[Congressional Record (Bound Edition), Volume 145 (1999), Part 18]
[House]
[Pages 25662-25663]
[From the U.S. Government Publishing Office, www.gpo.gov]



                   PAIN RELIEF PROMOTION ACT OF 1999

  Mr. BLUMENAUER. Mr. Speaker, this week H.R. 2260, the so-called Pain 
Relief Promotion Act will be brought to the floor of this chamber. The 
bill's supporters say passage will result in more humane treatment of 
terminally-ill patients. Tragically, they are mistaken.
  This bill's passage will do two things. It will overturn Oregon's 
death with dignity law, and it will undermine the rights of States to 
establish medical standards. It also puts law enforcement agencies in 
the position of second-guessing one of the most difficult medical 
decisions faced by doctors: how to best alleviate the pain terminally-
ill patients suffer, whether or not that treatment involves life-ending 
decision-making.
  Congress is frequently put in a position of judging whether to 
intervene in the States' decisions. Some judgments are relatively easy 
to make. For example, we now have reached the point where most people 
are comfortable with the Federal Government protecting against racial 
discrimination. Such was not always the case. Many decisions, however, 
are very much in a gray area, which some choose, unfortunately, to use 
for political reasons. One such gray area, the issues that affect the 
end-of-life decisions, is not only difficult but personal.
  In my State of Oregon we have struggled, debated, and agonized with 
this issue throughout the last decades. The end-of-life issue is a very 
complex one. With the advent of new medical technologies, it is 
becoming even more challenging. There are a wide range of moral and 
medical issues associated with end-of-life decisions, but none that 
require Federal interference. Yet Congress is being asked to pass 
legislation that would undermine a law passed and subsequently upheld 
not once but twice by a vote of the citizens of Oregon.
  Now, our death with dignity legislation is still a work in progress, 
but the preliminary evidence suggests that this option may actually 
reduce the incidence of suicide. Rather than having a flood of people 
to our State to take advantage of the provisions of the law, it appears 
that individuals having the knowledge that they, their families, and 
their doctor can control this situation, gives them a sense of peace 
and contentment that enables many to move forward, enduring the pain 
and the difficulty without resorting to taking their own life. It may 
actually reduce the incidence of suicide.
  As Americans struggle with these issues, mostly hidden from public 
view, it is important that we not have the personal tragedy, that 
agony, that frustration made more difficult by laws that ignore the 
range of legitimate medical choices.
  There are some very serious technical problems with this legislation. 
It would interfere with the practice of

[[Page 25663]]

medicine, of pharmacy, of pain management in ways that can have a 
profound effect on the rights that many in America take for granted. 
This is why a large number of medical professionals have come forward 
in opposition to this legislation.
  This bill asks law enforcement agencies, not doctors, law enforcement 
agencies, to make, on a case-by-case basis, judgment as to whether a 
doctor intended a terminally-ill patient's death while trying to 
alleviate pain. Asking nonmedical personnel to determine a doctor's 
intent and subsequent causal connection is neither appropriate nor is 
it even practical. The threat of these investigations can have a 
chilling effect open the treatment of pain.
  Now, at the same time, some medical boards can and have imposed 
sanctions on doctors, including in Oregon, for not treating pain 
aggressively enough. So here we have put physicians in an impossible 
situation: On one hand nonmedical activities second-guessing them and 
being sanctioned; on the other hand for not being aggressive enough.
  Today, doctors help deal with end-of-life decisions everywhere in 
America; and, in some cases, I guaranty that every day in America there 
are the equivalent of physician-assisted suicides. In every State but 
Oregon people look the other way. Oregon stands out because we have at 
least attempted to provide a framework. If this misguided legislation 
were to be passed, ironically, Oregon, the only State with guidelines 
where we are trying to deal with it, would be subjected to 
extraordinary scrutiny. Elsewhere, people would continue to look the 
other way.
  I strongly urge the defeat of this ironically termed Pain Relief 
Promotion Act before it undermines not only the will of the people of 
Oregon, but also before it damages the sanctity of the doctor-patient 
decision-making process and erodes quality end-of-life medical 
treatment.

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