Congress is considering a bill, the Lethal Drug Abuse Prevention Act
of 1998, which would keep the terminally ill from receiving adequate
doses of painkillers. While this bill is meant to prevent
physician-assisted suicide, it would have an adverse effect on
end-of-life care.

It requires that in instances in which a patient using
physician-prescribed narcotics dies, the incident be investigated. The
Drug Enforcement Administration will have to question the patient's
grieving family to divulge information to an investigator about the
most private of family matters -- the circumstances of a loved one's
death.

While the bill is being proposed ostensibly to prohibit dispensing of
narcotic drugs for the purpose of hastening death, a laudable goal,
the legislation will seriously impair a physician's ability to
prescribe narcotics in doses necessary to overcome a terminally ill
patient's pain.

The burden would be on the physician to prove to the DEA that the drug
was needed to relieve pain, not hasten death. Even if a physician were
ultimately exonerated, the damage would be done. A physician would be
left with no choice but to question how effectively he or she could
treat other patients in the future.

These patients represent the sickest of the sick and deserve to get
the best care possible. If this bill were passed, it would stop the
profession's progress in its tracks. The American College of
Physicians -- American Society of Internal Medicine opposes this
legislation, which will have an adverse effect on end-of-life care.

Mahendr S. Kochar Professor of Medicine and Pharmacology Medical
College of Wisconsin