I

104TH CONGRESS

2D SESSION H. R. 4149

To clarify Federal law with respect to assisted suicide, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

SEPTEMBER 24, 1996

Mr. HALL of Texas (for himself, Mr. ALLARD, Mr. BAKER of California, Mr.

BALLENGER, Mr. BARCIA, Mr. BARR of Georgia, Mr. BARTLETT of

Maryland, Mr. BARTON of Texas, Mr. BONILLA, Mr. BOEHNER, Mr.

BROWNBACK, Mr. BRYANT of Tennessee, Mr. BUNN of Oregon, Mr.

BUNNING of Kentucky, Mr. BURR, Mr. CAMP, Mr. CANADY of Florida,

Mr. CHABOT, Mrs. CHENOWETH, Mr. CLINGER, Mr. COBLE, Mr.

COBURN, Mr. COLLINS of Georgia, Mr. COOLEY of Oregon, Mr.

CREMEANS, Mr. CUNNINGHAM, Mr. DEAL of Georgia, Mr. DICKEY, Mr.

DOOLITTLE, Mr. DORNAN, Mr. DOYLE, Mr. DUNCAN, Ms. DUNN of

Washington, Mr. ENGLISH of Pennsylvania, Mr. FRISA, Mr.

FUNDERBURK, Mr. GOODLATTE, Mr. GRAHAM, Ms. GREENE of Utah,

Mr. HASTINGS of Washington, Mr. HAYES, Mr. HAYWORTH, Mr.

HILLEARY, Mr. HOKE, Mr. HOLDEN, Mr. HOSTETTLER, Mr. HOEKSTRA,

Mr. HUNTER, Mr. HUTCHINSON, Mr. HYDE, Mr. INGLIS of South Carolina, Mr. ISTOOK, Mr. KING, Mr. KASICH, Mr. KINGSTON, Mr.

KNOLLENBERG, Mr. LAHOOD, Mr. LARGENT, Mr. LATHAM, Mr. LEWIS

of Kentucky, Mr. LINDER, Mr. LIPINSKI, Mr. LIVINGSTON, Mr.

MCHUGH, Mr. MANTON, Mr. MANZULLO, Mr. MASCARA, Mr. MICA, Mr.

MOORHEAD, Mr. MYERS of Indiana, Mrs. MYRICK, Mr. NEY, Mr. NORWOOD, Mr. OBERSTAR, Mr. ORTON, Mr. PACKARD, Mr. PARKER, Mr. PETERSON of Minnesota, Mr. PETRI, Mr. POSHARD, Mr. QUINN, Mr. RAHALL, Mr. ROBERTS, Mr. SCARBOROUGH, Mr. SCHIFF, Mrs. SEASTRAND,

Mr. SENSENBRENNER, Mr. SKELTON, Mr. SMITH of New Jersey, Mr.

SMITH of Texas, Mrs. SMITH of Washington, Mr. SOLOMON, Mr.

SOUDER, Mr. STEARNS, Mr. STENHOLM, Mr. STOCKMAN, Mr. STUMP,

Mr. STUPAK, Mr. TALENT, Mr. TAYLOR of North Carolina, Mr. TAYLOR

of Mississippi, Mr. TIAHRT, Mr. VOLKMER, Mrs. VUCANOVICH, Mr.

WAMP, Mr. WATTS of Oklahoma, Mr. WELDON of Pennsylvania, Mr.

WELDON of Florida, Mr. WICKER, Mr. WOLF, Mr. MONTGOMERY, Mr.

CONDIT, Mr. SISISKY, Mr. CRAMER, Mr. CLEMENT, Mr. DELAY, Mr.

BREWSTER, Mr. FROST, and Mr. DE LA GARZA) introduced the following

bill; which was referred to the Committee on Commerce, and in addition

to the Committees on Ways and Means, the Judiciary, Economic and

Educational Opportunities, Government Reform and Oversight, Re-
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sources, and International Relations, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions

as fall within the jurisdiction of the committee concerned

A BILL

To clarify Federal law with respect to assisted suicide, and

for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Assisted Suicide Fund5 ing Restriction Act of 1996’’.

6 SEC. 2. GENERAL PROHIBITION ON USE OF FEDERAL

7 ASSISTANCE.

8 Notwithstanding any other provision of law, no funds

9 appropriated by the Congress shall be used to provide,

10 procure, furnish, fund, or support, or to compel any indi11 vidual, institution, or government entity to provide, pro12 cure, furnish, fund, or support, any item, good, benefit,

13 program, or service, the purpose of which is to cause, or

14 to assist in causing, the suicide, euthanasia, or mercy kill15 ing of any individual.

16 SEC. 3. RULE OF CONSTRUCTION.

17 Nothing in this Act, or in an amendment made by

18 this Act, shall be construed to create any limitation relat19 ing to—
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1 (1) the withholding or withdrawing of medical

2 treatment or medical care;

3 (2) the withholding or withdrawing of nutrition

4 or hydration;

5 (3) abortion; or

6 (4) the use of an item, good, benefit, or service

7 furnished for the purpose of alleviating pain or dis8 comfort, even if such use may increase the risk of

9 death, so long as such item, good, benefit, or service

10 is not also furnished for the purpose of causing, or

11 the purpose of assisting in causing, death, for any

12 reason.

13 SEC. 4. AMENDMENTS TO ACTS REGARDING INDIVIDUALS

14 WITH DISABILITIES.

15 (a) AMENDMENTS TO DEVELOPMENTAL DISABIL16 ITIES ASSISTANCE AND BILL OF RIGHTS ACT.—

17 (1) STATE PLANS REGARDING DEVELOPMENTAL

18 DISABILITIES COUNCILS.—Section 122(c)(5)(A) of

19 the Developmental Disabilities Assistance and Bill of

20 Rights Act (42 U.S.C. 6022(c)(5)(A)) is amended—

21 (A) in clause (vi), by striking ‘‘and’’ after

22 the semicolon at the end;

23 (B) in clause (vii), by striking the period

24 at the end and inserting ‘‘; and’’; and
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1 (C) by adding at the end the following

2 clause:

3 ‘‘(viii) such funds will not be used to

4 support any program or service that has a

5 purpose of assisting in procuring any item

6 or service the purpose of which is to cause,

7 or to assist in causing, the death of any in8 dividual, such as by assisted suicide, eutha9 nasia, or mercy killing.’’.

10 (2) LEGAL ACTIONS BY PROTECTION AND AD11 VOCACY SYSTEMS.—Section 142(h)(1) of the Devel12 opmental Disabilities Assistance and Bill of Rights

13 Act (42 U.S.C. 6042(h)(1)) is amended by inserting

14 before the period the following: ‘‘, except that no

15 such system may use assistance provided under this

16 chapter to bring suit or provide any other form of

17 legal assistance for the purpose of—

18 ‘‘(A) securing or funding any item, benefit,

19 program, or service furnished for the purpose of

20 causing, or the purpose of assisting in causing,

21 the death of any individual, such as by assisted

22 suicide, euthanasia, or mercy killing;

23 ‘‘(B) compelling any individual, institution,

24 government, or governmental body to provide,

25 fund, or legalize any item, benefit, program, or
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1 service for the purpose of causing, or the pur2 pose of assisting in causing, the death of any

3 individual, such as by assisted suicide, eutha4 nasia, or mercy killing; or

5 ‘‘(C) asserting or advocating a legal right

6 to cause, or to assist in causing, or to receive

7 assistance in causing, the death of any individ8 ual, such as by assisted suicide, euthanasia, or

9 mercy killing.’’.

10 (3) PROHIBITED ACTIVITIES REGARDING

11 GRANTS TO UNIVERSITY AFFILIATED PROGRAMS.—

12 Section 152(b)(5) of the Developmental Disabilities

13 Assistance and Bill of Rights Act (42 U.S.C.

14 6062(b)(5)) is amended by inserting before the pe15 riod the following: ‘‘, or for any program or service

16 which has a purpose of assisting in procuring any

17 item, or service, the purpose of which is to cause, or

18 to assist in causing, the death of any individual,

19 such as by assisted suicide, euthanasia, or mercy

20 killing’’.

21 (4) REQUIREMENTS REGARDING GRANTS FOR

22 PROJECTS OF NATIONAL SIGNIFICANCE.—Section

23 162(c) of the Developmental Disabilities Assistance

24 and Bill of Rights Act (42 U.S.C. 6082(c)) is

25 amended—
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1 (A) in paragraph (4), by striking ‘‘and’’

2 after the semicolon at the end;

3 (B) in paragraph (5), by striking the pe4 riod at the end and inserting ‘‘; and’’; and

5 (C) by adding at the end the following

6 paragraph:

7 ‘‘(6) the applicant provides assurances that the

8 grant will not be used to support or fund any pro9 gram or service which has a purpose of assisting in

10 the procuring of any item, benefit, or service fur11 nished for the purpose of causing, or the purpose of

12 assisting in causing, the death of any individual,

13 such as by assisted suicide, euthanasia, or mercy

14 killing.’’.

15 (b) AMENDMENT TO PROTECTION AND ADVOCACY

16 FOR MENTALLY ILL INDIVIDUALS ACT OF 1986; SYSTEM

17 REQUIREMENTS.—Section 105(a) of the Protection and

18 Advocacy for Mentally Ill Individuals Act of 1986 (42

19 U.S.C. 10805(a)) is amended—

20 (1) in paragraph (8), by striking ‘‘and’’ at the

21 end thereof;

22 (2) in paragraph (9), by striking the period and

23 inserting ‘‘; and’’; and

24 (3) by adding at the end thereof the following

25 new paragraph:
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1 ‘‘(10) not use allotments provided to a system

2 to assist in—

3 ‘‘(A) procuring or funding any item, bene4 fit, or service for the purpose of causing, or the

5 purpose of assisting in causing, the death of

6 any individual, such as by assisted suicide, eu7 thanasia, or mercy killing;

8 ‘‘(B) compelling any individual, institution,

9 government, or governmental body to provide

10 any item, benefit, or service for the purpose of

11 causing, or the purpose of assisting in causing,

12 the death of any individual, such as by assisted

13 suicide, euthanasia, or mercy killing; or

14 ‘‘(C) asserting or advocating a legal right

15 to cause, or to assist in causing, or to receive

16 assistance in causing, the death of any individ17 ual, such as by assisted suicide, euthanasia, or

18 mercy killing.’’.

19 (c) AMENDMENT TO REHABILITATION ACT OF 1973;

20 REQUIREMENTS FOR ASSISTANCE FOR PROTECTION AND

21 ADVOCACY SYSTEMS.—Section 509(f) of the Rehabilita22 tion Act of 1973 (29 U.S.C. 794e(f)) is amended—

23 (1) in paragraph (6), by striking ‘‘and’’ after

24 the semicolon at the end;
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1 (2) in paragraph (7), by striking the period at

2 the end and inserting ‘‘; and’’; and

3 (3) by adding at the end the following para4 graph:

5 ‘‘(8) not use allotments provided under this sec6 tion to support or fund any program or service

7 which has the purpose of assisting in—

8 ‘‘(A) procuring or funding any item, bene9 fit, or service for the purpose of causing, or the

10 purpose of assisting in causing, the death of

11 any individual, such as by assisted suicide, eu12 thanasia, or mercy killing;

13 ‘‘(B) compelling any individual, institution,

14 government, or governmental body to provide

15 any item, benefit, or service for the purpose of

16 causing, or the purpose of assisting in causing,

17 the death of any individual, such as by assisted

18 suicide, euthanasia, or mercy killing; or

19 ‘‘(C) asserting or advocating a legal right

20 to cause, or to assist in causing, or to receive

21 assistance in causing, the death of any individ22 ual, such as by assisted suicide, euthanasia, or

23 mercy killing.’’.
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1 SEC. 5. AMENDMENT TO PUBLIC HEALTH SERVICE ACT.

2 Title II of the Public Health Service Act (42 U.S.C.

3 201 et seq.) is amended by adding at the end thereof the

4 following new section:

5 ‘‘SEC. 245. BAN ON USE OF FUNDS FOR ASSISTED SUICIDE

6 AND RELATED SERVICES.

7 ‘‘Appropriations for carrying out the purposes of this

8 Act shall not be used or made available to provide any

9 item, or service, furnished for the purpose of causing, or

10 the purpose of assisting in causing, the death of any indi11 vidual, such as by assisted suicide, euthanasia, or mercy

12 killing.’’.

13 SEC. 6. PROHIBITION OF FEDERAL FINANCIAL PARTICIPA14 TION UNDER MEDICAID FOR ASSISTED SUI15 CIDE OR RELATED SERVICES.

16 (a) IN GENERAL.—Section 1903(i) of the Social Se17 curity Act (42 U.S.C. 1396b(i)) is amended—

18 (1) by striking ‘‘or’’ at the end of paragraph

19 (14);

20 (2) by striking the period at the end of para21 graph (15) and inserting ‘‘; or’’; and

22 (3) by inserting after paragraph (15) the fol23 lowing new paragraph:

24 ‘‘(16) with respect to any amount expended for

25 any item, or service, furnished for the purpose of

26 causing, or the purpose of assisting in causing, the
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1 death of any individual, such as by assisted suicide,

2 euthanasia, or mercy killing.’’.

3 (b) TREATMENT OF ADVANCE DIRECTIVES.—Section

4 1902(w) of such Act (42 U.S.C. 1396a(w)) is amended

5 by adding at the end the following new paragraphs:

6 ‘‘(5) Nothing in this subsection shall be construed to

7 create any requirement with respect to a portion of an ad8 vance directive that directs the purposeful causing, or the

9 purposeful assisting in causing, of the death of any indi10 vidual, such as by assisted suicide, euthanasia, or mercy

11 killing.

12 ‘‘(6) Nothing in this subsection shall be construed to

13 require any provider or organization, or any employee of

14 such a provider or organization, to inform or counsel any

15 individual regarding any right to obtain an item or service

16 furnished for the purpose of causing, or the purpose of

17 assisting in causing, the death of the individual, such as

18 by assisted suicide, euthanasia, or mercy killing.’’.

19 SEC. 7. RESTRICTING TREATMENT UNDER MEDICARE OF

20 ASSISTED SUICIDE OR RELATED SERVICES.

21 (a) PROHIBITION OF EXPENDITURES.—Section

22 1862(a) of the Social Security Act (42 U.S.C. 1395y(a))

23 is amended—

24 (1) by striking ‘‘or’’ at the end of paragraph

25 (14);
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1 (2) by striking the period at the end of para2 graph (15) and inserting ‘‘; or’’; and

3 (3) by inserting after paragraph (15) the fol4 lowing new paragraph:

5 ‘‘(16) where such expenses are for any item, or

6 service, furnished for the purpose of causing, or the

7 purpose of assisting in causing, the death of any in8 dividual, such as by assisted suicide, euthanasia, or

9 mercy killing.’’.

10 (b) TREATMENT OF ADVANCE DIRECTIVES.—Section

11 1866(f) of such Act (42 U.S.C. 1395cc(f)) is amended by

12 adding at the end the following new paragraphs:

13 ‘‘(4) Nothing in this subsection shall be construed to

14 create any requirement with respect to a portion of an ad15 vance directive that directs the purposeful causing, or the

16 purposeful assisting in causing, of the death of any indi17 vidual, such as by assisted suicide, euthanasia, or mercy

18 killing.

19 ‘‘(5) Nothing in this subsection shall be construed to

20 require any provider of services or prepaid or eligible orga21 nization, or any employee of such a provider or organiza22 tion, to inform or counsel any individual regarding any

23 right to obtain an item, or service, furnished for the pur24 pose of causing, or the purpose of assisting in causing,
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1 the death of the individual, such as by assisted suicide,

2 euthanasia, or mercy killing.’’.

3 SEC. 8. AMENDMENT TO OLDER AMERICANS ACT.

4 Section 712 of the Older Americans Act of 1965 (42

5 U.S.C. 3058g) is amended by adding at the end thereof

6 the following new subsection:

7 ‘‘(k) ASSISTED SUICIDE.—No State or local ombuds8 man program, entity, or representative shall, with funds

9 allotted under this section, provide any assistance or serv10 ice to assist in—

11 ‘‘(1) securing or funding any item, benefit, or

12 service for the purpose of causing, or the purpose of

13 assisting in causing, the death of any individual,

14 such as by assisted suicide, euthanasia, or mercy

15 killing;

16 ‘‘(2) compelling any individual, institution, gov17 ernment, or governmental body to provide any item,

18 benefit, or service for the purpose of causing, or the

19 purpose of assisting in causing, the death of any in20 dividual, such as by assisted suicide, euthanasia, or

21 mercy killing; or

22 ‘‘(3) asserting or advocating a legal right to

23 cause, or to assist in causing, or to receive assist24 ance in causing, the death of any individual, such as

25 by assisted suicide, euthanasia, or mercy killing.’’.
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1 SEC. 9. PROHIBITION AGAINST USE OF BLOCK GRANTS TO

2 STATES FOR SOCIAL SERVICES TO PROVIDE

3 ITEMS OR SERVICES FOR THE PURPOSE OF

4 INTENTIONALLY CAUSING DEATH.

5 Section 2005(a) of the Social Security Act (42 U.S.C.

6 1397d(a)) is amended—

7 (1) by striking ‘‘or’’ at the end of paragraph

8 (8);

9 (2) by striking the period at the end of para10 graph (9) and inserting ‘‘; or’’; and

11 (3) by adding at the end the following:

12 ‘‘(10) for the provision of any item, or service,

13 furnished for the purpose of causing, or the purpose

14 of assisting in causing, the death of any individual,

15 such as by assisted suicide, euthanasia, or mercy

16 killing.’’.

17 SEC. 10. INDIAN HEALTH CARE.

18 Section 201(b) of the Indian Health Care Improve19 ment Act (25 U.S.C. 1621(b)) is amended by adding at

20 the end the following:

21 ‘‘(3) Funds appropriated under the authority of this

22 section may not be used for the provision of any item or

23 service (including treatment or care) furnished for the

24 purpose of causing, or the purpose of assisting in causing,

25 the death of any individual, such as by assisted suicide,

26 euthanasia, or mercy killing.’’.
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1 SEC. 11. MILITARY HEALTH CARE SYSTEM.

2 (a) MEMBERS AND FORMER MEMBERS.—Section

3 1074 of title 10, United States Code, is amended by add4 ing at the end the following:

5 ‘‘(d) Under joint regulations prescribed by the admin6 istering Secretaries, no one under the jurisdiction of the

7 administering Secretaries may furnish any item or service

8 (including any form of medical care) for the purpose of

9 causing, or the purpose of assisting in causing, the death

10 of any individual, such as by assisted suicide, euthanasia,

11 or mercy killing.’’.

12 (b) PROHIBITED HEALTH CARE FOR DEPEND13 ENTS.—Section 1077(b) of title 10, United States Code,

14 is amended by adding at the end the following:

15 ‘‘(4) Items or services (including any form of

16 medical care) furnished for the purpose of causing,

17 or the purpose of assisting in causing, the death of

18 any individual, such as by assisted suicide, eutha19 nasia, or mercy killing.’’.

20 (c) PROHIBITED HEALTH CARE UNDER

21 CHAMPUS.—

22 (1) SPOUSES AND CHILDREN OF MEMBERS.—

23 Section 1079(a) of title 10, United States Code, is

24 amended—

25 (A) in paragraph (16), by striking ‘‘and’’

26 at the end thereof;
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1 (B) in paragraph (17), by striking the pe2 riod and inserting ‘‘; and’’; and

3 (C) by adding at the end the following:

4 ‘‘(18) No contract for the provision of health5 related services entered into by the Secretary may

6 include coverage for any item or service (including

7 any form of medical care) furnished for the purpose

8 of causing, or the purpose of assisting in causing,

9 the death of any individual, such as by assisted sui10 cide, euthanasia, or mercy killing.’’.

11 (2) OTHER COVERED BENEFICIARIES.—Section

12 1086(a) of title 10, United States Code, is amend13 ed—

14 (A) by inserting ‘‘(1)’’ after ‘‘(a)’’ the first

15 place it appears; and

16 (B) by adding at the end the following:

17 ‘‘(2) No contract for the provision of health-related

18 services entered into by the Secretary may include cov19 erage for any item or service (including any form of medi20 cal care) furnished for the purpose of causing, or the pur21 pose of assisting in causing, the death of any individual,

22 such as by assisted suicide, euthanasia, or mercy killing.’’.

23 SEC. 12. FEDERAL EMPLOYEES HEALTH BENEFIT PLANS.

24 Section 8902 of title 5, United States Code, is

25 amended by adding at the end the following:
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1 ‘‘(o) A contract may not be made or a plan approved

2 which includes coverage for any benefit, item, or service

3 that is furnished for the purpose of causing, or the pur4 pose of assisting in causing, the death of any individual,

5 such as by assisted suicide, euthanasia, or mercy killing.’’.

6 SEC. 13. HEALTH CARE PROVIDED FOR PEACE CORPS

7 VOLUNTEERS.

8 Section 5(e) of the Peace Corps Act (22 U.S.C.

9 2504(e)) is amended—

10 (1) by inserting ‘‘(1)(A)’’ after ‘‘(e)’’;

11 (2) by striking ‘‘Subject to such’’ and inserting

12 the following:

13 ‘‘(2) Subject to such’’; and

14 (3) by adding at the end of paragraph (1) (as

15 so designated by paragraph (1)), the following:

16 ‘‘(B) Health care provided under this subsection to

17 volunteers during their service to the Peace Corps shall

18 not include any item or service furnished for the purpose

19 of causing, or the purpose of assisting in causing, the

20 death of any individual, such as by assisted suicide, eutha21 nasia, or mercy killing.’’.

22 SEC. 14. MEDICAL SERVICES FOR FEDERAL PRISONERS.

23 Section 4005(a) of title 18, United States Code, is

24 amended—

25 (1) by inserting ‘‘(1)’’ after ‘‘(a)’’; and
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1 (2) by adding at the end the following:

2 ‘‘(2) Services provided under this subsection shall not

3 include any item or service furnished for the purpose of

4 causing, or the purpose of assisting in causing, the death

5 of any individual, such as by assisted suicide, euthanasia,

6 or mercy killing.’’.

7 SEC. 15. PROHIBITING USE OF ANNUAL FEDERAL PAYMENT

8 TO DISTRICT OF COLUMBIA FOR ASSISTED

9 SUICIDE OR RELATED SERVICES.

10 (a) IN GENERAL.—Title V of the District of Colum11 bia Self-Government and Governmental Reorganization

12 Act is amended by adding at the end the following new

13 section:

14 ‘‘BAN ON USE OF FUNDS FOR ASSISTED SUICIDE AND

15 RELATED SERVICES

16 ‘‘SEC. 504. None of the funds appropriated to the

17 District of Columbia pursuant to an authorization of ap18 propriations under this title may be used to furnish any

19 item, or service, for the purpose of causing, or the purpose

20 of assisting in causing, the death of any individual, such

21 as by assisted suicide, euthanasia, or mercy killing.’’.

22 (b) CLERICAL AMENDMENT.—The table of sections

23 of the District of Columbia Self-Government and Govern24 mental Reorganization Act is amended by adding at the

25 end of the items relating to title V the following new item:

‘‘Sec. 504. Ban on use of funds for assisted suicide and related services.’’.
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1 (c) EFFECTIVE DATE.—The amendments made by

2 this section shall apply to payments to the District of Co3 lumbia for fiscal years beginning with fiscal year 1997.

4 SEC. 16. LEGAL SERVICES.

5 Section 1007(b) of the Legal Services Corporation

6 Act (42 U.S.C. 2996f(b)) is amended—

7 (1) by striking ‘‘and’’ at the end of paragraph

8 (9);

9 (2) by striking the period at the end of para10 graph (10) and inserting ‘‘; and’’; and

11 (3) by adding after paragraph (10) the follow12 ing:

13 ‘‘(11) to provide legal assistance for the pur14 pose of—

15 ‘‘(A) securing or funding any item, benefit,

16 program, or service furnished for the purpose of

17 causing, or the purpose of assisting in causing,

18 the death of any individual, such as by assisted

19 suicide, euthanasia, or mercy killing;

20 ‘‘(B) compelling any individual, institution,

21 government, or governmental body to provide,

22 fund, or legalize any item, benefit, program, or

23 service for the purpose of causing, or the pur24 pose of assisting in causing, the death of any
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1 individual, such as by assisted suicide, eutha2 nasia, or mercy killing; or

3 ‘‘(C) asserting or advocating a legal right

4 to cause, or to assist in causing, or to receive

5 assistance in causing, the death of any individ6 ual, such as by assisted suicide, euthanasia, or

7 mercy killing.’’.

Æ