US Congress Resolution H.Con.Res.79: Assisted suicide puts everyone at risk of deadly harm.

(Link to the Congressional Resolution H.Con.Res.79)

Expressing the sense of the Congress that assisted suicide (sometimes referred to using other terms) puts everyone, including those most vulnerable, at risk of deadly harm.

IN THE HOUSE OF REPRESENTATIVES
December 12, 2019

Mr. Correa (for himself, Mr. Wenstrup, Mr. Peterson, Mr. Smith of New Jersey, Mr. Langevin, Mrs. Wagner, Mr. Lipinski, Mr. LaHood, Mr. Cartwright, Mr. Harris, and Mr. Abraham) submitted the following concurrent resolution; which was referred to the Committee on Energy and Commerce.

Whereas “suicide” means the act of intentionally ending one’s own life, preempting death from disease, accident, injury, age, or other condition;

Whereas “assisting in a suicide”, sometimes referred to as death with dignity, end-of-life options, aid-in-dying, or similar phrases, means knowingly and willingly prescribing, providing, dispensing, or distributing to an individual a substance, device, or other means that, if taken, used, ingested, or administered as directed, expected, or instructed, will, with reasonable medical certainty, result in the death of the individual, preempting death from disease, accident, injury, age, or other condition;

Whereas society has a longstanding policy of supporting suicide prevention such as through the efforts of many public and private suicide prevention programs, the benefits of which could be denied under a public policy of assisted suicide;

Whereas assisted suicide most directly threatens the lives of people who are elderly, experience depression, have a disability, or are subject to emotional or financial pressure to end their lives;

Whereas the Oregon Health Authority’s annual reports reveal that pain or the fear of pain is listed second to last (25 percent) among the reasons cited by all patients seeking lethal drugs since 1998, while the top 5 reasons cited are psychological and social concerns: “losing autonomy” (92 percent), “less able to engage in activities that make life enjoyable” (90 percent), “loss of dignity” (79 percent), “losing control of bodily functions” (48 percent), and “burden on family friends/caregivers” (41 percent);

Whereas the Supreme Court has ruled twice (in Washington v. Glucksberg and Vacco v. Quill) that there is no constitutional right to assisted suicide, that the Government has a legitimate interest in prohibiting assisted suicide, and that such prohibitions rationally relate to “protecting the vulnerable from coercion” and “protecting disabled and terminally ill people from prejudice, negative and inaccurate stereotypes, and ‘societal indifference’”;

Whereas clearly expressing that assisted suicide is not a legitimate health care service, Congress passed, with a nearly unanimous vote, and President Bill Clinton signed, the Assisted Suicide Funding Restriction Act to prevent the use of Federal funds for any item or service, including advocacy, provided for the purpose of causing, or assisting in causing, the death of any individual such as by assisted suicide, euthanasia, or mercy killing;

Whereas a handful of States have authorized assisted suicide, but over 30 States have rejected over 200 attempts at legalization since 1994;

Whereas States that authorize assisted suicide for terminally ill patients do not require that such patients receive psychological screening or treatment, though studies show that the overwhelming majority of patients contemplating suicide experience depression;

Whereas the laws of such States contain no requirement for a medical attendant to be present at the time the lethal dose is taken, used, ingested, or administered to intervene in the event of medical complications;

Whereas such State laws contain no requirement that a qualified monitor be present to assure that the patient is knowingly and voluntarily taking, using, ingesting, or administering the lethal dose;

Whereas such State laws contain no requirement to secure lethal medication if unwanted or if death occurs before such medication is used;

Whereas such State laws do not prevent family members, heirs, or health care providers from pressuring patients to request assisted suicide;

Whereas such States qualify some patients for assisted suicide by using a broad definition of “terminal disease” and “going to die in six months or less” that includes diseases (such as diabetes or HIV) that, if appropriately treated, would not otherwise result in death within six months;

Whereas it is extremely difficult even for the most experienced doctors to accurately prognosticate a six-month life expectancy as required, making such a prognosis a prediction, not a certainty;

Whereas reporting requirements vary by State, but when required, rely on prescribing physicians or dispensing pharmacists to self-report;

Whereas such reporting is neither conducted by an objective third party nor of sufficient depth and accuracy to effectively monitor the occurrence of assisted suicide;

Whereas there is an astounding lack of transparency in the practice of assisted suicide to the extent that State health departments and other authorities admittedly have no method of knowing if it is being practiced within the bounds of State laws and have no funding or authority to make such a determination;

Whereas some State laws actively conceal assisted suicide by directing the physician to list the cause of death as the underlying condition without reference to death by suicide;

Whereas the confidential nature of end-of-life decisions makes it virtually impossible to effectively monitor a physician’s behavior to prevent abuses, making any number of safeguards insufficient;

Whereas the cost of lethal medication is far less costly than many life-saving treatments, which threatens to restrict treatment options, especially for disadvantaged and vulnerable persons, as has happened in several known cases and presumably many more unknown in which insurers have denied or delayed coverage for life-saving care while offering to cover assisted suicide;

Whereas access to personal assistance services such as in-home hospice and palliative care, home health care aides, and nursing care/nursing assistance is regretfully limited and subject to long waiting lists in many areas, placing systemic pressure on patients in need of such personal assistance services to resort to assisted suicide; and

Whereas for all these reasons, assisted suicide undermines the integrity of the health care system: Now, therefore, be it

Resolved by the House of Representatives (the Senate concurring), That it is the sense of Congress that the Federal Government should ensure that every person facing the end of their life has access to the best quality and comprehensive medical care, including palliative, in-home, or hospice care, tailored to their needs and that the Federal Government should not adopt or endorse policies or practices that support, encourage, or facilitate suicide or assisted suicide, whether by physicians or others.

Washington DC assisted suicide Act puts patients at risk and prioritizes cost over compassion.

This article was published by the National Review on February 3, 2017

Representatives Brad Wenstrup and Phil Roe

Two members of Congress, both physicians, urge caution.

Do no harm.” Three short words, but to physicians they represent a sacred charge. Three short words that now hang in the balance here in the District of Columbia, after the D.C. council passed the Death with Dignity Act (Act 21-577), legalizing physician-assisted suicide in the nation’s capital. In authorizing doctors to violate the Hippocratic oath of “do no harm,” physician-assisted suicide undermines a key safeguard that protects our nation’s most vulnerable citizens and helps to ensure our loved ones receive the best medical care when they need it most.

Rep Brad Wenstrup

As doctors, we are concerned about providing care and comfort to those facing the heart-wrenching difficulty of dealing with a terminal disease. It is an issue close to our hearts. However, for patients with terminal diseases who are not seeking treatment and instead coping with the complexities of end-of-life preparations, there are already a myriad of end-of-life care options currently at a patient’s disposal.

Instead of simply providing end-of-life comfort, D.C.’s new law is poised to do more harm than good. Even those disagreeing on the merits of the larger issue should take a close look at the text of Act 21-577, which leaves patients unprotected, doctors unaccountable, and our most vulnerable citizens at risk of having fewer medical options at their disposal rather than more. 

Sign the petition supporting H.J. Res 27, to reject the DC assisted suicide Act 21-577.

Phil Roe

Act 21-577 allows adults diagnosed with a terminal disease, having less than six months to live, to receive a prescription for medication to end their life. There are concerns that the definition of “terminal disease” is too broad, since most doctors will admit that accurately predicting life expectancy is almost impossible. Additionally, many conditions, such as diabetes and HIV, are considered “incurable and irreversible” or “terminal” if left untreated.

One of the greatest concerns that medical professionals have about Act 21-577 is its failure to adequately protect patients from potential coercion and abuse. When someone is considering ending his or her own life, regardless of the reason, he or she is in a vulnerable mental and emotional state. A report by the National Institute of Health found that, contrary to popular belief, pain is not the primary factor motivating patients to seek assisted suicide. More frequently cited motivations include depression, hopelessness, dependency, and loss of control or autonomy. Despite the fact that depression is commonly associated with a patient’s seeking assisted suicide, D.C.’s legislation does not make screening for mental illness mandatory. It also has no safeguard against pressure that family members, heirs, or health-care providers might exert on a patient to choose assisted suicide. This leaves some of our nation’s most vulnerable citizens — the disabled, the elderly, and those fighting mental illnesses — at the most risk under this law.

Additionally, a stunning lack of accountability is built into the bill, as doctors self-report their participation in assisted suicide and their compliance with regulation. Compliance with the bill’s limited safeguards is difficult to track because the bill directs doctors not to place the actual cause and manner of death (assisted suicide) on the death certificate, and the reporting requirements in the bill are not subject to the Freedom of Information Act. Once the prescription for lethal medication is filled, oversight is non-existent. This means that after the lethal medication, which can cause death in hours, leaves the pharmacy, it can be left unsecured in the medicine cabinet or on a bedside table. The lack of oversight opens up a number of potential nightmare scenarios: The medication could be accidentally taken by a child. It could be administered to a patient against his or her will. It could be used on an individual for whom the medication was not intended.

Perhaps most troubling of all, under the new law, patients may end up with fewer options, not more. D.C. residents who are not able to pay for health care out of pocket may find their options severely limited when facing a new diagnosis, suffering from a chronic illness, facing a disability, or struggling with mental illness. For certain medical conditions, assisted suicide could become the cheapest option. By some estimates, lethal medication costs no more than $300. The consequences could be harmful on two levels: given less incentive, innovative treatments could become less likely to develop, and then insurance programs could deny payment for costly treatment options even if they prove to be successful for many cases.

At age 53, Randy Stroup was living in Oregon after assisted suicide was legalized there. Uninsured and fighting prostate cancer, he was relying on Oregon’s state-run health plan for care when he applied for an expensive form of chemotherapy that his doctor recommended and was denied. Instead, he received a letter informing him that the state of Oregon would pay for physician-assisted suicide. As much as we wish it weren’t the case, cost factors into practical implementation of health-care policy. Because assisted suicide could end up being the cheapest “treatment,” it’s not difficult to see how patients could be incentivized to end their lives when the alternative is a costlier treatment option.

Ultimately, whatever its intentions, D.C.’s new law puts patients at risk and could limit their access to high-quality health care. It prioritizes cost over compassion. Since the Constitution charges Congress with legislative jurisdiction over D.C., Congress has a duty to carefully scrutinize this bill, its impact on medical patients, and its effects on our health-care system. We have weighed the legislation and found it wanting. D.C. residents deserve better. 

Sign the petition supporting H.J. Res 27, to reject the DC assisted suicide Act 21-577.

Brad Wenstrup, of Ohio’s second congressional district, is a member of the House of Representatives. Phil Roe represents Tennessee’s first congressional district.