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HOW HE SEES IT Assisted suicide cannot be permitted



Published: Sun, April 28, 2002 @ 12:00 a.m.



By ERIC CHEVLEN, M.D.

SPECIAL TO THE VINDICATOR

The Vindicator's editorial concerning physician-assisted suicide in Oregon was wrong on the facts and wrong on the law. Your readers deserve a better understanding of this important issue.

The practice of medicine is regulated by both state and, to a lesser extent, federal laws. The state grants physicians the license to practice medicine. The role of the federal government is far more limited. It regulates the prescription of a small number of drugs which have abuse potential, the so-called controlled substances. The barbiturates, powerful and potentially dangerous sedatives with no pain-relieving properties, belong to this class of drugs.

For some 30 years, the federal Controlled Substances Act has regulated the prescription of controlled substances. To minimize the potential harm of controlled substances, Congress mandated that they be prescribed only by practitioners who were licensed by the Drug Enforcement Agency . Congress also demanded -- and who could argue with this? -- that the prescribing of the controlled substances be done only for legitimate medical purposes.

Legitimacy

Until quite recently, there was never any argument over the meaning of the term legitimate medical purposes. Every doctor knew that he could not simply sell prescriptions for cash. He could not swap prescriptions for sexual favors. He could not use prescribed drugs to commit homicide, even if the victim consented or participated in that act.

There was never any question about all this. The meaning of the law was plain, and it was buttressed by numerous uncontroversial court decisions.

This clarity and integrity of the federal law was challenged, however, after the passage of Oregon's notorious physician-assisted suicide law. The question arose: if an Oregon practitioner is in compliance with the admittedly loose requirements of that state law, may he prescribe a barbiturate to kill his patient? The head of the DEA said no: a state law cannot change the fact recognized by federal law that killing people is simply not a legitimate medical purpose. State law is subordinate to federal law.

Then-Attorney General Janet Reno overruled him. She said, in effect, that federal law must yield to state law. In 49 states, killing patients with controlled substances would remain an illegitimate medical act, punishable under the CSA. Only in Oregon would assisting a suicide would be considered a legitimate medical purpose under the federal law.

Attorney General John Ashcroft restored the law to the original meaning intended by the Congress as expressed by the law's passage and in numerous acts since then. The federal government will not allow its authority to be used to kill depressed, sick, and vulnerable people.

Other drugs permitted

It is important to note that, contrary to the errors of your editorial, federal law does not prevent physician-assisted suicide in Oregon. It merely forbids the use of federally controlled substances to commit it. Many other drugs can be used to commit this act. A physician who uses a federally controlled substance to assist a suicide in Oregon under the terms of the state law may lose his DEA license to prescribe controlled substances, but will not be prevented from "writing prescriptions for any drug." He will still be allowed to practice medicine. This is not heavy-handedness on the part of the attorney general but restoration of the proper balance of federal and state law.

The answer to human suffering is not assisted suicide, but compassion and palliative care. The answer to a state's dereliction in its duty to protect vulnerable human life is not federal acquiescence, but steadfast adherence to principles of law and federalism.

X The writer is a cancer and pain specialist, and co-author of the recently published "Power Over Pain -- How to Get the Pain Control You Need.




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