Urgently Needed Legislation on the Pain Relief Promotion Act

Cardinal Keeler's Letter to the Senate Judiciary Committee (H.R. 2260, S. 1272)

April 5, 2000

Dear Judiciary Committee Member:

As the Judiciary Committee prepares to vote on the Pain Relief Promotion Act (H.R. 2260, S. 1272), I am writing to reaffirm the strong support of the Catholic Bishops of the United States for this urgently needed legislation.

The Act is designed to promote pain management and palliative care, including the appropriate use of federally regulated drugs to control pain, without authorizing use of such drugs for assisted suicide and euthanasia. It is tragic that such clarification of federal law is needed at all; it is now long overdue.

Overall federal policy on assisted suicide has been clear since 1997, when Congress overwhelmingly approved the Assisted Suicide Funding Restriction Act. That Act was approved 99-to-0 by the Senate. It ensured that, regardless of any action a State may take, assisted suicide would not be permitted or seen as part of medical practice in federally funded programs or federal health facilities.

One program was not addressed by the 1997 law: The program by which the Drug Enforcement Administration registers health professionals to prescribe and dispense federally regulated drugs solely for "legitimate medical purposes." The relevant statute, the Controlled Substances Act, already prohibited use of these drugs to endanger "public health and safety," and had been strengthened in 1984 precisely to ensure effective enforcement against their misuse for deadly overdoses. No one imagined then that "health and safety" could be redefined to encompass deliberate use of these drugs to kill patients.

Yet in June 1998, Attorney General Janet Reno ruled that Oregon must be allowed unilaterally to redefine these terms as a matter of federal law, unless the federal statute is clarified to forbid use of federal prescribing authority to assist suicides. Because of Congress's long delay in addressing this problem, at least 43 Oregon patients have now been assisted in suicide by federal authorization -- their lethal barbiturate overdoses, in every case, prescribed using a federal DEA license.

This gross abuse of federal authority must end, so that once again no federal program will be used to support the killing of vulnerable patients. At the same time, the federal government should more fully support and promote the legitimate use of controlled substances to alleviate the pain and discomfort that can often attend the dying process.

The Pain Relief Promotion Act will serve both goals. It will provide a "safe harbor" for physicians using controlled substances for pain management and palliative care, by ensuring that aggressive efforts to control pain are protected as an integral part of legitimate medical practice under federal law. The Act will also promote better understanding of this field of medicine, not least by providing $5 million a year for education and training grants for health professionals. Finally, it will amend the existing continuing education program for DEA agents and other law enforcement personnel to help them better understand and accommodate such legitimate use of these drugs for pain management.

Our nation stands at a crossroads on this moral and social issue. Not only the medical profession, but patients and their families, as well as Americans from all walks of life, will be greatly affected by Congress's action on this legislation. We must decide whether all patients will be seen as deserving the very best that palliative medicine has to offer, because each and every patient has inherent worth and dignity up to his or her last moments -- or whether some patients will be "written off" as deserving nothing better than a lethal overdose, because someone has decided their lives are less worth protecting and the federal government can find no reason to disagree.

I urge you today to choose life and dignity over death and despair. Please approve the Pain Relief Promotion Act, and commit our government to caring solutions for patients most in need of our help.


Cardinal William H. Keeler
Archbishop of Baltimore
Chairman, Committee for Pro-Life Activities
National Conference of Catholic Bishops