Another Battle over Assisted Suicide

By Pretzer, Michael | Medical Economics, December 2, 1999 | Go to article overview

Another Battle over Assisted Suicide


Pretzer, Michael, Medical Economics


On the surface, the Pain Relief Promotion Act of 1999, which prohibits physicians from using controlled substances in the assistance of patient suicide, seems superfluous-if not a little silly. Superfluous because much of the territory it covers is already dealt with by the Controlled Substances Act and by state laws. Silly because anyone prioritizing the nation's problems would rank substance abuse by physicians for the purpose of euthanasia near the bottom.

But when the House passed its version of the bill (HR 2260) in late October, it became obvious that opinions about the issue run strong and deep. The bill divides organized medicine-the American Medical Association in favor, and the American Academy of Family Physicians and several state medical societies in opposition-- and puts some of the country's foremost physician politicians at odds with each other.

Part of the problem is the Pain Relief Promotion Act's ambiguity. Prescribing a controlled substance is okay if the purpose is to alleviate pain-even though the,drug's use may increase the risk of death. But prescribing with the intent of causing death is not okay. The act seems to outlaw a hard-to-discern motive rather than a specific action.

Critics claim the act will cause physicians to think twice before prescribing pain relievers, for fear their motives will be misinterpreted by the Drug Enforcement Administration and other authorities. Proponents, on the other hand, say the act will shield physicians: For the first time, the law will recognize that inherent in the use of drugs to lessen pain is the danger of hastened death. The act "explicitly acknowledges the medical legitimacy of the double effect," says Yank D. Coble, the AMA's secretary-treasurer.

Compounding the problem is the question of the bill's true purpose. Is the Pain Relief Promotion Act supposed to protect individuals who wish to die with the help of a physician?

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