[Congressional Record Volume 163, Number 20 (Monday, February 6, 2017)]
[House]
[Pages H998-H1001]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
EXPRESSING STRONG OPPOSITION TO D.C.'S ASSISTED SUICIDE PROGRAM
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 3, 2017, the gentleman from Pennsylvania (Mr. Rothfus) is
recognized for 60 minutes as the designee of the majority leader.
Mr. ROTHFUS. Mr. Speaker, I rise here tonight to raise a very serious
and consequential issue that is taking place in our Nation's capital.
Washington, D.C., our Federal city, the second hometown of every
American, is just weeks away from implementing a deadly assisted
suicide program.
The D.C. City Council recently passed a so-called Death With Dignity
Act, which would allow adults who have been diagnosed with a terminal
disease and who have been told they have 6 months or less to live to
receive a prescription from their doctor to end their life. Six States,
including California, Oregon, Vermont, Washington, Montana, and
Colorado, have already headed down this dangerous path.
I raise this issue tonight, Mr. Speaker, because our Founders gave
Congress the power in the Constitution to ``exercise exclusive
Legislation in all Cases whatsoever over such District'' that would
become the seat of the Government of the United States.
As a result, this Congress has the opportunity to stop this law. I am
grateful that my colleagues are here tonight to join me: Dr. Wenstrup,
Mr. Jody B. Hice of Georgia, Dr. Harris, Dr. Hartzler, Dr. Marshall.
They are joining me tonight to speak in defense of patients who deserve
protection, especially when dealing with the unimaginable difficulty of
a terminal disease.
Like me, they are deeply troubled that in Washington, D.C., an
alabaster city that gleams as a beacon for the principles on which we
were founded, this policy is about to be put in place, jeopardizing the
lives of the most vulnerable among us.
Mr. Speaker, Washington, D.C., is, indeed, a remarkable city. I still
remember coming to this special place as a 10-year-old child with my
parents, coming down the George Washington Parkway in Virginia, as
millions of other tourists have, with excitement to see our national
monuments and the Capitol in which I now speak.
We Americans approach this city with awe, as we know how Washington
is intertwined with our Nation's history and that this city both guards
our Nation's founding documents--the Declaration of Independence and
the Constitution--and hosts the very government that our Constitution
envisioned. Those founding documents frame a Republic grounded in the
principles of sovereignty in the people, subject to the protection of
God-given inalienable rights, among them the right to life, liberty,
and the pursuit of happiness.
Nowhere, Mr. Speaker, in my opinion, is the view of this city more
beautiful than from the hills of Arlington Cemetery in Virginia and,
specifically, the resting place of our 35th President, John F. Kennedy.
One cannot think of President Kennedy without thinking also of his
inaugural address, which is a call to action for a new generation of
Americans. That call was grounded in the exceptional nature of our
land.
{time} 1930
``And yet,'' President Kennedy said, ``the same revolutionary beliefs
for which our forebears fought are still at issue around the globe--the
belief that the rights of man come not from the generosity of the state
but from the hand of God.''
D.C.'s assisted suicide law, Mr. Speaker, threatens the inalienable
rights of vulnerable citizens. Not only does the new D.C. statute tear
at the tapestry of our Nation's founding, it directly contradicts the
Hippocratic oath every physician takes, to do no harm.
I shudder to think of the lives that will be lost because our society
tells the weak, the despairing, the suffering, or the hopeless that
suicide is the best option for them. Laws similar to the D.C. Death
with Dignity Act in the U.S. and Europe have resulted in individuals
being pressured to end their lives, and insurance companies covering
the reimbursements for suicide treatment but not for other care.
If patients find themselves unable to pay for expensive treatments
out-of-pocket, they may find their options severely limited when facing
a new diagnosis, facing a disability, or struggling with mental
illness. In some cases, death may become the only affordable option.
Proponents of physician-assisted suicide point to real and tragic
stories of suffering individuals at the end of their lives. However,
according to a report by the National Institutes of Health, pain is not
the primary factor motivating patients to seek a lethal dose of
medication. More commonly cited motivations include depression,
hopelessness, and the loss of control or autonomy. Allowing physicians
to prescribe lethal medications to these patients would mean we are
abandoning our Nation's most vulnerable citizens and, instead,
succumbing to a culture that is worse than the disease.
Instead of death and despair that are the underlying principles of
assisted suicide, our laws should reflect a culture that promotes life
and hope, even in our suffering, even in our illness, and even in our
weakness.
Jeanette Hall of Oregon was diagnosed with cancer in the year 2000.
She was a supporter of her State's assisted suicide program, and she
even voted for it. She considered taking her own life with the help of
her physician when she learned she only had 6 months to live.
Thankfully, she had a life-affirming doctor who simply asked her how
her son, who was attending the police academy at the time, would feel
about it. This made her stop and think.
His question inspired her to opt for radiation and chemotherapy,
instead of suicide, and, over a decade later, she is still sharing her
testimony. She is extremely happy to still be alive.
I have no doubt that Americans like Jeanette with chronic illnesses,
disabilities, or struggling with mental illness will be exploited under
this law, and perhaps even encouraged to pursue suicide rather than
continue living until natural death. This dangerous trend is already
taking shape in the six States that have legalized physician-assisted
suicide. Precious lives have already met a premature end.
Mr. Speaker, there is dignity in all human life, and the root meaning
of dignity is worth. Nothing--not illness, not weakness, or despair--
can decrease the worth of a human life. I cannot stand idly by and
watch our laws corrupt our culture.
I am thankful to be joined by several of my colleagues who refuse to
let this dark policy move forward unchecked. With that, I would like to
yield to my colleague from Ohio (Mr. Wenstrup). Dr. Wenstrup is a
physician. He has served our country in the Army Reserves having
deployed to Iraq to treat our wounded servicemembers. Dr. Wenstrup, is
the prime sponsor of H.J. Res. 27, which will overturn this misguided
legislation.
Mr. WENSTRUP. I appreciate that, and I thank you for yielding and
thank you for taking the charge on this this evening to share this
message.
Mr. Speaker, first, do no harm. Do no harm. These are three short
words, but, to physicians, they represent a sacred charge--three short
words that now hang in the balance here in the District of Columbia
after the D.C. Council passed the Death with Dignity Act legalizing
physician-assisted suicide in the Nation's Capital.
In authorizing doctors to violate the Hippocratic oath of ``do no
harm,'' physician-assisted suicide undermines a key safeguard that
protects our Nation's most vulnerable citizens: the disabled, the sick,
the poor--a key safeguard that helps to ensure our loved ones receive
the best medical care when they need it the most.
Instead of simply providing end-of-life comfort and a potential for
cure, D.C.'s new law is poised to do more harm than good. This act
leaves patients unprotected, doctors unaccountable, and our most
vulnerable citizens at risk of having fewer medical options at their
disposal rather than having more. It is too broad. This act allows
adults diagnosed with a terminal disease having less than 6 months to
live to receive a prescription for medication to end their life on
their own--alone.
There are concerns that the definition of ``terminal disease'' is too
broad since most doctors will admit that accurately predicting life
expectancy is almost impossible; and it is. There are many conditions
such as diabetes or HIV--they are considered incurable or
[[Page H999]]
irreversible, and they are terminal if left untreated. There are many
diseases that are terminal if left untreated, but curable if treated.
This bill fails to accurately protect patients from coercion or
abuse. Despite the fact that depression is commonly associated with a
patient seeking assisted suicide, D.C.'s legislation does not make
screening for mental illness mandatory. It also has no safeguard
against pressure that family members or heirs might exert on a patient
to choose suicide.
It leaves doctors unaccountable. Compliance with the bill's limited
safeguards is difficult to track because the bill directs doctors not
to place the actual cause and manner of death on the death certificate.
It doesn't say ``suicide.'' The report requirements in the bill are not
subject to the Freedom of Information Act. Perhaps most concerning of
all, once the prescription for lethal medication is filled, oversight
is nonexistent. There is no requirement to ensure that the prescription
was used as intended.
This could limit care. Under the new law, patients may end up with
fewer options, not more options. D.C. residents who are not able to pay
for health care out of pocket may find their options limited when
facing a new diagnosis, suffering from a chronic illness, facing a
disability, or struggling with mental illness. For certain medical
conditions, assisted suicide could become the cheapest option.
Ultimately, whatever its intentions, D.C.'s new law puts patients at
risk and could limit their access to high-quality health care. It could
limit their access to cures. It prioritizes cost over compassion, cost
over care. We have weighed this legislation. We have looked at it
seriously, and we find it very wanting. D.C. residents deserve better.
Twenty-two years ago, my sister was diagnosed with an incurable
cancer, and she had very little time to live. She was, at one point,
given the option of a bone marrow transparent, and her insurance said:
It is experimental. We don't cover it.
We had to fight that, and we were going to do it anyway. It is 22
years later. She survived. She is doing well. She is married and has
two children, but somebody was telling her: It is not worth it.
This affects people with disabilities. This affects the poor. This
attitude reminds me of a comment from the movie, ``It's a Wonderful
Life'' when Mr. Potter says to George Bailey: ``George, you're worth
more dead than alive.'' That is not who we are, folks.
In this bill, there is no verification or validation that the
prescription was taken as intended, for the person intended, or even
taken at all. There is no witness necessary, no provider to address any
complications that may occur when taking the medications, no assurance
that it is not misused or used on someone else, and no actual cause of
death is reported.
In this, they say: ``Actions taken in accordance with this act do not
constitute suicide, assisted suicide, mercy killing, or homicide.'' Oh,
really? Maybe they should look up the definitions of those words. The
definition of homicide is the killing of one person by another whether
intended or not. The definition of suicide is the act of taking one's
own life voluntarily and intentionally.
This bill is bad for the people of D.C. This is bad for America. This
is not who we are. This is not who we are as a compassionate, caring
group of Americans--especially caregivers, especially doctors. We can
do better, and we all need to stand up against this.
Mr. ROTHFUS. Dr. Wenstrup, I thank you for introducing this
legislation and for having the courage to live the life you have lived
in serving our Armed Forces overseas.
I yield to the gentleman from Georgia (Mr. Jody B. Hice) who co-
chairs our Values Action Team.
Mr. JODY B. HICE of Georgia. I thank my friend and colleague for
leading this Special Order and for taking the leadership on this very
important issue.
Mr. Speaker, I am here to try to implore our leadership to bring H.J.
Res. 27 to the floor and, hopefully, to enable us, the Members of the
people's House, to strike down this deeply flawed and deceptively
written Death with Dignity Act that has been passed in the District of
Columbia.
This is not a bill about the elderly. It is not a bill about the sick
and dying, as has been stated here. This is a bill that legalizes
suicide. It actually attempts to normalize euthanasia. As you know, Mr.
Speaker, this bill applies to individuals with ``a terminal disease.''
We all know that could be applied to almost anyone. We could have
someone with diabetes, for example, who is able to live a perfectly
normal life, in spite of the fact of having an insulin dependency, but
without the insulin, it could be terminal--they would be. So this bill
applies to individuals who also may have been misdiagnosed.
I appreciate Mr. Rothfus mentioning Jeanette Hall. What a powerful
story that is--someone who actually voted for this bill in Oregon, and
then a few years later comes to find out that she herself has cancer.
She tries to have her doctor help her end her life. The doctor urges
her to fight to have treatment. She does so, and now 16 years later,
she is alive and healthy.
There is no reason for us to have this bill. If you look at the
suicide rate in Oregon since that bill was passed in that State in
1997, they have 42 percent above the national average of suicide in
that State.
I appreciate Dr. Wenstrup, too. Just the flaws that he identified
that this bill has are alarming. The fact that it, more than likely,
will--certainly, the potential is there--lead to elder abuse. The bill
has no requirement that the death certificate lists the real cause of
death. It will just be required to say ``natural causes'' when, in
fact, there was a lethal drug injected. The drug itself is not required
to be disclosed. The bill does not require a medical professional to be
present to administer the lethal drug.
Furthermore, as was alluded to a moment ago, the bill bars law
enforcement and, arguably, courts from reviewing medical records at the
Department of Health, effectively potentially preventing them from
doing their jobs in cases where there may have been foul play.
Mr. Speaker, please know that this does not simply apply to D.C.
residents but to those who reside in D.C., which would include everyone
in this House.
I urge my colleagues to join in cosponsoring H.J. Res. 27. I urge our
leadership to bring this to the floor for a vote. I thank the gentleman
for giving me the opportunity to speak.
{time} 1945
Mr. ROTHFUS. I thank Representative Hice.
Mr. Speaker, this law, the point about what is going to go on the
death certificate, we have had a debate lately in our country about
alternative facts, and here we have a law that says you can't say on
the death certificate what the cause of death was. It's going to be
poison. It's going to be some administered drug that is not supposed to
be used as it was intended, as it was authorized by the FDA to be used,
but for a whole other purpose--to end the life of somebody. I think
that is a very serious concern. I think, again, this is at war with
truth and at war with logic.
Mr. Speaker, I yield to the gentlewoman from Missouri (Mrs.
Hartzler). Vicky co-chairs our values action team with Mr. Hice.
Mrs. HARTZLER. Thank you very much, Representative Rothfus. I
appreciate so much your leadership on this issue, as well as Dr.
Wenstrup, bringing this very, very necessary bill to the floor. Time is
of the essence, and literally lives are at stake. Sometimes you hear
that discussed here, well, this bill is going to impact life. This one
truly does. This is a life-or-death matter with just a time limit.
The way that this works is that the Constitution gives Congress
authority over the District of Columbia. While they can have their own
council and they can make laws, we have ultimate oversight as elected
Representatives of this country over what happens here. When they pass
a bill here allowing death to occur by physician-assisted suicide, we
have the opportunity and we have the obligation to step in and to say
no.
As Representative Rothfus said, this is the people's town. This is
representative of our entire country here, and this does not represent
what we stand for, that if someone has an awful diagnosis that they are
encouraged and enabled to be able to take their own life without any--
any--oversight in this.
[[Page H1000]]
We have got to reject this. That is why we are here tonight.
The statistics are staggering. Suicide is the tenth leading cause of
death across the spectrum of ages, and the death toll is, sadly, on the
rise. Nearly 43,000 individuals took their own life in 2014. Now, that
is a heart-wrenching number of people desperate and seemingly without
hope and whose solution to traumatic life situations, clinical
depression, or mental disorders was to take their own life.
But another, more sinister layer to this suicide crisis in America
arises when agents of healing become distributors of lethal dosages.
Five States now and the District of Columbia have legalized physician-
assisted suicide.
The taking of human life is a criminal act in nearly every State and
throughout the Federal Code; yet a few regions of the country, sadly,
have embraced the tragic idea that it is better to prescribe death than
to provide life-sustaining care, and they are tasking the medical
profession, those sworn to provide and take care of people--they have
tasked them with carrying out this ghastly deed.
So you go to your doctor on one hand when you have an illness or your
child is sick and you are asking and expecting the doctor to be looking
out for your best interests and to prescribe medicine to help you get
better, and then the next day you are tasking that same physician--you
are supposed to go back and ask them to kill your relative and
prescribe death medicine? This is wrong.
But here is another sobering fact: legalizing physician-assisted
suicide can lead to an increase in overall suicide rates. That was just
what was shared by Representative Hice, what has exactly happened in
Oregon, with an over 40 percent higher rate of suicide there than in
other places. So if you are concerned about suicide prevention, you
should be concerned about efforts to normalize doctors prescribing a
bottle of pills intended to end a patient's life.
Physician-assisted suicide preys on the sick, the elderly, and the
disabled. The frail are the most vulnerable to rising healthcare costs,
elder abuse, and physician-assisted suicide. There is no accountability
should a family member, friend, or medical provider determine that a
particular patient is too sick, too old, or too disabled to continue
living. Any doctor can write a prescription, and no witness is
required.
Physician-assisted suicide shreds human dignity by legally and
subjectively distinguishing between a life worth living and a life
better off dead. The focus should be on improving healthcare options,
palliative, and end-of-life care for terminally ill patients, not
killing those suffering from sickness or disease.
So I call on my fellow Members of Congress to pass the resolution of
disapproval sponsored by Dr. Brad Wenstrup to reject D.C.'s dangerous
policy and to ensure that all Americans, including those here in the
District of Columbia, are granted the basic right to life.
Mr. ROTHFUS. Mr. Speaker, I thank Representative Hartzler for coming
to the floor tonight and speaking on this bill. It is interesting that
legalizing assisted suicide can lead to an increase in suicide. We
spend hundreds of millions of dollars in our country on suicide
prevention. It would seem that laws such as the one that the District
of Columbia has passed really go against that fundamental public policy
that we have in this country of saying no to suicide.
With that, it is a real privilege for me to yield to the gentleman
from Maryland (Mr. Harris). Andy Harris is another physician whom I
serve with who has served in our Nation's military.
Mr. HARRIS. Mr. Speaker, I want to thank the gentleman from
Pennsylvania for yielding to me.
The gentleman just brought up an interesting point. It is true that
in the Netherlands, when they reviewed their experience, they found
that just legalizing physician-assisted suicide actually increases the
amount of nonphysician-assisted suicide. It sends the wrong message. It
absolutely sends the wrong message.
I want to thank the good doctor from Ohio for introducing this bill
because certainly the Nation's Capital is one where we should be very
careful since the Constitution has entrusted us with approving or
disapproving the laws in the Nation's Capital. It behooves Congress to
take a good look at a law like this, the so-called Death with Dignity
Act. Now, that is striking because most people don't associate suicide
with dignity in any way, shape, or form, and for good reason. But I
will get to that.
There are a lot of myths associated with the bill. First of all,
assisted suicide somehow offers patients more choices. It actually
doesn't. What it does is it actually sends a very strong message that
regardless of the many types of disease you might have and the many
types of treatment that may be available, there is one final, common
pathway that the State--in this case, the District--would now say is
perfectly acceptable. In fact, it is not only perfectly acceptable, it
is legal to actually go to a physician and ask them to participate in
your suicide. That doesn't lead to more choice; that ultimately leads
to less choice.
But the use of the word ``dignity'' is striking to me because the
number one group of individuals, if we would collectively look at how
we would describe those individuals to whom this applies, really, are
individuals with some kind of disability, perhaps with a disease or
disability that, according to the law, two physicians would just have
to agree, knowing how imperfect the idea to predict lifespan is, that
those could result in death in 6 months. Associating that kind of
problem with the ultimate outcome of death by suicide I think removes
dignity. It doesn't add dignity to anyone's life.
Worse than that, what we have done now and what we have seen in terms
of the functional reduction of choice is that, according to many of the
new payment systems for health care in this country, you actually align
the incentives of the patient's health care from top to bottom.
What do I mean by that?
Now over half the physicians in the country no longer work for
themselves; they are employed by entities. Frequently, these entities
share the same financial risk as the physicians in terms of their being
driven to save money. That is it. There are numerous incentives to save
money within the law. If you don't believe me, go back and read the
Medicare rules and regulations.
In fact, it should be noted that in the Netherlands, where assisted
suicide has been legal for years, the average age for women is 65 who
participate; for men it is 62. That means, Mr. Speaker, almost half the
individuals are Medicare patients. There are powerful incentives built
into Medicare to save money--powerful incentives--accountable care
organizations, for instance, where the physician who is the patient's
attending physician happens to work for the same healthcare system that
shares in financial incentives if money is saved.
Mr. Speaker, I would proffer--and I think any Member who is against
this legislation and for the Death with Dignity Act should stipulate
that, clearly, it saves money to give someone a $300 prescription for
secobarbital rather than pay for expensive cancer therapy or expensive
therapy that might cure a patient. That doesn't give a patient dignity.
That doesn't add to their dignity. What that does is it now places the
patient in the situation, if they truly understand the financial
incentives in the system, to actually question whether their physician
is doing the right thing for them.
In fact, the consulting physician under the Death with Dignity Act
doesn't have to belong to a different financial entity. A physician
working for this healthcare entity who actually saves money through the
act of suicide can send the patient right across the hall to a
consulting physician to agree, that consulting physician being a part
of the same accountable care organization. That is wrong. But that is
the situation patients will find themselves in, questioning whether
their physician has a financial incentive to write that lethal
prescription.
Now, the other straw man that is set up very frequently, and if you
look at the Pew Research study that asks people their opinion, ``Do you
think we should allow death with dignity?'' they frequently mention
only one situation: a patient with terminal disease in extreme pain.
But, Mr. Speaker, the data
[[Page H1001]]
is that only 20 percent of patients who seek physician-assisted suicide
have pain as their primary reason.
Now, we are all compassionate people. Every human being has suffered
pain, some human beings more than others, and it is not hard to
understand how someone answering that poll question thinking of a
patient with terminal illness in severe pain, knowing what pain is
about, how difficult it is to treat pain unless it is done with the
most modern methods, might say, yeah, maybe dying is better. But, Mr.
Speaker, that is a straw man: 80 percent of patients say it is
something else; 92 percent saying it is losing autonomy--losing
autonomy.
Our solution to losing autonomy in a patient or being less able to
engage in activities making life enjoyable, 90 percent of patients
saying that, society's solution is to write a lethal prescription?
I will tell you, I am most troubled--and I will close with this. As a
physician, I went into medicine to actually help people, to help people
get better. That is why people go into health care. That is why my
daughters became nurses. They became nurses to help people get better.
God knows that is what we want to do. That is true compassion.
But now to say that if a physician, against their Hippocratic oath,
shall prescribe a medication that knowingly kills a patient--and let's
not mince words. That is what the Death with Dignity Act does. It says
a licensed practitioner with a license to heal now has a license to
kill--knowingly kill--a patient put under their care. That is a step,
Mr. Speaker, I would offer that, as a society, we should take a long
and hard look at before we ask our healers to, effectively, become
killers.
Mr. ROTHFUS. Mr. Speaker, I thank Dr. Harris for taking a long, hard
look at what is going to happen here in the District of Columbia if we
do not bring H.J. Res. 27 to the floor to block this misguided
legislation.
Dr. Harris talked about compassion. Certainly, we all have family
members, we all have friends who have had very difficult illnesses, and
we have been at bedsides when people have passed.
{time} 2000
It is good to know that we have palliative care that is available to
help people in pain, to make sure that they are getting everything they
can without having a doctor violate his or her Hippocratic oath to do
no harm.
I really thank Dr. Harris for his words and for reminding us how he
was called to the healing arts. He has got family members engaged in
the healing arts.
Mr. Speaker, I yield to the gentleman from Kansas (Mr. Marshall),
another Representative that we are joined by this evening, a newer
member from the Big One, I think it is called, also having served in
the Army Reserve. He did not do his physician's work in the Army
Reserve, because I don't know what the rules are with women
servicemembers and giving birth, but certainly we have women
servicemembers giving birth. I don't think they are overseas, although
they may be in Germany and other places. I don't think they are going
to be in a war zone.
Certainly, he has got plenty of experience. He has delivered over
5,000 babies. He certainly has seen his share of difficult cases with
patients. It is good to have him here this evening to talk about this
legislation.
Mr. MARSHALL. Mr. Speaker, I rise tonight with fellow physicians and
other colleagues to speak out against the shameful act being allowed in
some parts of this country: physician-assisted suicide.
When I became a physician, I took an oath in which I promised to help
the sick and to abstain from all intentional wrongdoing and harm. To
help intentionally take the life of a patient is morally abhorrent.
It is not only the beginning of a slippery slope that devalues the
sanctity of all human life. It is not only based on a subjective set of
qualifications lawyers and lobbyists agree to. It is against the very
oath that my fellow physicians swear to uphold. I encourage my
colleagues to fight for these same beliefs, to treat life as sacred,
and, first of all, to do no harm.
Mr. ROTHFUS. Mr. Speaker, it is simple: this Congress has a
responsibility. The Founders made us, this Congress--the House and the
Senate--the stewards of this city, this beautiful Federal alabaster
city. The Founders vested in us the exclusive legislative power over
the District of Columbia.
H.J. Res. 27, which will block the so-called D.C. Death With Dignity
Act, is a bill that goes to the character of this Congress, to the
character of the District, to the character of this country.
Will this Congress allow this law to go into effect?
For the vulnerable, I hope not. For the physicians who are supposed
to heal, I hope not.
Earlier in my remarks, I talked about how beautiful it is to look at
this city from Arlington and to recollect our 35th President and the
inspiring words he spoke on January 20, 1961. He ended that address
with these words: ``With a good conscience our only sure reward, with
history the final judge of our deeds, let us go forth to lead the land
we love, asking His blessing and His help, but knowing that here on
earth God's work must truly be our own.''
Mr. Speaker, let's lead the land we love. Let this House move ahead
with H.J. Res. 27 and prevent this legislation, the D.C. Death With
Dignity Act, from staining our Nation's capital.
Mr. Speaker, I yield back the balance of my time.
____________________