just want pain relief, 
because the doctors are afraid of a civil medical malpractice lawsuit.
  So what does the underlying bill do? It provides for a criminal 
penalty against doctors, 20 years in jail maximum. It provides license 
revocation, if a DEA drug enforcement agent can go through the pain 
prescription of every doctor prescribing pain prescription in America, 
and this drug enforcement agent feels the pain medication might have 
been intentionally overdone.
  Now, if one thinks there is a chilling effect on doctors providing 
pain medication now, wait till H.R. 2260 if this bill gets passed. 
Hopefully my colleagues on both sides of the aisle who agree with me, 
and there are many of us, will support the substitute.
  What does the substitute say? It says we are against physician-
assisted suicide. We are against physician-assisted suicide. It says we 
want more research into pain medication. We want more understanding 
amongst doctors about the right way to prescribe pain medication.
  But what it does not have, what the underlying bill has, is it does 
not provide this criminal penalty against doctors and license 
revocation. It keeps our eye on the ball.
  We are talking about providing pain relief for those millions of 
American children, men and women in agony, dying horrible deaths. So 
why would my colleagues, some of them, be wanting to introduce this 
bill in the first place? It is clear, and they say so quite

[[Page H10871]]

candidly. They do not like the Oregon physician-assisted suicide law. 
Many of us do not.
  I voted against physician-assisted suicide here in the Congress, as 
did the majority of my colleagues. We do not like the Oregon physician-
assisted suicide law, but do not have a law. Go to the Supreme Court. 
Get it thrown out if it is unconstitutional. But do not have a law that 
will affect all 50 States, tens of millions of Americans who are 
suffering who need pain medication. Do not affect all those Americans 
because one does not like the law that the people of Oregon twice chose 
in referendum. If my colleagues do not like it, ask the Supreme Court 
to declare it unconstitutional, but do not cause so much suffering.
  Some of my colleagues will say, well, there is a law like the one we 
want to introduce today in Congress passed in a couple of States, and 
pain medication went up, and they had no problem. Well, those State 
laws did not involve the Drug Enforcement Agency having the right to 
review every single prescription for pain medication that every doctor 
in America is going to prescribe. It goes against common sense.
  If one is a doctor and now the DEA can come in to review one's 
records of every pain prescription one prescribes, it would go to 
intimidate. The Drug Enforcement Agency should be going after the drug 
cartels in South America. They should not be looking at every single 
pain prescription that every single doctor in America prescribed.
  We need pain relief. We need doctors and local medical societies, the 
majority of whom support the substitute and are against the bill. The 
majority of the nurses associations in America are for the substitute 
and against the bill, while the doctor organizations are split.
  What you have here is obvious. Doctors are conflicted. They are 
afraid. They are uncertain. The nurses who are the last line of 
defense, who treat these terminally-ill patients writhing in pain, they 
are almost unanimous against the bill and in favor of the substitute.
  So if my colleagues want to deal with pain in America and they do not 
want to inhibit doctors from providing the pain medications that tens 
of millions of Americans are going to be affected with, vote against 
the bill, vote for the substitute which says we are against physician-
assisted suicide.
  We want more doctors to prescribe pain medication, not to kill the 
patient, but to provide the relief that they are begging for in their 
last days and months on Earth. But do not put them in jail. Do not 
threaten to put them in jail. Let the States' local medical societies 
who each have their own traditions and customs and have worked on the 
details of these bills for so long, let them deal with it 
appropriately. I ask my colleagues to support the substitute.
  Mr. LINDER. Mr. Speaker, I am pleased to yield 4 minutes to the 
gentleman from Oklahoma (Mr. Coburn.)
  Mr. COBURN. Mr. Speaker, this is the bill. What the gentleman from 
New Jersey (Mr. Rothman) just said is false. There is no penalty in 
here. Every doctor in this country today, every controlled substance is 
available for review by the DEA. There is no change in that. The 
gentleman knows that. There is no penalty, new penalty in this bill for 
anybody. What this bill is about is saying that Federal law, as far as 
narcotics control, cannot be preempted by a State in the use of those 
narcotics. That is what it is about.
  The gentleman has not ever given pain medicine to somebody who is 
dying. I have. I have intentionally medicated somebody to help them 
with their pain. Unfortunately, as a consequence of that, some have 
died. There is nothing that keeps us from doing that today except our 
fear of rhetoric that is untrue.
  That is untrue, absolutely blatantly false that there is criminal 
penalties in this bill for any doctor who does the right thing. This is 
about not allowing the State to stick their nose out at a Federal law 
that we all know is important, and that is controlling dangerous 
substances.
  Now, the gentleman's desire is an honorable desire that, in fact, we 
should help doctors alleviate pain; and we can do that. There is no 
question that I have seen in my 18 years of practice of medicine that 
we, in fact, do not do as good a job as we should at that issue. But to 
take and create that as a reason to allow any State to use narcotics to 
kill a patient is wrong. That is what is going to happen.
  We have great testimony. We have the great experience of the Dutch. 
We had 2,100 people in 1995 in Holland who were euthanized against 
their will. They did not want to die. But a doctor decided they should 
not live anymore.
  The slippery slope that the gentleman from Texas (Mr. Paul) talked 
about and his understanding of this bill I believe is wrong. There is a 
slippery slope. But it is not the slope of allowing the Federal 
Government to continue to enforce the laws of this land and to have a 
Federal standard on narcotics. That is not the slippery slope.
  The slippery slope is to create an environment where any State, 
regardless of their own desires, can ignore Federal law today; every 
doctor who writes a prescription for a controlled substance can be 
reviewed; every prescription can be looked at by the DEA.
  There is no new authority for the DEA in this. What this bill says, 
and it is only this few pages, is that the law applies to every State 
equally, and that just because Oregon decides that they want to take 
someone's life, that they should not be able to say that Federal law 
does not apply.
  The fact is all life has value. As we have determined in this 
country, we have said the unborn does not have value. Now Oregon says 
the dying do not have value, and that in the future, those that are not 
dying have no value.

                              {time}  1100

  There were just 1,100 babies that were born last year and the year 
before in the whole land that the doctor decided should not live. So 
what did they do? They gave them paregoric, they paralyzed the 
respiration, and they died.
  Do we want doctors deciding who lives and who dies? No, we do not 
want that. This is a slope, a real slope where we are going to become 
God. We do not have that power. The Declaration of Independence says 
that we should have the right to pursue life, liberty, and the pursuit 
of happiness. Nothing in it says we have the right to pursue death, 
nothing.
  Mr. MOAKLEY. Mr. Speaker, I yield 1 minute to the gentleman from New 
Jersey (Mr. Rothman).
  Mr. ROTHMAN. Mr. Speaker, I would like to respond to my colleague.
  The gentleman was very clever. Even though he is a physician, he 
spoke like a Philadelphia lawyer, and he said this bill does not 
provide criminal penalties if they do nothing wrong. But if they did in 
the opinion of the Drug Enforcement Agency, then the doctor can go to 
prison.
  Mr. LINDER. Mr. Speaker, will the gentleman yield?
  Mr. ROTHMAN. I yield to the gentleman from Georgia.
  Mr. LINDER. Mr. Speaker, what he said, as I heard it, is that it does 
not provide any additional penalties that are not already there.
  Mr. ROTHMAN. Mr. Speaker, reclaiming my time, he said that. And then 
he said, to clarify it, there will be no jail time if they do not do 
anything wrong, or words to that effect. Because if they do do 
something wrong in the opinion of the Drug Enforcement Agency, which is 
now being called upon in this bill to look into this, they can go to 
jail and they will lose their license.
  Again, the question is, if we are concerned about pain medication, 
let us pass a bill about pain medication. That is the substitute, which 
is also against physician-assisted suicide. And if my colleagues did 
not like the Oregon referendum of physician-assisted suicide, as I do 
not, then go to the Supreme Court and declare it unconstitutional.
  Do not let the tens of millions of American children, men, and women 
suffer because they do not like the Oregon law. Change the law, get it 
declared unconstitutional, and leave these patients and doctors alone.
  Mr. LINDER. Mr. Speaker, for a point of clarification, I yield myself 
30 seconds to make this point.
  What the gentleman from Oklahoma (Mr. Coburn) said was that this bill 
does not provide any new or additional penalties that are already not 
extant. This is nothing changed. Those penalties can occur today. He 
made the point very clear, I thought, that the whole point of this bill 
is to not allow

[[Page H10872]]

States on their own to exempt themselves from Federal laws with respect 
to controlled substances.
  Mr. MOAKLEY. Mr. Speaker, I yield 3 minutes to the gentleman from 
Oregon (Mr. DeFazio).
  Mr. DeFAZIO. Mr. Speaker, I thank the gentleman for yielding.
  Mr. Speaker, the gentleman who preceded me in the well may well be a 
good physician, but he is not an attorney.
  The Department of Justice says, ``By denying authorization under the 
Controlled Substances Act, H.R. 2260 would make it a Federal crime for 
a physician to dispense a controlled substance to aid a suicide. 
However, a physician who prescribes the controlled substances most 
commonly used to aid a suicide would, because he or she necessarily 
intends death to result, or may have intended death to result, or 
should have known that death should have resulted, would face a 20-year 
mandatory minimum sentence in Federal prison.''
  That is what we are talking about here, the Drug Enforcement 
Administration second-guessing the intention after the fact of every 
physician in America.
  Let us use a real-life example. This is a pain medication. If this 
were a barbiturate for end-of-life care and it was prescribed by my 
physician aggressively that I was to take one every 2 hours to relieve 
my excruciating pain, say from bone cancer, that would be legal.
  Now, if this prescription, a pain relief prescription, was prescribed 
by my doctor for aggressive pain relief management, one to be taken 
every 2 hours, and I took this entire vial all at once and died, the 
question would be what was my physician's intent in giving me this 
prescription? Was it that I would really take one every 2 hours, or did 
my physician know or should my physician have known that I might choose 
to take all of them at once?
  What this means ultimately, the absurdity of this, is any physician 
who does not want to risk being investigated by the Drug Enforcement 
Administration, and nobody wants that, is going to have to say they can 
have one pill every 2 hours, send their wife or kids down to the 24-
hour pharmacy to pick them up for them, because he gives them more than 
one and they take them all at once and they die, the Drug Enforcement 
Administration is going to question his intent.
  That is the cover of law that is being ripped away by this well-
sounding, theoretically well-meaning legislation.
  In their zeal to overturn the Oregon law, which is not euthanasia, 
which does not allow a doctor to give an injection, which does not 
allow a doctor to administer a prescription, which allows individuals 
who are terminally ill who have a diagnosis they will die within 6 
months, after consulting with two physicians, after consulting with a 
psychiatrist to go to their physician and ask for a prescription which 
they can only self-administer.
  This is not euthanasia, and it has been very, very infrequently used 
in our State. In fact, probably fewer people have shot themselves or 
otherwise killed themselves under fear of the pain they were going to 
undergo because of the Oregon law.
  But these people on this side of the aisle who are for States' rights 
every day of the week when a State says something they agree with are 
suddenly today standing up and saying, well, we are for States' rights 
as long as we agree with the State.
  Preempt the will of the Oregon people. It is not the State of Oregon, 
it is the people of the State of Oregon twice by initiative and 
referendum who have passed this law.
  Mr. LINDER. Mr. Speaker, for a quiet and dignified response, I yield 
2 minutes to the gentleman from Oklahoma (Mr. Coburn).
  Mr. COBURN. Mr. Speaker, what the gentleman fails to state is that 
the DEA already has that power.
  Yes, there is no more important thing than intent. Every doctor, when 
they graduate from medical school, their goal is to preserve life, not 
take it. There are lots of times in my life that have been low, I would 
have loved to have been out of here. But I am glad somebody did not 
help me leave. Because there is always another day.
  For those of my colleagues who have not treated dying patients with 
metastatic bone cancers, first of all, we do not use barbiturates. We 
use narcotics. Barbiturates are not used for pain relief. They are used 
to accentuate pain relief. But narcotics are used for pain relief.
  There is no new law. The DEA, if I misuse a drug today, a controlled 
substance, can in fact harm me, take away my license to dispense drugs, 
and incarcerate me. And rightly so.
  We do not in this country, under our Constitution or our Declaration 
of Independence, have the right to die. That is not one of the 
guaranteed freedoms in this country. We do not have the right to die. 
As a matter of fact, it is against the law to commit suicide in many 
States.

  So what we are really saying is the motivation of the people from 
Oregon is a good motivation. People are in pain. How do we fix that? 
Well, the professionals have already said we need to do a better job of 
training doctors and we need to make sure doctors do not feel afraid to 
go up with the intention of alleviating pain and worry about the 
unintended consequence it might suppress somebody's respiration and 
they die.
  This bill truly addresses that because it does not give the free will 
for a physician to say, we are going to take their life. Most people 
who want their life taken have a clinical depression, a clinical 
depression. They have another illness besides the illness that is in 
front of everybody, and it is that, that we need to recognize.
  Mr. MOAKLEY. Mr. Speaker, I am happy to yield 3\1/2\ minutes to the 
gentlewoman from Oregon (Ms. Hooley).
  Ms. HOOLEY of Oregon. Mr. Speaker, I rise in opposition to the 
underlying bill and in support of the Johnson-Rothman-Hooley substitute 
amendment to H.R. 2260.
  All of us come to this issue of pain and end of life from very 
different perspectives. Some would like to effectively overturn 
Oregon's law that allows physicians to assist terminally-ill patients 
with less than 6 months to live in ending their lives. Since we passed 
that law, and we passed it twice, 15 terminally-ill patients have used 
such assistance.
  Undoubtedly, the proponents of H.R. 2260 are motivated by a heartfelt 
desire to eliminate a physician-assisted suicide. The Johnson 
substitute seeks that same outcome, but the difference is it addresses 
the problem as a medical problem and not a law enforcement problem.
  In the 6 months that it took the gentlewoman from Connecticut (Mrs. 
Johnson) and I to draft the Conquering Pain Act, H.R. 2188, from which 
this Johnson substitute is derived, not one expert concerning improving 
end-of-life care said we need to take away authority from the State. 
Not one expert recommended amending the Controlled Substances Act, in 
which the Pain Relief Promotion Act would. Not one expert said this was 
the best way to improve pain management.
  Interestingly, the American Medical Association and the National 
Hospice Organization were an integral part in our working group and 
ultimately endorsed the Conquering Pain Act, on which the Johnson 
substitute is based, never once raising the issue of the Controlled 
Substances Act.
  In fact, at a hearing in October at the Senate Committee on Health, 
Education, Labor, and Pensions, where experts were asked where should 
we begin to improve management, every expert witness said we should 
begin with education and research. Not one expert said the best way to 
improve management pain management for patients is to amend the 
Controlled Substances Act.
  Dr. Richard Payne, Chief of Pain & Palliative Care Services at 
Memorial Sloan Kettering Cancer Center, and a co-chair of the Agency 
for Health Care Policy and Research panel on cancer pain guidelines 
summed it up well. ``While H.R. 2260 is well-intentioned, it is 
counterproductive. It would have a chilling effect on aggressive pain 
management.''
  Dr. Payne and many physicians and other health care practitioners, 
those who specifically specialize in pain management, not the 
generalist, are urging the support of the substitute based on H.R. 
2188, ``the bill that would constructively promote end-of-life and 
palliative care,'' and urge a no vote on H.R. 2260 as reported by 
committee.
  I know others may disagree. But it is clearly not worth the risk that 
people

[[Page H10873]]

will suffer, and people will suffer in more pain by passing H.R. 2260.
  Under the Johnson substitute amendment, Congress expresses its clear 
opposition to assisted suicide, makes every effort to reduce it. What 
is more important is the Johnson substitute seeks to address the reason 
a suffering individual at the end of their life might seek that 
dreadful option, fear and exhaustion of being in pain.
  I urge a yes vote on the Johnson substitute and a no vote on H.R. 
2260.
  Mr. LINDER. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Connecticut (Mrs. Johnson), the author of the Johnson substitute.
  Mrs. JOHNSON of Connecticut. Mr. Chairman, I thank the gentleman for 
yielding me the time, and I rise in support of the rule and appreciate 
the Committee on Rules allowing me to offer my substitute.
  To just comment on the earlier debate, Mr. Chairman, the Hyde bill 
does not impose new penalties, but the Hyde bill does identify a new 
role for DEA agents, who are nonmedical people. That role involves 
judging the intent of a physician and thereby exposing physicians to 
criminal penalties, not for trafficking or other illegal activities 
involving drugs but for exercising their professional judgment in the 
delivery of patient care.

                              {time}  1115

  But I rise at this point in the debate to call the attention of my 
colleagues to a Dear Colleague that I sent out recently about the 
testimony of David Jorensen. He is the director of the pain and policy 
studies group at the Comprehensive Cancer Center at the University of 
Wisconsin, cofounder of the National Association of State Controlled 
Substances Authorities and the State cancer pain initiative. He served 
many years on the drafting committee of the national conference of 
commissioners on uniform State laws to revive the Uniform Controlled 
Substances Act for the United States. In other words, he is extremely 
experienced in this issue of managing controlled substances and in pain 
management. I urge my colleagues to review the rather dry Dear 
Colleague that I sent out, because it lays out the clear history of 
this matter. Under current law, medical issues are deferred to 
enforcement by medical agencies, whether it is HHS at the national 
level or State medical agencies or medical review boards that have been 
put in place to oversee medical practice and standards of care at the 
State level. In other words, current law clearly allows the use of 
controlled substances for pain management and regulates such medical 
uses through HHS and State health agencies, including medical review 
boards and licensure laws and clearly does not allow DEA or agencies 
who have no knowledge in this area to be part of the enforcement 
mechanism.
  Mr. MOAKLEY. Mr. Speaker, I yield 5\1/2\ minutes to the gentleman 
from North Carolina (Mr. Watt).
  Mr. WATT of North Carolina. Mr. Speaker, I rise in opposition to the 
rule and in opposition to the bill in its current form and want to make 
several points. First of all, this is the whip notice for today. It 
says we are getting out of session this afternoon between 3 and 4 
o'clock. Two amendments, very important amendments, were offered to the 
Committee on Rules which the Committee on Rules chose not to make in 
order, we presume because we do not have time to debate the issues that 
were to be debated related to this bill. One of those amendments is an 
amendment that would have been offered by myself in conjunction with 
the gentleman from Oregon (Mr. Wu) and several other Members of this 
House which in effect walks a line between the bill as it is currently 
structured and the substitute as it is proposed. There are some of us 
who really do not have any problem with parts of this bill as it is 
drawn. We ought to be encouraging palliative care and pain relief, but 
we ought to be doing it in such a way that it is explicitly clear that 
we are not preempting States' laws. That is what our amendment would 
have done. But apparently the Committee on Rules decided that that kind 
of balanced approach to this debate was not something that this House 
ought to entertain. We ought to either have it all on the one hand or 
have a complete substitute on the other hand. That should not have 
happened and it certainly should not have happened on a day that the 
House is recessing at 3 or 4 o'clock in the afternoon.
  The second amendment that was offered is one that is of equal 
importance, because a number of us through the years have had severe 
problems with the disparity in sentencing between crack cocaine and 
powder cocaine. Under this bill, a physician can prescribe cocaine for 
the purposes of alleviating pain. It is a schedule 2 drug under the 
Controlled Substances Act. But if that physician prescribes crack, a 
form of cocaine, and if the opponents of this bill are correct that 
that would subject the physician to a criminal penalty if he prescribed 
powder cocaine for the relief of pain, it would subject him to one-
tenth of the penalty that it would subject the physician to if he 
prescribed crack cocaine, a derivative of the same product, we should 
at least equalize the penalties if we are going to penalize physicians 
even if there were some rationale for doing it out in the community 
which we do not believe there is and which has resulted in disparate 
imprisonment between poor people and rich people, poor people being 
typically people who take crack cocaine and rich people being people 
who take powder cocaine, the only distinction rationally that you could 
even argue. There is no reason that we ought to penalize a physician 
disproportionately under this bill.
  Now, there is something wrong with my colleagues saying one day that 
we believe in States' rights and the next day saying we are going to 
preempt Oregon's State law. That is what my amendment would have done. 
It would have protected Oregon's law in one simple phrase, the simple 
phrase being ``except in compliance with applicable State or Federal 
laws.'' This whole law could have applied. If the objective is to 
increase the use of palliative care and encourage pain relief, then we 
should not be here debating about whether to overrule a State's law.
  Unlike the physician who came to the floor who may be very skilled in 
his knowledge of medicine, I want to direct his attention to amendment 
10 to the Constitution. It says that the powers not delegated to the 
United States by the Constitution nor prohibited to the States are 
reserved to the States respectively or to the people. The people have 
the right to pass a statute in Oregon and have that statute honored and 
we should honor it here on this floor of the House.
  Mr. LINDER. Mr. Speaker, I yield 1 minute to the gentleman from 
Florida (Mr. Canady), the author of the bill.
  Mr. CANADY of Florida. Mr. Speaker, I appreciate the gentleman 
yielding time. Actually the gentleman from Illinois (Mr. Hyde) is the 
author of this legislation.
  I want to address this misconception that we keep hearing here, that 
somehow this bill will expand the investigative or enforcement 
authority of the DEA. That is simply not true. That is not what this 
bill will do. If we look at what the Attorney General said, and I do 
not agree with the Attorney General on the way she has approached the 
application of the law in Oregon, but she said, ``Adverse action under 
the Controlled Substances Act may well be warranted where a physician 
assists in a suicide in a State that has not authorized the practice 
under any conditions or where a physician fails to comply with State 
procedures in doing so.'' She herself has acknowledged that. Everyone 
who has looked at the law understands that physicians who violate a 
State law in providing a controlled substance for assisted suicide face 
penalties from the DEA. There is no question about that. That is the 
state of the law now. We are not creating any additional regulatory 
scheme. That scheme is already in place. It is very important that 
people understand that.
  Mr. MOAKLEY. Mr. Speaker, I yield 5 minutes to the gentleman from 
Michigan (Mr. Stupak).
  Mr. STUPAK. Mr. Speaker, I rise to support the rule. I am proud to 
have introduced this legislation with the gentleman from Illinois (Mr. 
Hyde) of the Committee on the Judiciary. This legislation is 
cosponsored by 150 bipartisan Members of this House.
  This legislation amends the Controlled Substances Act to clarify that 
doctors and other licensed health care professionals who dispense, 
distribute and administer pain control drugs for legitimate medical 
purposes of alleviating a patient's pain or discomfort

[[Page H10874]]

are permitted to do so even if the use of these drugs may increase the 
risk of death.
  This bill also reinforces current Federal policy that the 
administration, dispensation or distribution of a controlled substance 
for the purpose of assisting in a suicide is not authorized by the 
Controlled Substances Act. We make clear that the Attorney General in 
implementing the Controlled Substances Act shall not recognize any 
State law permitting assisted suicide or euthanasia.
  This legislation reflects the hard work of many, many people and many 
organizations. We have brought the hospice organizations on board to 
support this legislation. In addition to the National Hospice 
Organization, this bill is supported by the American Medical 
Association, Hospice Association of America, American Academy of Pain 
Management, American Society of Anesthesiologists, American College of 
Osteopathic Family Physicians and C. Everett Koop.
  Some organizations and Members as we have heard today are concerned 
that this bill would chill the doctor's ability to prescribe pain 
medication. Nothing could be further from the truth. Currently, doctors 
run afoul of the Controlled Substances Act if their actions cause or 
contribute to the fatal or near fatal overdose of drugs. In essence, 
the current standard for enforcement by the DEA is whether or not the 
use of controlled substances by a doctor served a legitimate medical 
reason. That is the standard. The bill makes clear that the Controlled 
Substances Act allows doctors to administer drugs for the purpose of 
relieving pain. This has always been the Federal policy and it remains 
the Federal policy under this legislation.
  If the critics would examine the first sentence of section 101 of the 
bill, they will see that the bill provides for a safe harbor for 
aggressive treatment of pain, even if the treatment increased the risk 
of death. The second sentence of the same provision limits the safe 
harbor, because without it people could always claim they were 
assisting suicide in the treatment of pain.
  I urge my colleagues to listen to the criticism and compare it to the 
actual language of the bill and I am confident that my colleagues are 
inaccurate who criticize this bill.
  H.R. 2260 does a lot more than provide a safe harbor for the 
treatment of pain. Last year in the Committee on Commerce, we debated 
the Assisted Suicide Funding Restriction Act. Many Members expressed 
concern that the lack of palliative care in this country was 
responsible for the helplessness that many chronically ill patients 
feel that lends to assisted suicide. The bill addresses those concerns 
as we amend the Public Health Services Act to authorize the development 
and advancement of scientific understanding of palliative care. The 
agency is directed to collect and disseminate protocols and evidence-
based practices for palliative care with priority for terminally ill 
patients. The bill also amends the Public Health Services Act by 
authorizing a program for education and training in palliative care.
  This bill ends assisted suicide and relieves pain. This legislation 
makes sense. It makes clear and again reinforces the current Federal 
policy that under the Controlled Substances Act, the distribution of a 
controlled substance for the purpose of assisting in suicide is 
illegal. The legislation gives physicians the ability to treat 
patients, to provide palliative care and increase our understanding of 
palliative care. The bill reinforces the written policy of the Federal 
Government and the administration, and I quote from that policy, that 
it ``strongly opposes the practice of physician-assisted suicide and 
would not support the practice as a matter of Federal policy.'' What we 
are doing here is reinforcing Federal policy that has always been on 
the books.

  Vote for the Pain Relief Promotion Act of 1999. Stand up for 
palliative care for terminally ill patients and their families and 
stand up against assisted suicide. Vote ``yes.''
  Mr. LINDER. Mr. Speaker, I am pleased to yield 3 minutes to the 
gentleman from Arkansas (Mr. Hutchinson).
  Mr. HUTCHINSON. I thank the gentleman for yielding me this time.
  Mr. Speaker, I rise in support of the Pain Relief Promotion Act. This 
bill is good legislation because it is simple, it is straightforward 
and it addresses the concerns of every family member who has ever held 
the hand of a loved one who is in pain and near death.
  The gentleman from North Carolina (Mr. Watt) for whom I have high 
regard raised the concern about States' rights and are we violating 
this. First of all, it is very appropriate and necessary that Congress 
legislate on this issue in order to retain a uniform national standard 
over controlled substances. This is very important.

                              {time}  1130

  I want to harken back to the gentlewoman from Connecticut who raised 
an issue and said this is a new role for the DEA. This is not a new 
role for the DEA. The DEA does not have the final judgment over this.
  I was United States Attorney. I actually had to prosecute a doctor 
for dispensing controlled substances without a legitimate medical 
purpose. It appeared to me that that was the case, that they were just 
putting out controlled substances without any good medical reason for 
it. Well, we went to a jury on that case, and the medical community 
came in, and they gave testimony and said it was for a legitimate 
medical purpose. They reviewed that and said it was appropriate, and 
then the jury made a decision on that.
  That is how the system presently works, but the problem is because of 
the issue of physician-assisted suicide and because of the chilling 
impact and the concern of physicians they are not dispensing pain 
relief medication because they are concerned that they could be second 
guessed that it is not for legitimate medical purpose.
  So what this does is it tightens it, it makes it clear, it tells the 
DEA that we cannot look into it if it is to relieve pain. We want to 
make it clear and provide the guidance for physicians. We want to 
remove that chilling impact so that they can appropriately administer 
pain medication without concern that they are going to be second 
guessed by someone that it is not for legitimate medical purpose.
  But we also clarify that if they have the intent to cause the death 
of someone, then they cross the line. They cross the line, and that 
will not be accepted medical purpose. It will not be accepted in our 
society, and so we are drawing a clear line of distinction there that 
gives the physician the guidance that they need, it takes the 
discretion away from a DEA agent, and it follows the same path that we 
have handled in our cases under the Controlled Substances Act for 
decades and decades.
  And so this should be helpful to the physicians, but it should be 
very helpful to our society and to the patients who need the pain 
medication, who want a higher quality of life as death approaches or 
they have a terminal illness; but it makes it clear that in our society 
that doctors honor the Hippocratic Oath that they will protect and 
enhance the quality of life. I ask support.
  Mr. LINDER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Kansas (Mr. Moran).
  Mr. MORAN of Kansas. Mr. Speaker, I thank the gentleman for yielding 
this time to me.
  Mr. Speaker, I speak today in support of H.R. 2260, the Pain Relief 
Promotion Act, and in support of this rule. This legislation will 
establish that the practice of assisted suicide and euthanasia are 
neither legal nor condoned medical procedures in this country. In 
addition, this legislation is a significant step forward in our efforts 
to effectively encourage pain management for terminally-ill Americans.
  For those who have concerns with this measure, I would encourage them 
to read the bill language. The legislation is explicit that it does not 
affect health professionals providing care and treatment even in the 
case of accidental death. In fact, H.R. 2260 encourages, encourages 
physicians to provide the full range of treatment to alleviate pain and 
suffering for their patients.
  Physicians in the hospice community have endorsed this bill, and the 
evidence is clear that banning assisted suicide does not deter pain 
relief. I would encourage any remaining skeptics to look at the 
experiences in my home State of Kansas and other States

[[Page H10875]]

 where similar measures have been implemented. The concern by the 
opponents of this legislation is that it would deter the use of pain 
medications such as morphine.
  While I was a member of the State Senate, Kansas first enacted 
legislation to ban assisted suicide in 1993 and then again strengthened 
those protections in 1998. The evidence in our State of Kansas is 
clear. The use of morphine to alleviate pain has not declined and in 
fact has risen significantly. In 1993 Kansas health professionals 
administered roughly 561 grams of morphine per 100,000 individuals. Six 
years after the ban on assisted suicide, morphine prescriptions rose to 
4,573 grams, a significant increase, not a decrease.
  Mr. Speaker, rather than encouraging euthanasia, we need to 
aggressively pursue effective pain management. Today, we have the 
technology and medication to successfully control pain. This 
legislation establishes education and training initiatives to ensure 
that health professionals recognize the array of pain management tools 
that are available to them. I encourage my colleagues to support this 
rule and to ultimately support the passage of this act.
  Mr. LINDER. Mr. Speaker, I yield 2 minutes to the gentleman from Iowa 
(Mr. Latham).
  Mr. LATHAM. Mr. Speaker, I thank the gentleman for yielding this time 
to me, and I just rise in support of the rule and, as a cosponsor of 
the bill, obviously for passage of this.
  I really believe that we are on a very slippery slope when we look at 
the sanctity of life and the quality of life, and it is a very personal 
issue with me. I have an 87-year-old father who has advanced 
Alzheimer's; and as my colleagues know, we could question what the 
quality is or what the value of that life is, but to my mother who has 
been married, they have been married for 61 years, and that is her life 
every day, is to go to the home, visit my father, and there is 
extraordinary quality there.
  And my parents have worked very, very hard all of their lives, and 
they are fortunate that they have enough money saved up that they are 
able to pay for their care. I am very concerned that on this slippery 
slope, if we have the opportunity for a third person to make decisions, 
life and death decisions for folks, who is going to live and who is 
going to die in the case of my father as an example. My father is able 
to pay for his care. If we have a third person, a bureaucrat who is 
making a decision for a ward of the county or of the State, what is 
their decision? I think we have to look very, very closely at the 
direction we are heading in this country. This bill allows my father, 
if he were to go into pain, have real problems, to get that kind of 
treatment. But it is wrong, it is very wrong, for someone else to make 
that decision to take his life and for other motivations that may be 
outside of his own well-being, obviously.
  So again, on a very personal level I rise in support of this rule and 
in support of the underlying bill.
  Mr. MOAKLEY. Mr. Speaker, I yield 30 seconds to the gentleman from 
Oregon (Mr. Wu).
  Mr. WU. Mr. Speaker, I rise in opposition to the rule and to address 
an issue placed on this floor by the gentleman from Oklahoma concerning 
whether there is a constitutional right involved in this debate or not. 
I commend to the gentleman the Bill of Rights amendment number four, 
the right of the people to be secure in their persons shall not be 
violated, and amendment 10, the powers not delegated to the United 
States, et cetera, are reserved to the States or to the people.
  I submit to my colleague that 208 years ago the founders of this 
republic foresaw this day when the rights of the few would be trampled 
by the political fears of the many, and that is why these amendments 
are in this Constitution.
  Mr. LINDER. Mr. Speaker, I yield 2 minutes to the gentleman from 
Oklahoma (Mr. Coburn).
  Mr. COBURN. As my colleagues know, I thank the gentleman for his 
words. I actually take that a completely different way. One does have 
the right to be secure, which means nobody has the right to take their 
life, nobody; and I would put forth to this body that if our Founding 
Fathers thought we killed 3 to 5 million unborn babies a year in this 
country, they would be sickened of heart at how we have not held on to 
the very principles of life, liberty and the pursuit of the qualities 
that go along with life and liberty.
  There is not a stronger States' rights person here than me, but with 
the tenth amendment gives no right to take someone's life. We do have a 
Constitution of the United States; and if it was my own State, 
Oklahoma, had passed the Oregon law, I would be here fighting them 
because not only are they wrong constitutionally, they are wrong 
morally; and our founders founded this country on the basis of moral 
beliefs and the beliefs of a higher being that endowed us with 
inalienable rights, but one of those rights was not the right to take 
someone's life.
  Mr. MOAKLEY. Mr. Speaker, I yield 5 minutes to the gentleman from 
Massachusetts (Mr. Frank).
  Mr. FRANK of Massachusetts. Mr. Speaker, to begin, I will 
respectfully dissent from the notion that this should be settled by the 
moral views of the Founding Fathers. They were very wise people in 
deciding how government should be structured, but people who spent a 
lot of time protecting the institution of slavery are not my moral 
instructors in all things.
  What we have is a decision that we have to make, not people who lived 
200 years ago, and the question is: does an individual who has been 
found competent, not a third party, because the Oregon law that is here 
under assault from the majority, the Oregon law that would be 
effectively repealed by this action of the United States Congress, the 
Oregon law twice passed by a referendum by the people of Oregon that 
would be undone, makes it clear that there is not a third party 
involved. The person themself must have made the decision that they 
want assistance in committing suicide and they must be found competent 
to do so.
  Now we can argue about the role of the DEA and this and that, but 
that is not what got any of us here. We are talking about two 
fundamental philosophical questions. One is the right of a State to 
make decisions. We have traditionally said that where there is no need 
for a national uniform policy we will leave it to the States, and 
Members have said, ``Oh, no, we have to have a uniform drug policy.''
  Well, we have to have uniform policy sometime for manufacturing. It 
is true if we are talking about manufacturing a substance in one State 
to be sold in every State it has to be uniform, but why the need for 
uniformity here? Is it the fear that someone will be in Idaho and 
mistakenly think she is in Oregon? Is it that someone will be in Oregon 
and forget and think they are in Washington? We are talking here about 
a specific discrete physical act, the act of someone being assisted in 
ending a life which he or she has decided, being of sound mind, that 
this life is no longer supportable.
  There is no confusion. Everyone will know where the person is. There 
is no need for uniformity except, as the previous speaker said, if we 
decide to impose nationally the moral judgment of the Federal 
Government on this issue, and clearly the people of Oregon knew what 
they were doing; they were put to this twice.
  They have twice decided that a sound individual, an individual of 
sound mind who finds life insupportable, who finds pain overwhelming, 
who finds paralysis in which they could do nothing but lay in bed 
intolerable, that that individual has the right to ask for assistance 
in committing suicide. And remember what I assume we are talking about, 
people who clearly would have the right, and I assume no one is 
interposing a Federal objection to suicide if the individual is capable 
of doing it. So the question is whether individuals who are not 
physically capable themselves and would otherwise have the right to 
commit suicide can ask someone, being of sound mind, to do that.
  Now clearly there is no reason why the Federal Government has to 
intervene. There is no need for uniformity here. The existence of a 
right of assisted suicide in Oregon has no effect in Massachusetts or 
Oklahoma or Washington State unless someone wanted an individual to be 
transported there. But clearly the need for uniformity simply reflects 
a desire of people here to impose their moral views on the people of 
Oregon who have been found to be morally deficient in this particular 
regard.

[[Page H10876]]

  Now that is a perfectly rational argument, but it is not one we can 
make and still be a States' rights proponent.
  Let me also say, by the way, that the arguments about including 
palliative care, et cetera, those really cannot be made here because 
the gentleman from North Carolina pointed out he had a perfectly 
sensible amendment that would have preserved every aspect of this bill 
except its impulse to overturn the Oregon law. His amendment would have 
allowed every single other factor of the bill and say and because of 
that the Committee on Rules unfortunately would not allow it.
  So the only thing that is at issue between us is this decision to 
overturn the Oregon law, and now we get to the philosophical issue: 
Does an individual have the control of his or her own life; does an 
individual have the right to say it is my life and I am in charge of 
it, and that includes the right to decide that it should be ended?
  And we have people who believe philosophically, some out of a 
religious belief, some out of some other set of philosophical belief, 
that that is not true, one's life does not belong to them. We, the 
government, the national government of the United States, we, the 
Congress, can say to them: no, they may not do that.

                              {time}  1145

  We do not care how much pain one is in. We do not care how much one 
is tormented. We do not care how much, and I believe in many cases the 
psychological pain of being confined, rigid, being only a mind and 
nothing else, being totally dependent on others for everything else, 
and perhaps combining that with some pain, that is irrelevant. We will 
decide. We will decide under what conditions one will live. We will 
compel one to live against one's will.
  That is what we are saying here, we, the United States Government, 
will compel one to live against one's will even though the people of 
one's State decided otherwise, because we have a moral framework which 
excludes one's right to end one's life.
  I do want to have one other point here. We say, well, this is not 
interfering with States' rights, because these are federally controlled 
substances, so the Federal Government has the right to control them. 
The fact that we regulate something in one regard does not mean the 
Federal Government owns it. What is at stake here is a decision by the 
Federal Government to impose the moral views of a majority of this 
House on the people of the State of Oregon.
  Mr. LINDER. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, nearly 50 years ago, Doctors Watson and Crick were given 
the Nobel Prize in medicine for discovering the stuff of life. They 
defined deoxyribonucleic acid, DNA. Twenty years ago, Dr. Crick 
suggested seriously in Great Britain that people reaching the age of 80 
ought to be eliminated because they were very expensive and not 
productive. That is the casual attitude about life and death that we 
ought not let States undertake.
  This bill does two substantive things. It adds protections for 
doctors who use medications to treat pain, and it applies a 1970 law on 
controlled substances equally across 50 States. All States must abide 
by that law, irrespective of Oregon's decision to exempt itself from 
it.
  If Texas chose to exempt itself from a national law in deadbeat 
parents, would we sit by and say, well, that is fine; they had a vote, 
it is not our business? If New York voted to allow no welfare reform 
and allow people to stay on welfare forever, would we sit back and say 
that is fine, it is not of our business, they voted?
  Federal laws should be abided by equally by 50 States, and we have a 
1970 Controlled Substances Act that Oregon has chosen to exempt itself 
from. This law would change that. Must we treat life with more dignity 
than we are in Oregon? Should we allow people to take their lives or to 
ask others to take their lives? We think so.
  Two decades ago, a Methodist pastor was in Connecticut Hospital in 
serious pain from cancer and wrote a letter to Bill Buckley, the 
editorialist. He said, ``I have spent a great bit of time thinking 
about suicide and praying about it. But then I concluded that I have no 
right to take away what God has given me on this Earth. I do, however, 
have the right to pray for early release from this diseased ravaged 
carcass.''
  We have no right to take away what God has put on this Earth or 
asking our friends who are doctors to take it away. But this bill is 
not about that. This bill is about saying that 50 States must abide 
equally by national laws, in this instance the 1970 Controlled 
Substances Act.
  Mr. Speaker, I yield back the balance of my time, and I move the 
previous question on the resolution.
  The previous question was ordered.
  The resolution was agreed to.
  A motion to reconsider was laid on the table.

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