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June 14, 2000

Legislation and End-of-Life Care

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Contributing EditorIndividualAuthor


Copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2000

JAMA. 2000;283(22):2933. doi:10.1001/jama.283.22.2931

To the Editor: The article by Drs Orentlicher and Caplan1 is misleading. Contrary to their assertion, the PRPA would give the Drug Enforcement Administration no new power over most physicians. The act would nullify Oregon's current law2 that provides physicians with legal immunity for knowingly writing prescriptions for deliberately lethal overdoses by declaring that such practices will not count as the "legitimate practice of medicine." Oregon could still pass a new statute granting physicians legal immunity for assisting in suicide in other ways, such as carbon monoxide, firearms, other lethal drugs, or even plastic bags. Since these can be quite effective in causing death, objections to such alternative means must be to the aesthetics, rather than the ethics, of physician-assisted suicide. The major departure from current law is not excessive federal regulation of controlled substances generally, but use of federal law to define "legitimate medical practice," something that has historically been left up to the individual states. We agree that this raises serious questions as to the appropriate allocation of power between states and the federal government in the control of medical practice. But this general concern should not lead to alarmist and misleading interpretations of this particular bill and its effect.

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