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Six years ago, a majority of Oregonians voted for the Death With Dignity Act. In a suit filed by the National Right to Life Committee, the law was held up in the courts for three years, until the suit was finally dismissed. The Legislature insisted that a measure to rescind the law be on the ballot in 1997. But 60 percent of Oregonians said that they knew what they were doing three years before, and the measure remained law. It meant that those terminally ill, mentally competent adults who repeatedly asked for a prescription that would hasten a peaceful death would be able to get their wish. The two reports published on the Death With Dignity Act in 1998 and 1999 show that out of 60,000 people who died in Oregon during that period, only 43 took advantage of the law. They were people who valued their autonomy and wanted control of how the end came. Since 1994, Oregon has become the best place in the country for end-of-life care. It has one of the consistently highest rates of morphine use; twice as many people use hospice care there than other places in the country; and more people die at home than in a hospital. In November 1997, Representative Henry Hyde, R-Ill., contacted Attorney General Janet Reno, asking that the Justice Department intervene. In June 1998, Ms. Reno announced that the Justice Department would not step in and that the Death with Dignity Act was not a violation of the Federal Controlled Substances Act. She reminded opponents that Chief Justice William H. Rehnquist, in the 1997 Glucksberg case challenging state prohibitions against assisted suicide as a violation of the 14th Amendment, wrote that, although not a constitutional issue, physician aid in dying is a matter for the states to decide. STILL UNCONVINCED That afternoon, Rep. Hyde introduced a bill, the Lethal Drug Prevention Act of 1998, making it a federal crime for doctors to prescribe federally controlled substances with the intent to cause death. The bill, opposed by the American Medical Association and the National Hospice Organization, failed in the 105th Congress. Undaunted, in the next session Rep. Hyde, with co-sponsor Don Nickles, R-Okla., in the Senate, introduced the Pain Relief Promotion Act. This bill, a more sophisticated version of the earlier one, was written with the help of the National Conference of Catholic Bishops, which, along with the National Right to Life Committee, is its main supporter. This time the AMA and Hospice went along. One part of the act says that no doctor will be prosecuted for administering any dose of medication to a dying person as long as the intention is to relieve pain. The next part, however, reads that if the intention is to cause death, as it would be in Oregon (and as it will be in Maine), they could be subject to 20 years in federal prison and suspension of their license. Eighty million dollars is authorized for the Drug Enforcement Administration to investigate physicians’ intent. More than 40 groups, including the American Cancer Society, oppose the pain relief act because of the chilling effect it could have on the treatment of pain. The act passed the House last spring and the Senate Judiciary Committee this fall, with two crossover votes: Republican Arlen Spector of Pennsylvania voting nay with the Democrats and Democrat Joseph Lieberman voting yea with the Republicans. Ron Wyden, the Democratic senator from Oregon, threatened to filibuster if the bill came up in the Senate. For fear of election-year brouhaha and a number of cloture votes, it did not come up. Instead, it was cynically attached to H.R. 2614, a bill to raise the minimum wage. So when the Senate reconvenes, there it will be. Whether Sen. Wyden will fight on the floor, whether the bill will pass, whether our lame-duck, pro-choice president will veto it, whether there will be enough votes to override — all are questions that will make the rest of the session interesting. Oregon’s congressional delegation, governor and attorney general have urged the president to veto on the grounds that the bill is unconstitutional. The one sure thing is that there will be a 10th Amendment challenge if it does become law. It will be ironic to see the defenders of state’s rights argue that Congress should override a decision twice voted in by the people of Oregon. Ms. Girsh is the executive director of The Hemlock Society USA, based in Denver, Colo.

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