Physicians for Compassionate Care Testimony against Oregon Assisted Suicide Law expansion bill.

Testimony in opposition to Oregon SB 1003
Sharon Quick, MD, MA (Bioethics)
President, Physicians for Compassionate Care Education Foundation
Expertise: Pediatric Anesthesiology/Critical Care, Medical Ethics
Senate Rules Committee June 2, 2025

I am Dr. Sharon Quick, President of the Physicians for Compassionate Care Education Foundation (PCCEF), an organization without religious or political affiliation. We advocate for the vulnerable terminally ill, promoting good palliative care. I have expertise in pediatric anesthesiology, critical care, and medical ethics. We oppose SB 1003-A Engrossed. Please see the following reasons for our opposition.

1. Reducing the waiting period to 7 days from 15 days (p. 5, lines 27-31, 40-43) does not allow adequate time to fully assess a patient who may be suffering from complex emotional/mental health/existential problems that can worsen physical pain. Mental health problems and deficits in decision-making capacity are common in the terminally ill but often missed by physicians. This bill devalues vulnerable patients suffering from disabilities—such as mental health problems, lack of capacity, psychological distress over loss of function—that will not be uncovered due to inadequate time for assessment. Nor is there time for patients to change their minds, which they often do.

a. It is unclear why there is a need to reduce the waiting period. No dying patient should have unbearable pain. Such a complaint indicates the clinician lacks knowledge about the management of complex pain—an unawareness that is far too common. Lethal drugs are a poor solution for lack of education of clinicians. Furthermore, patients in significant pain have compromised capacity to choose, invalidating consent for lethal drugs.
b. Lethal drugs do not guarantee a peaceful death; there are many contraindications and side effects to these mouth-burning, experimental concoctions. Palliative care can ensure a peaceful death to a far greater degree than lethal drugs.

2. There are good medical reasons to DISALLOW lethal drugs the closer a patient gets to death, but this bill authorizes the opposite (waiving the waiting period for patients close to death)—and allows this difficult determination by one clinician, without any defined expertise, and without a second opinion. (p. 5, lines 44-45 to p. 6, lines 1-4) PATIENTS WITHIN A WEEK OF DEATH USUALLY HAVE COMPROMISED MENTAL CAPACITY AND INABILITY TO INGEST LIQUIDS, MAKING CONSENT UNLIKELY AND INGESTION DANGEROUS.

3. Shortening and/or eliminating the waiting period provide a mechanism for anyone, whether terminally ill or not, to access lethal drugs through voluntarily stopping eating and drinking (VSED). This is happening in OR, but physicians have not been sanctioned for this abuse.

a. Voluntarily stopping eating and drinking (VSED) has been used as a “bridge” to prescription of lethal drugs in Oregon. In 2023, Oregon resident Cody Sontag, decided to commit suicide via VSED to prevent her dementia from advancing. On her fifth day of VSED, a physician assessed Cody as “terminally ill” due to dehydration, and a consulting physician concurred through telehealth. The physician determined that Cody would die within 15 days and waived her waiting period; she died by lethal drug ingestion 2 days later. This action is in clear violation of Oregon’s law which defines terminal illness as an “incurable and irreversible disease.” Dehydration is neither incurable nor irreversible, nor is it a “disease.” Additionally, dehydration reduces cognition, and this is worsened by a baseline of dementia; it is unlikely that Cody had sufficient decision-making capacity to make her consent valid. VSED could potentially be used in this way for any adult for any reason. In 2024, 179 patients (29% of those who received lethal drug prescriptions) had their waiting periods waived. How many of these patients had an induced “bridge” to lethal prescriptions like Cody? No one, including physicians, should be granted god-like powers to decide which disabilities make life worthless and to assist with termination of those so judged.

4. The bill removes the requirement for the second opinion to include evaluating patient capacity, absence of coercion, and a fully informed decision. (p. 3, lines 42-43; p. 4, lines 35-40) These are potentially more difficult assessments than determining the presence of a terminal disease, and a second opinion should be mandatory for those assessments.

5. Requiring health care facilities and hospice programs to publicly disclose their positions on participation in assisted suicide may be a conscience violation. Assisted suicide is not considered a medical procedure but unethical patient abandonment by most physicians and health care practitioners in the world. Requiring health care facilities or programs to make statements about their degree of involvement with it has the effect of making those facilities appear to agree that assisted suicide is a medical practice, even when they do not agree that it is. This is a conscience violation.

6. Changing the word “physician” to “practitioner” is confusing and unnecessary if only physicians are allowed to prescribe lethal drugs. The obvious reason for this word change is to set the stage to allow non-physicians, such as nurse practitioners or physician assistants to prescribe lethal drugs by a simple definition change of “practitioner” in line 42 on page 2 (p. 2, Sec. 3, lines 8-9, 15-17, 42). Vulnerable patients wanting to hasten death with lethal drugs risk their lives on the decisions made--they deserve the highest level of expertise from physicians. Reasons to not open the door to non-physicians:

a. Proponents have stated that rural areas lack physicians willing to prescribe lethal drugs, and advocate allowing non-physicians to participate to expand access in these areas. However, both rural access to palliative care and the number of palliative care prescribers are estimated to be insufficient to meet Oregon’s needs.1 It is a disservice to patients to potentially make lethal drugs more accessible than palliative care.
b. Medicare requires that a physician, not other types of clinicians, certify that a patient is terminally ill for hospice admission.
    i. Although physicians are frequently wrong about a 6-months prognosis, there is evidence that physicians are more accurate than nurses in prognoses.
    ii. Physicians often miss depression2 and deficits in decision-making capacity3; those with lesser qualifications should not make such judgments.
    iii. The training of physician assistants (PAs) is insufficient in end-of-life care, evaluating a patient’s decision-making capacity, determining prognosis for terminal illness, or deciding that death is imminent.4

7. Given the current abuse of Oregon’s law, allowing it to function as a mechanism for termination of people who may not be terminally ill or may be under coercion, please oppose SB 1003, which drops further safeguards. Instead, perhaps further safeguards and better oversight need to be put in place.

a. VSED, as described in #3 above, is being used as a way for non-terminally ill patients to obtain lethal drug prescriptions.
b. In Oregon, patients are getting lethal prescriptions for diagnoses of anorexia, hernia, and arthritis (Oregon 2021 Data Summary, p. 14, footnote 3)—diagnoses that are not terminal by themselves—but there is no process for challenging physician actions. Oregon, California, and Colorado have unethically provided lethal drugs to patients with eating disorders.
c. Thomas Middleton, a terminally ill Oregon resident, moved in with the trustee of his estate and then died by physician-assisted suicide in 2008. The trustee sold his house and deposited the money in her account; she was arrested on theft and criminal mistreatment charges, but whether physicians had inappropriately prescribed lethal drugs (by not properly investigating coercion) was never investigated.

NOTES
1. Only 40% of rural and 32% of suburban areas have access to hospital-based palliative care—numbers which are below both the national and Pacific region averages. (Link)
2. Oregon patients with depression have died from lethal prescriptions. Ganzini, L., E. R. Goy, and S. K. Dobscha. "Prevalence of Depression and Anxiety in Patients Requesting Physicians' Aid in Dying: Cross Sectional Survey." Bmj 337 (2008): a1682.
3. One study found that about 90% of cancer patients had deficits on some subscale of decision-making capacity, but the majority of physicians missed these deficits. Kolva, E., B. Rosenfeld, and R. Saracino. "Assessing the Decision-Making Capacity of Terminally Ill Patients with Cancer." Am J Geriatr Psychiatry 26, no. 5 (May 2018): 523-531. (Link).
4. As of 2023 only 227 PAs (0.2%) in the nation had specialty training in hospice and palliative care. This bill does not distinguish between PAs with experience/expertise and those without. (Link), p. 6

Vermont House Bill 75 to expand assisted suicide law again.

House Bill 75, if passed, would be the third expansion of Vermont's assisted suicide law.

Alex Schadenberg

Alex Schadenberg
Executive Director, 

Euthanasia Prevention Coalition

Vermont House Bill 75 (H 75) will expand the state assisted suicide law by allowing (non physicians) naturopathic physicians, nurse practitioners, and physician assistants to participate in assisted suicide.

Are naturopathic physicians, nurse practitioners and physician assistants demanding the right to be involved with killing people?
Or is it that there are too few physicians who are willing to kill?

H 75 has been referred to the Committee on Health Care.

If passed, H 75 would be the third expansion of Vermont's assisted suicide law. 

Assisted suicide laws, once legal, inevitably expand (Article Link).

When writing about Vermont's continuous expansion of their assisted suicide law I ask the question, will there ever be enough killing?

On January 5, 2024 I reported that data from the Vermont Department of Health indicated that the number of assisted suicide deaths more than quadrupled in 2022/2023 from the previous two years.

The increase in Vermont assisted suicide deaths is partly due to the expansions of the Vermont assisted suicide law.

In 2022 Vermont passed assisted suicide bill S74 which expanded their assisted suicide law by allowing assisted suicide by telemedicine, (permitting lethal assisted suicide poison prescriptions to be written without meeting the person), eliminating the 48 hour waiting period before prescribing and defining assisted suicide as a "healthcare service."

On March 14, 2023 Vermont's Attorney General's Office  reached an agreement with the assisted suicide lobby to remove the residency requirement for assisted suicide in Vermont. That means residents form other states can die by assisted suicide in Vermont. A media report  indicated that a Connecticut woman died by assisted suicide in Vermont. 

Now Vermont wants to permit expand the law by permitting other medical professionals to also be legally capable of killing their patients.

Vermont assisted suicide deaths more than quadruple.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

According to the Vermont Department of Health, the number of assisted suicide deaths more than quadrupled in the past two years. According to the report, in the past two years there were 72 reported assisted suicide deaths which was up from 17 reported assisted suicide deaths in the previous two years.

The latest assisted suicide report from the Vermont Department of Health indicates that there were 85 "reportable events" between July 1, 2021 and June 30, 2023 which was up from 29 "reportable events" between July 1, 2019 and June 30, 2021 in the previous report. The new report also indicates that since assisted suicide was legalized in 2013 there have been 203 "reportable events."

According to the Vermont report:

Eighty-four out of the eighty-five total reportable events have a death certificate on file with the Vermont Vital Records’ Office. All of the available death certificates list the appropriate cause (the underlying disease) and manner of death (natural), per Act 39 (2013) requirements.

Notice how the Vermont law requires falsification of the death certificate.

The Vermont report indicated that of the 84 death certificates, 72 died by assisted suicide, 8 died from their underlying disease, 1 died from another cause and in 3 deaths, the cause was unknown.

The report from two years ago stated that of the 29 death certificates, 17 died by assisted suicide, 10 died from their underlying disease, 1 died from another cause and in 1 death the cause was unknown.

When the cause of death is unknown, the person may have died by assisted suicide but no report was received.

The increase in Vermont assisted suicide deaths is partly due to the expansions of the Vermont assisted suicide law.

In 2022 Vermont passed assisted suicide bill S74 which expanded assisted suicide by allowing assisted suicide by telemedicine, (permitting a doctor to prescribe lethal assisted suicide poisons without directly examining the person), eliminating the 48 hour waiting period before prescribing the lethal drugs and defining assisted suicide as a "healthcare service."

On March 14, 2023 Vermont's Attorney General's Office reached an agreement with the assisted suicide lobby to remove the residency requirement for assisted suicide in Vermont. A recent media report indicated that a Connecticut woman recently died by assisted suicide in Vermont.

Court rules that assisted suicide is suicide.

This article was published by Bioedge on December 7, 2023.

Michael Cook

By Michael Cook

Such is the stigma surrounding suicide that advocates of “voluntary assisted dying” insist vehemently that it is by no means suicide.

For instance, Go Gentle Australia, a leading lobby group for VAD, explains in its website’s FAQ that:

“People seeking voluntary assisted dying are not suicidal; they don’t want to die but are dying of a terminal illness and simply want to control how and when it happens and how much they need to suffer at the end. Australian laws expressly state that voluntary assisted dying is not suicide.”

In Australia, this is more than a quibble over words. In 2005 the Federal government amended the Commonwealth Criminal Code Act 1995. It introduced two sections which criminalised counselling or instructing people about suicide over “carriage services”, which included communication over telephones and the internet.

It had good reason to do so. Access to the internet was growing, young people were being bullied or coaxed into killing themselves in internet chatrooms. Introducing the bill at the time, the Attorney-General explained that “internet chat room discussions have led to a person attempting suicide, and sometimes successfully. This research points to evidence that vulnerable individuals were compelled so strongly by others to take their own lives that they felt to back out or seek help would involve losing face.”

Chatrooms in Japan were particularly gruesome. In 2003, NBC News reported that strangers were organising suicide pacts over the internet. In one shocking case, four young men organised to gas themselves in a car overlooking Mount Fuji.

Furthermore, Dr Philip Nitschke, an Australian assisted suicide promoter and facilitator, began providing information about suicide techniques over the internet. At the time, the changes were even dubbed “the Nitschke amendment”.

However, after all of Australia’s states have legalised VAD, the Federal criminal code has become, in the words of advocates, a barrier to access, because it equates VAD with suicide. People who want to access VAD in rural areas may not be able to find a local doctor who is prepared to cooperate. For other medical consultations, they would be able to speak over the phone with a specialist. But for VAD, such a consultation would be a crime. It purportedly causes “delay and hardship for patients”.

So a doctor from Victoria, Nicholas Carr, recently asked the Federal Court to rule that “voluntary assisted dying” is not suicide. The judge, Justice Abraham, refused.

After a long examination of the relevant legislation and parsing the word “suicide”, she concluded that:

“in so far as the VAD Act purports to authorise medical practitioners to provide information about particular methods of committing suicide via a carriage service, it purports to authorise them to engage in conduct that the Criminal Code has criminalised.”

Taking a common sense approach to the definition, Justice Abraham consulted Australia’s Macquarie Dictionary and the Oxford English Dictionary. They supported her stand. Suicide is “the intentional taking of one’s own life, and the act of doing so” and therefore VAD is suicide.

Dr Carr’s lawyers had another argument, an ingenious one. The Federal legislation bans incitement “to commit suicide”. The word “commit”, which is associated with committing a sin or committing a crime, must obviously mean that only stigmatised species of suicide are banned.

Justice Abraham dismissed this objection. 

“There is no basis to infer, from the text, context or purpose of the provisions that the word ‘commit’ was chosen by Parliament to denote that the term ‘suicide’ only applies to certain circumstances in which one takes one’s own life.”

When there is a clash between state and Federal law in Australia, Federal law prevails. For the moment, no one in Australia can use a telephone or the internet to give advice about VAD. It may be difficult to draft a law which will allow doctors to give advice about “voluntary assisted dying” but will stop people from encouraging unbalanced and distressed people to end their lives.

Australian Federal Court rules that assisted suicide is suicide under Criminal Code

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Natassia Chrysanthos reported for the Sydney Morning Herald on November 30, 2023 that Federal Court Justice Wendy Abraham ruled that:

voluntary assisted dying was considered suicide under the code, which means doctors could be charged under laws that prohibit using a carriage service – such as telehealth, email or phone calls – to incite or provide information about suicide.

The landmark decision means that doctors who approve assisted suicide via telehealth or by any other carriage service, can be charged under the federal law for inciting or providing information about suicide.

Chrysanthos reported that Nick Carr, a Melbourne doctor who brought the case to the federal court argued that:

the term suicide should not apply to voluntary assisted dying because the latter involved a legal right to intentionally take one’s life that was regulated by law.

The court disagreed and ruled that:

suicide, as used in the criminal code, applied to ending a person’s life under state voluntary assisted dying laws – meaning that doctors who consulted patients about euthanasia over the phone, email or telehealth were breaking the law, even if those actions had been authorised under state legislation.

Chrysanthos reported that a Victoria government spokesperson and the Queensland Attorney-General stated their intention of changing the law. Federal Independent MP, Kate Cheney announced that she will be introducing a Private Members bill to amend Australia's Suicide Act.

Australia's Suicide Act was amended to prevent suicide information sharing via a carriage service in order to stop Philip Nitschke from providing information and suicide advice.

Australia's federal court made the correct decision. Whether someone is counselling assisted suicide or suicide for other reasons, the act is the same.

Michigan debates deceptive assisted suicide Senate Bill 0681

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Michigan assisted suicide Senate Bill 0681 is similar to previous versions of the Oregon assisted suicide law. Senate Bill 0681 is a tighter assisted suicide bill which tells me that the assisted suicide lobby doesn't have the votes in Michigan.

Senate Bill 0681 is a "trojan horse" as it is designed to sell assisted suicide and if passed  the assisted suicide lobby will soon expand the law.

The Oregon assisted suicide law is promoted as having safeguards, in fact the law lacks any effective oversight.

What you need to know about the Oregon assisted suicide law

The 2022 Oregon assisted suicide report indicated that there were 278 reported assisted suicide deaths up from 255 in 2021. There were 431 lethal death prescriptions up from 383 in 2021.

The 2022 report indicates that even though there were 278 reported assisted suicide deaths, there were an additional 101 deaths where ingestion status was unknown. When the ingestion status is unknown, the person received the lethal drugs and died but there is no information as to whether the person died by assisted suicide or by a natural death.

As with previous years, the report implies that the deaths were voluntary (self-administered), but the information in the report does not address that subject.

The assisted suicide lobby, for political reasons, has decided to introduce an older style Oregon assisted suicide bill in Michigan, but once legal they will move to expand the law.

Expansion of assisted suicide

Oregon Governor Kate Brown, in July 2019, signed Bill SB 0579 into law which essentially eliminated the 15 day assisted suicide waiting period by allowing the physician to waive the waiting period. If the patient is depressed, the patient loses the opportunity to change their mind.

The physician waived the 15 day waiting period in 109 assisted suicide deaths in 2022. In some cases the lethal drug cocktail was ingested the day after the first request.

Oregon has removed the assisted suicide residency requirement

A story published in the Daily Mail stated that an assisted suicide clinic in Oregon has started doing assisted suicide for out-of-state residents (suicide tourism). The Daily Mail reports:

Oregon has become America’s first ‘death tourism’ destination, where terminally ill people from Texas and other states that have outlawed assisted suicide have started travelling to get their hands on a deadly cocktail of drugs to end their lives, DailyMail.com can reveal.

In the liberal bastion Portland, at least one clinic has started receiving out-of-staters who have less than six months to live and meet the other strict requirements of the state’s Death with Dignity (DWD) law.

Dr. Nicholas Gideonse, the director of End of Life Choices Oregon, recently told a panel that he was advising terminally ill non-residents on travelling to Oregon to end their lives, despite a legal gray area.

The assisted suicide lobby, over the past few years, has expanded existing assisted suicide laws. Oregon has eliminated their reflection period and their residency requirement. Vermont is permitting assisted suicide by telehealth and have eliminated their residency requirement, Washington state, California and Hawaii also expanded their assisted suicide laws. New Mexico has the most extreme assisted suicide law in America.

Assisted suicide drug experimentation

Assisted suicide activists have been experimenting with lethal drug cocktails on people approved for assisted suicide. An article by Lisa Krieger published by the Medical Xpress on September 8, 2020 uncovers information about the lethal drug experiments:

A little-known secret, not publicized by advocates of aid-in-dying, was that while most deaths were speedy, others were very slow. Some patients lingered for six or nine hours; a few, more than three days. No one knew why, or what needed to change.

"The public thinks that you take a pill and you're done," said Dr. Gary Pasternak, chief medical officer of Mission Hospice in San Mateo. "But it's more complicated than that."

Assisted suicide is sold to the public as offering a peaceful death. Assisted suicide is far more complicated than that.

The 2021 Oregon report emphasizes that the use of the fourth generation of lethal drug cocktails show that the length of time to die has reduced but the problems with the lethal drug cocktail experiments continue.

The yearly Oregon DWD reports are based on data from the physicians who prescribe and carry-out the assisted suicide deaths. The data is not independently verified. 

 

Data concerning complications and length of time for death, etc., can only be reported when a healthcare provider is present at the death. Information from Oregon concerning complications is only available for 150 of the 278 reported assisted suicide deaths in 2022. For the other 128 assisted suicide deaths, no information is known about the death.

The assisted suicide lobby claims that Oregon has a "safe" assisted suicide regime but in fact the Oregon law lacks effective oversight. 

A recent report published in the British Medical Journal Supportive and Palliative Care examines the data from the Oregon Death with Dignity reports (1998 to 2022) and uncovers significant problems with the Oregon assisted suicide data.

Don't let the trojan horse of assisted suicide Senate Bill 0681 into Michigan.

Once assisted suicide is legal, the assisted suicide lobby will lobby or launch court cases to expand the law. The original assisted suicide bill is designed to pass in the legislature, once passed incremental extensions will follow.

Assisted suicide by telehealth may continue until 2025.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Euthanasia Prevention Coalition opposes the dangerous practice of assisted suicide by telehealth.

An October 10, a CNN news report by Kristen Rogers stated that:

The DEA and the Substance Abuse and Mental Health Services Administration announced May 9 that the temporary rules would be extended through November 11, while the DEA and HHS considered the public comments and any revisions to the proposals — buying more time for telehealth patients who might have otherwise experienced a disruption in care.

Now, after holding two days of public listening sessions on the rules in September, the DEA and HHS have further extended the flexibilities through December 31, 2024.

This means that the dangerous practise of approving assisted suicide by telehealth will continue in states that permit assisted suicide until December 31, 2024.

The CNN article stated that the American Medical Association was pleased with the decision to extend the practise of prescribing Schedule II medications or narcotics by telehealth. The reality is that this decision enables assisted suicide to be prescribed by telehealth and ignores the concerns around the opioid crisis.

The Drug Enforcement Administration (DEA) began their consultation on the proposed rules for prescribing controlled substances via telehealth in February 2023.

The assisted suicide lobby has been promoting the approval of assisted suicide by telehealth. The assisted suicide lobby also wants to have the lethal assisted suicide drug cocktail delivered by courier.

On April 17, 2023, Kristen Senz reported for The Journalists Resource that the DEA had approved the guidelines and stated that they would go into effect on May 1, 2023.

The proposed DEA guidelines stated that prescribing Schedule II controlled substances would require an in-person visit. Patients being treated for opioid use disorder could be prescribed via telemedicine but they would be required to have an in-person visit within 30 days of receiving a prescription for buprenorphine (Suboxone, Zubsolv, and Sublocade) via telemedicine and to obtain refills.

But the story didn't end there. 

Based on a massive response by the assisted suicide lobby the DEA placed their guidelines on hold until November 11, 2023.

The Euthanasia Prevention Coalition opposes the dangerous practice of assisted suicide by telehealth and supported the DEA proposed guidelines that were approved in April, 2023.

The DEA guidelines were based on reducing the opioid crisis by making it more difficult for people to obtain Schedule II controlled substances for resale. 

Previous articles:

• The US Drug Administration tightens regulations on Schedule II Controlled Substances (Link). 
• Help EPC stop assisted suicide by Telehealth (Link).

US Drug Enforcement Administration (DEA) consultations on prescribing controlled substances by Telehealth.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Euthanasia Prevention Coalition  opposes the dangerous practice of assisted suicide by telehealth.

The US Drug Enforcement Administration continues the consultation on their proposed rules for prescribing controlled substances via telehealth. Listening sessions have been organized by the DEA for September 12 & 13, 2023 to hear all issues and concerns related to requiring an in-person visit before a physician can prescribe Schedule II controlled substances.

The Drug Enforcement Administration (DEA) began their consultation on February 24, 2023 on the proposed rules for prescribing controlled substances via telehealth. The proposed rule states that when a person has not seen a medical practitioner and requires a prescription for Schedule II medications or narcotics, the prescription cannot be made via telehealth and the patient will be required to see a medical practitioner in person before receiving the prescription.

The proposed rules are important. The assisted suicide lobby wants to approve assisted suicide drug cocktail prescriptions without directly meeting with or examining the person. They also want to have the lethal drug cocktail sent to the person by courier.

Kristen Senz reported for The Journalists Resource on April 17 that the DEA approved the new guidelines and that it will go into effect on May 1.

The proposed DEA rules states that Schedule II controlled substances will require an in-person visit. Patients being treated for opioid use disorder can be prescribed via telemedicine but they will be required to have an in-person visit within 30 days of receiving a prescription for buprenorphine (Suboxone, Zubsolv, and Sublocade) via telemedicine, to obtain refills.

But the story doesn't end there. 

Based on a massive response by the US assisted suicide lobby the DEA placed their guidelines on hold for six months. The assisted suicide lobby emphasized the need for emergency prescriptions for pain medications needed for palliative care.

The Euthanasia Prevention Coalition opposes the dangerous practice of assisted suicide by telehealth and supports the DEA proposed guidelines that were approved in April.

If the DEA decides to compromise their position, they should state that it is dangerous and unethical to prescribe assisted suicide drug cocktails by telehealth.

The DEA rules are based on reducing the opioid crisis to make it more difficult for people to obtain Schedule II controlled substances for resale. 

Previous articles:

• The US Drug Administration tightens regulations on Schedule II Controlled Substances (Link). 
• Help EPC stop assisted suicide by Telehealth (Link).
  

US Drug Enforcement Administration (DEA) tightens regulations on Schedule II controlled substances

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Article: EPC-USA works to prevent assisted suicide by telemedicine (Link).

This is a big victory for preventing assisted suicide by Telemedicine.

The Drug Enforcement Administration (DEA) began a consultation on February 24 on proposed rules for prescribing drugs via telehealth. The proposed rule stated that when a person has not seen a medical practitioner and requires a Schedule II medication or narcotic that the prescription could not be prescribed via telehealth and the patient would be required to see a medical practitioner in person before receiving the prescription.

The proposed rule was important for the assisted suicide issue. The assisted suicide lobby wants to approve a death by lethal drugs without directly meeting with or examining the person and then have the lethal drugs sent to the person by courier.

Kristen Senz reported for The Journalists Resource on April 17 that the DEA approved new guidelines will go into effect on May 1. Senz reported:

Patients being treated remotely with buprenorphine for opioid use disorder, Ritalin for attention deficit disorders, ketamine for depression, or testosterone for gender-affirming care, among other controlled-drug treatments, will need to schedule an in-person exam, either with their telemedicine prescriber or a local provider who is registered with the federal Drug Enforcement Administration, according to the DEA’s proposed rules.

The draft regulations, which were first announced Feb. 24, allow telemedicine providers to initially prescribe 30 days’ worth of select medications, including buprenorphine, testosterone, or ketamine, before an in-person exam is required. Patients taking narcotic pain medication, or common ADD medicines, will need an in-person exam before any new prescriptions can be issued. Patients and providers who established treatment relationships remotely during the pandemic, when in-person exam requirements were temporarily waived, would have 180 days to comply with the new laws.

As the proposed DEA rules state, Schedule II controlled substances will require an in-person visit. Patients being treated for opioid use disorder can be prescribed via telemedicine but they will be required to have an in-person visit within 30 days of receiving a prescription for buprenorphine (Suboxone, Zubsolv, and Sublocade) via telemedicine, to obtain refills.

The new DEA rules are based on reducing the opioid crisis and make it more difficult for people to obtain Schedule II controlled substances for resale.

EPC-USA supports the DEA rules. We support tighter regulations for controlled substances in order to prevent opioid abuse, especially since some of these drugs can be used for lethal purposes.

Proposed Regulation for Prescribing Controlled Substances via Telemedicine

RE: DEA NPRM (Document Citation 88 FR 12875) regarding telemedicine prescribing of controlled substances

• Help EPC Prevent Assisted Suicide by Telehealth (Link)

Dear Administrator Milgram:

The Euthanasia Prevention Coalition-USA (EPC-USA) and the Catholic Medical Association (CMA) represents thousands of physicians, attorneys, nurses, health care professionals, disability rights advocates, and citizens across the country. Members of our organizations oppose assisted suicide and euthanasia, and support positive measures to improve the quality of life of Americans. We fully support your proposed requirement for in-person examination before a Schedule II controlled substance can be prescribed. The patient would be required to see the medical practitioner in person before receiving the prescription.

DEA regulations require registration in each state in which a prescriber is licensed. They do not authorize interstate practice without licensure. This is already the standard of care. Our members have licensure and controlled substance licenses in a variety of states, along with the applicable separate DEA registrations. It is critically important that the final rule prohibit the use of telemedicine to cross state lines by unlicensed and unregistered clinicians.

We support the proposed prohibition on telemedicine prescribing of Schedule II controlled substances without an in-person medical evaluation. In addition, the prescriber must be licensed to practice in, and follow the laws of, the State where the patient is located. Without those regulations, prescribers of potentially dangerous drugs would be able to act beyond the regulatory reach of a state medical board.

Colleen Barry
Chair, Euthanasia Prevention Coalition-USA

Craig Treptow, M.D.
President, Catholic Medical Association