September 14, 1998
The President is opposed to assisted suicide and any Federal support for
it. The Administration, however, opposes H.R. 4006 because it represents a
flawed approach to the sensitive area of Federal regulation of medicine.
In particular, the Administration is concerned that the bill's insertion of
the Drug Enforcement Administration (DEA) into the role of overseer of the
practice of medicine in the unique circumstances of suffering, terminally
ill patients would inevitably divert agency attention away from its core
drug enforcement mission. In addition, the medical, scientific, ethical,
and related aspects of the practice of medicine at the end of life would
involve the DEA in issues in which it has no particular expertise.
Furthermore, there is a growing consensus that the American medical system does not adequately provide palliative care to terminally ill patients and in particular that it fails to provide effective pain management. The Administration is concerned that this bill would chill effective pain management, and patients may unnecessarily suffer.
Although the President opposes H.R. 4006 as currently drafted, he remains committed to working with Congress, health care providers, consumers, medical ethicists, States, and others to attempt to develop an appropriate approach to this complex, but extremely important issue.
H.R. 4006 could affect both direct spending and receipts: therefore, it is subject to the pay-as-you-go requirement of the Omnibus Budget Reconciliation Act of 1990. OMB's preliminary scoring estimate of this bill is that it would have a net effect of less than $500,000.