[Congressional Record (Bound Edition), Volume 146 (2000), Part 15]
[Senate]
[Pages 22124-22125]
[From the U.S. Government Publishing Office, www.gpo.gov]



  AMERICAN CANCER SOCIETY'S POSITION ON THE PAIN RELIEF PROMOTION ACT

  Mr. WYDEN. Mr. President, on October 4, 2000, I did not correctly 
state the American Cancer Society's position on S. 1272, when I stated 
that they ``. . . strongly opposed . . . the Pain Relief Promotion 
Act.'' Their actual position, taken directly from their recent 
statement on the legislation, is as follows:


[[Page 22125]]

       . . . The American Cancer Society appreciates the 
     commitment shown by the sponsors of the legislation to 
     address these issues, but unfortunately is unable to support 
     this legislation as written . . . Careful analysis of the 
     House-passed measure and a substitute version of the Senate 
     bill . . . have serious potential to exacerbate the current 
     problem of under treatment of pain. While there are 
     provisions to proactively address pain and symptom 
     management, the Society maintains that any benefit from such 
     provisions would not outweigh the potential threat posed by 
     the changes to CSA. Furthermore, neither section of the bill 
     comprehensively addresses the needs of providers, patients, 
     and families for ongoing support and education to counter the 
     current problem of under-treatment of pain--a problem that 
     often leads to requests for physician-assisted suicide . . . 
     Under the Act, all physicians and particularly physicians who 
     care for those with terminal illnesses will be made 
     especially vulnerable to having their pain and symptom 
     management treatment decisions questioned by law enforcement 
     officials not qualified to judge medical decision-making. 
     This can result in unnecessary investigation, and further 
     disincentives to aggressively treat pain.
       Unfortunately, `intent' cannot be easily determined, 
     particularly in the area of medicine where effective dosage 
     levels for patients may deviate significantly from the norm. 
     The question of deciding intent should remain in the hands of 
     those properly trained to make such decisions--the medical 
     community and state medical boards. The Pain Relief Promotion 
     Act seeks to hold harmless any physician who treats a 
     patient's pain even if death occurs, and the measure attempts 
     to create a `safe harbor' provision in an effort to shield 
     physicians whose use of federally-controlled drugs 
     unintentionally hasten or cause death. However, this 
     provision does not change the fact that the DEA would now 
     explicitly be charged with overseeing the medical use of 
     controlled substances, resulting in a negative impact on 
     cancer pain treatment. . .

  The American Cancer Society statement concluded with the following 
observation:

       The American Cancer Society has engaged in a deliberative 
     process to evaluate the impact of the Pain Relief Promotion 
     Act on our Quality of Life goals for all people living with 
     cancer. Its analysis included a review of existing Society 
     policies on pain and symptom management and opposition to 
     physician assisted suicide. We have concluded that as 
     written, the Pain Relief Promotion Act would ban the use of 
     federally controlled substances for physician-assisted 
     suicide at the expense of controlling pain and advancing 
     symptom management. These issues are both critically 
     important, but are separate issues. While the Society 
     strongly opposes all patient deaths stemming from assisted 
     suicides, we must give heavier weight to the more than 1500 
     individuals who die of cancer every day in this country--more 
     than half of whom die in pain unnecessarily. Moreover, the 
     American Cancer Society believes that the best approach to 
     help cancer patients and reduce and prevent assisted suicide 
     is through the adoption of proactive policies and the 
     provision of resources to prevent and ameliorate pain and 
     suffering in people with cancer, especially for those at the 
     end-of-life.

  I appreciate this opportunity to clarify the position of the American 
Cancer Society on S. 1272.

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