MANAGING PAIN

States' rights have become an issue in legislation setting new
national standards for easing the pain of severely or terminally ill
patients. The House of Representatives passed the legislation recently
and a companion measure is pending in the Senate.

Both would overturn Oregon's physician-assisted suicide law and
prevent other states from adopting similar laws. That's where the
states' rights issue comes in. But, ironically, it is liberals, not
conservatives, who have raised it.

Rep. John Conyers, D-Mich., protested that the House bill "imposes a
Washington-knows-best solution on a state that has twice affirmed the
will of its people that physician- assisted suicide in limited cases
is permissible."

Oregon lawmakers argued it was hypocritical for Republicans to
overturn a law approved by Oregon voters.

The House bill had the strong backing of the Republican leadership and
its chief sponsor is Rep. Henry Hyde, R- Ill., one of the party's
leading conservatives.

The measure did not specifically cite the Oregon law but instructs
U.S. attorneys general "to give no force and effect to state law
authorizing or permitting assisted suicide or euthanasia." So far,
Oregon's is the only law to be affected.

Hyde asserted the Oregon law has made doctors "messengers of death"
and asks them "to play the role of hired gun." The House bill, on the
other hand, upholds the sanctity of life while allowing aggressive
treatment of pain, he said.

Rep. Tom Coburn, R-Okla., who is a physician, insists the bill "would
encourage pain management even if the use of (narcotics)
unintentionally hastened death."

In a recent criticism of the bill, columnist Ellen Goodman noted that
"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." True.

But the lack of clear guidelines has caused many doctors to err on the
side of non-treatment. The House bill sets forth standards --
reasonable, workable ones, apparently, since the bill is endorsed by
the American Medical Association. It should be passed. ---