CONGRESS BECOMES A PAIN TO OREGON'S 'DIGNITY' LAW

BOSTON - And you thought the war on drugs was about keeping cocaine
out of the country and heroin out of the kids. Guess again. If the
bill that flew out of the House last week becomes law, those intrepid
folks at the Drug Enforcement Administration will be given
encouragement to go after doctors as if they were dealers.

The bill was titled, in the best Orwellian fashion, the Pain Relief
Promotion Act. In fact, it was a buffed and shined-up version of last
year's loser, the Lethal Drug Abuse Prevention Act.

Both bills to prevent the use of federally controlled substances by
doctors assisting suicides were deliberately aimed at overthrowing the
law approved by the voters in Oregon. But this year, the sponsors
added a few bucks for pain management and changed the name. They
convinced their colleagues that this was an easy way to oppose
doctor-assisted suicide while proving you were sympathetic to dying
patients, aka "I feel your pain."

According to the sales and spin, the bill that passed wouldn't affect
doctors who prescribed substances like morphine for pain relief, even
if the drug unintentionally caused death. But it would punish the
doctors who prescribed these substances intentionally to cause death.

As Illinois' Henry Hyde declaimed, "We believe doctors should help
people cope with the pain and terror of death, not thrust death upon
them." A fellow sponsor, Charles Canady of Florida, added, "We draw a
bright line here."

A bright line? The line between a dose that controls pain for the
terminally ill and a dose that ends up hastening death is one of the
murkiest in medicine. The bill doesn't say how doctors would walk this
line or how they would prove their intent.

If the companion law in the Senate passes, and the whole mess survives
a states' rights test, doctors could be sentenced to 20 years in
prison. Anybody could drop a dime and the DEA could be left to decide
the doctors' motives.

Joanne Lynn, the head of Americans for Better Care of the Dying,
opposes both assisted suicide and this law. But she can imagine signs
posted around hospitals saying: 1-555-CALLDEA. To put it bluntly, she
says, "Ordinary record-keeping and conversations would be insufficient
to protect us from prosecution."

The House bill was described by the media and the sponsors as a litmus
test on assisted suicide. It gave Hyde et al. a chance to thumb their
noses at Oregon voters, not to mention the voters in California and
Maine, where doctor-assisted suicide is going on the ballot.

But ironically, the law wouldn't actually ban all assisted suicide; it
would just prohibit the use of certain barbiturates. Remember Jack
Kevorkian? He used carbon monoxide in his "practice." There are plenty
of uncontrolled substances that can end life.

The bill for "pain relief" could, however, increase pain. Says Oregon
Sen. Ron Wyden, another opponent of both assisted suicide and this
bill, "The undertreatment of pain is a documented crisis. If the DEA
can second-guess doctors who are already reluctant, we'll see pain
relief programs set back."

Two months ago, for the first time, a pulmonary specialist was
disciplined for undermedicating patients. We know that in the last
week of life, a third of all people suffer moderate to severe pain.
This pain is a cause for the despair that underlies many requests for
a merciful death.

In the past several years, with all the discussion about the end of
life, Oregon has actually pulled ahead of the country in both hospice
care and pain management. Only one in 10,000 Oregon deaths have been
assisted suicides. Indeed, it's possible that the rate is lower in
Oregon than in states where it's still clandestine.

If our friends in Congress actually were interested in pain relief
rather than political grandstanding, there are two other bills - the
Compassionate Care Act and the Conquering Pain Act - that would build
family support networks, fund centers for pain-management research and
require report cards on treatment for pain. Neither is given a chance
of passage.

In the past years, the war on drugs has done enormous collateral
damage to sick civilians. We keep marijuana from cancer patients,
heroin from the dying. Now, the House of Representatives wants to
encourage the DEA to sniff around doctors' prescriptions of
barbiturates. And the Senate may follow.

Whatever happened to that old slogan of the drug war? "Just Say
No."