Measure Filled With Pain

Decent intentions have gone awry in a bill by Rep. Henry J. Hyde (R-Ill.) that Congress has fast-tracked for House and Senate votes in the coming week. In an attempt to outlaw assisted suicide, the measure would also make doctors less likely to prescribe adequate painkillers for terminally ill patients.

Hyde, saying he was concerned that Oregon’s implementation in January of a law allowing physician-assisted suicide would encourage the practice in other states, introduced the bill in June to overturn the Oregon law. The bill, however, also authorizes federal Drug Enforcement Administration agents to investigate any doctor who prescribes “a controlled substance” in amounts that might be lethal and revoke a doctor’s license if it finds any evidence of intent to hasten death. But who would decide, since tolerances to such drugs can vary wildly?

Hyde’s bill has rightly inspired a chorus of opposition from medical groups, including organizations like the American Medical Assn., which staunchly oppose any legalization of physician-assisted suicide. The groups argue that the Hyde bill would further discourage doctors from prescribing adequate pain control at a time when they are already undermedicating. One recent study found that of nearly 900 physicians caring for cancer patients, 86% reported that most patients were undermedicated for pain.

Since pain and suffering are the leading reasons patients seek to commit suicide in the first place, Hyde’s bill, by discouraging doctors from relieving severe pain, would only exacerbate the problem it was meant to solve.

The bill is peppered with impractical provisions. For instance, it requires pharmacists to record the medical factors that led a physician to prescribe a painkiller, a literally impossible task. Should the pharmacist guess wrong, the entire pharmacy could lose its ability to dispense all federally controlled drugs, not just the one in question.

The biggest problem with Hyde’s bill is that it puts the DEA, which by its own admission has no experience in pain management, in charge of medical decisions that 90% of Americans say ought to be left to doctors, their supervising medical boards, patients and their families.

Hyde is right to be concerned that the growing field of “palliative care,” which uses painkillers to make patients comfortable in the final stages of a disease--could be abused by unscrupulous health care providers simply wishing to trim the expenses they incur in caring for terminally ill patients.

But the solution to that problem does not lie in Hyde’s punitive, ill-conceived legislation, which House and Senate leaders irresponsibly scheduled for a vote without allotting the discussion time that would have enabled Congress to understand the ways in which the bill would overturn existing medical practices in America.

First, Congress should defeat this bill. Then lawmakers could let doctors and their patients safely and responsibly discuss how to best bring needed comfort and dignity to the terminally ill.