Today, the Judiciary Committee is holding a hearing on H.R. 2260, the Pain Relief Promotion Act. Its Senate companion, S. 1272, was introduced by Senator Nickles of Oklahoma.

Similar legislation has been considered by this Committee in the past. During the 105th Congress, the Senate Judiciary Committee held a hearing on S. 2151 and reported it to the Senate on September 24, 1998. In this Congress, the Pain Relief Promotion Act was passed by the House of Representatives on October 27, 1999, by a substantial 271-156 vote. In addition, the Senate HELP Committee held a hearing on this legislation late last year.

The Pain Relief Promotion Act has two main purposes: First, it encourages practitioners to prescribe and administer controlled substances to relieve pain and discomfort. Practitioners should be encouraged to treat pain aggressively even when the treatment may increase the risk of death. Almost every member of the committee has known someone who has confronted unbearable pain in an end-of-life situation. And we all understand that the medical community must be able to exercise certain discretion in ministering to those patients in these situations. Title I of the bill instructs HHS through the Agency for Healthcare Research and Quality to undertake activities that will promote and advance scientific understanding of pain management and palliative care.

This legislation states that alleviating pain with controlled substances in the usual course of medical practice is a legitimate medical purpose. Because pain treatment and palliative care are protected by a safe harbor is one reason why there is substantial support for this legislation from health care providers.

The second purpose of this legislation is to prevent the dispensing of controlled substances for causing death or assisting someone in causing his or her own death. This includes the practice of physician assisted suicide.

I believe that this practice is abhorrent. The question of how people should conduct their lives when confronted by a terminal disease involves intensely personal moral and religious issues. The old and wise principle of first, do no harm is irreconcilable with assisted suicide. I think the majority of the members of this committee agree with me.

In other words, aggressive pain management should be encouraged and assisted suicide using federally controlled substances should not be permitted under any circumstances. I do not think reasonable people will have any difficulty discerning the difference.

Let’s not forget why we are here. This bill simply tries to correct an erroneous, soft-headed interpretation of Title 21 of the Controlled Substances Act. Attorney General Reno, with her eye on the Oregon law, reinterpreted an existing federal statute in a fashion contrary to then DEA Administrator Constantine, our nation’s chief drug enforcement officer. Administrator Constantine had taken the traditional and legitimate view that the CSA does not permit controlled substances to be used to bring about assisted suicide or euthanasia. Unfortunately, the Attorney General chose to interpret the statute so that Oregon would be granted an exemption and, thus, Oregon’s physicians would be allowed to use controlled substances when assisting in a suicide.

The irony of this decision is that even the President has signaled his opposition to the practice of assisted suicide. Through this legislation, the statute will be applied consistently to all 50 states -- no exemptions will be granted just because a state like Oregon has approved an assisted suicide referendum.

But, let me make it clear that this bill does not direct DEA to launch a major investigatory initiative into the pain management arena. In fact, to address the concerns of health care providers, the substitute bill that I will offer during the Committee’s mark-up of H.R. 2260 contains a provision that is neither in the House bill nor the Senate companion bill.

The new provision, modeled on the legislation reported out of this Committee during the 105th Congress, establishes the higher clear and convincing evidentiary standard for DEA administrative hearings involving allegations of assisted suicide or euthanasia. I know DOJ and DEA oppose this higher standard. However, when we completed our mark-up in 1998, I pledged to the members of this Committee – to Senators Leahy and Feinstein -- that I would continue to work to see whether we could develop a broader consensus on this bill. I believe it is proper for Congress to make a strong statement about the need for state-of-the-art pain management and palliative care and to restore the original intent of our drug laws relative to assisted suicide.

Several groups who adamantly opposed the bill from the 105th Congress now support it. These groups include the National Hospice Organization, the Hospice Association of America, the American Academy of Pain Management, the American Society of Anesthesiologists, the Pain Care Coalition, and the American Medical Association. Without objection , I would like to include in the record a list of over 40 organizations and 20 prominent individuals.

Finally, I want to thank all of our witnesses who have taken time out of their busy schedules to be with us today. I certainly appreciate your willingness to share your views with us on this important issue.

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