My letter to the LA Times and the front-page story that inspired it.
Editors, Los Angeles Times:
RE: "House Appears Set to Criminalize Assisted Suicide"
It is difficult to read a "senior administration official" claim that
President Clinton has "allegiance to states rights" and have the Times
report "Clinton has walked a tortured course, threading between his moral
objection to assisted suicide and his support of states rights."
Clinton's Justice Department has for 15 months run roughshod over
California's states rights by denying me the use of medical marijuana to
keep down my nausea-producing AIDS medications. It plans to try me on
federal marijuana charges beginning November 16 and send me to prison for a
mandatory ten years, a certain death sentence considering my health. My
doctor agrees that the inability to keep down my AIDS medication--which
medical marijuana did successfully for two years prior to my arrest--is
rapidly hastening my death. All this despite the passage of Proposition 215
by 56.4 percent of the California electorate--far more than voted for
Clinton in the same election.
Clinton's "allegiance to states rights" apparently becomes
"tortured" when a
physician moves to end the suffering of a willing patient at the end of
life, but evaporates altogether when his Justice Department overrides state
law to end the life of someone who wants very much to live.
Los Angeles Times
October 22, 1999
House Appears Set to Criminalize Assisted Suicide
By ALISSA J. RUBIN, Times Staff Writer
WASHINGTON--Congress is looking to stymie the nascent
movement in the
states to make doctor-assisted suicide legal for the terminally ill.
The House is set to approve legislation today that
nullify Oregon's law allowing physician-assisted suicide for terminally ill
patients--the only such law in the country. The bill also could serve to
dampen support in California and a few other states with legislative
committees that are considering laws similar to Oregon's.
The measure on the House floor today would explicitly
make it a
crime--regardless of state law--for doctors to prescribe controlled
substances such as morphine with the intention of hastening death. Violators
would face mandatory prison terms--up to 20 years for the prescription of
morphine, one of the most commonly prescribed painkillers.
Although doctors could continue to prescribe
in lethal doses, most say that other available drugs would have to be taken
in doses too large to be practical or with too high a likelihood of botched
and painful results.
Doctors in Oregon say that, if the legislation becomes
law, they would
be forced to stop helping terminally ill patients end their lives.
The Senate will take up a similar bill by early next
Clinton, an ardent opponent of physician-assisted suicide, has sent signals
through the White House staff and the Justice Department that he will
consider signing the legislation but wants to see softer penalties for
doctors and a few other changes.
The administration's most recent letter to Congress
evaluating the bill
avoids any mention of a veto. "The administration strongly opposes the
practice of physician-assisted suicide and would not support the practice as
a matter of federal policy," said a Justice Department letter personally
approved by Clinton to House Judiciary Committee Chairman Henry J. Hyde
(R-Ill.), according to senior administration officials.
The letter spelled out concerns, however, about the
harsh penalties and
about the "heavy-handed" way in which the bill would preclude states
adopting policies authorizing physician-assisted suicide.
"This is a difficult issue for the
president," said another senior
administration official. "It plays into his personal abhorrence to
physician-assisted suicide and his allegiance to state rights. . . . They
are competing issues for him."
At stake is not only the future of the movement to make
suicide legal but also the willingness of doctors to use aggressive
pain-control measures for terminally ill patients. Even now, studies suggest
that doctors undertreat pain in terminally ill patients in 40% to 80% of
their cases and that they frequently cite the fear that law enforcement
officials will question prescriptions of high doses of painkiller, whether
or not the medication hastens death.
Much like abortion, physician-assisted suicide is a
issue that divides along ideological rather than party lines. Although a
majority of House members is expected to approve the bill today, there is
much disagreement about what might be constitutional and what might be
"On each side of this debate people have often
failed to think about
the contextual realities," said Walter Dellinger, the former solicitor
general who argued before the Supreme Court against a constitutional right
Given managed health care's emphasis on controlling
health costs and
the high cost of health care, there is a risk that some patients could feel
pressured into choosing the less costly option of assisted suicide--a point
often lost on proponents of assisted suicide, Dellinger said.
"And those who would use criminal bans are not
being sensitive to how
it would chill . . . limited use of powerful pain medication for people who
are in terminal suffering," Dellinger said.
In Oregon, whose voters twice approved
policymakers are frustrated by the assault from Washington.
"This bill . . . will make it risky for physicians
to be as aggressive
as they should be in treating terminally ill patients," said Mark Gibson,
who advises Oregon Gov. Jon Kitzhaber on health and human services. "I'm
sure what these folks are trying to accomplish."
Hyde, a sponsor of the bill, pointed out that it was
changed to make
clear that aggressive pain control would not be grounds for investigation or
prosecution. Doctors could prescribe all the controlled substances necessary
to alleviate pain, even if the effect is to hasten death, as long as the
intent is not to assist in a patient's suicide.
"We must take steps to kill the pain, not the
patient," Hyde said. He
urged his colleagues to vote for the bill to ensure "that powerful drugs
under federal control are used to eliminate pain and suffering, not to
eliminate our fellow Americans."
The bill also would authorize $5 million annually to
enforcement agents and doctors in appropriate pain treatment and to
establish protocols for treating severe pain. Many law enforcement officers
and even doctors are not aware that the dosages necessary to quell severe
pain at the end of life can run at least 500 times more than would be
appropriate for patients who had not already developed a tolerance for the
Doctors and experts in pain treatment are split on the
American Medical Assn. and the National Hospice Assn. support it, but nine
state medical associations, including those in California, Oregon and
Washington, signed a letter opposing the bill as an intrusion into the
sensitive area of pain treatment at the end of life and states' prerogative
to regulate the practice of medicine.
Clinton has walked a tortured course, threading between
objections to assisted suicide and his support of states' rights. The
Justice Department's most recent take on the issue left the president leeway
to go either way on whatever bill ultimately reaches his desk.
In 1997, Clinton signed a ban on using federal funds
programs as Medicare, Medicaid and the military health-care system for
assisted suicide. The previous year, arguing what were thought to be
Clinton's personal views, Dellinger told the U.S. Supreme Court that there
is no constitutional right to assisted suicide.