I
106TH CONGRESS
1ST SESSION
H. R. 2260
To amend the Controlled Substances Act to promote pain management and
palliative care without permitting assisted suicide and euthanasia, and
for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JUNE 17, 1999
Mr. HYDE (for himself, Mr. STUPAK, Mr. ADERHOLT, Mr. BAKER, Mr.
BALLENGER, Mr. BARCIA, Mr. BARTON of Texas, Mr. BLUNT, Mr. BRY-
ANT, Mr. BURR of North Carolina, Mr. BURTON of Indiana, Mr. CANADY
of Florida, Mr. CHABOT, Mr. COBURN, Mr. COLLINS, Mr. CUNNINGHAM,
Mr. DICKEY, Mr. DOOLITTLE, Mr. DOYLE, Mrs. EMERSON, Mr. EVER-
ETT, Mr. FOSSELLA, Mr. GRAHAM, Mr. GOODE, Mr. GOODLATTE, Mr.
HALL of Texas, Mr. HAYES, Mr. HERGER, Mr. HOEKSTRA, Mr. HUTCH-
INSON, Mr. ISTOOK, Mr. JOHN, Mr. KING, Mr. KNOLLENBERG, Mr. LA-
FALCE, Mr. LAHOOD, Mr. LARGENT, Mr. LEWIS of Kentucky, Mr.
LUCAS of Kentucky, Mr. LUCAS of Oklahoma, Mr. MCINTYRE, Mr. MIL-
LER of Florida, Mrs. MYRICK, Mr. NUSSLE, Mr. NETHERCUTT, Mr. PE-
TERSON of Pennsylvania, Mr. PETERSON of Minnesota, Mr. PHELPS, Mr.
PICKERING, Mr. PITTS, Mr. PORTMAN, Mr. RAHALL, Mr. ROGAN, Mr.
ROGERS, Mr. SALMON, Mr. SCHAFFER, Mr. SENSENBRENNER, Mr.
SHIMKUS, Mr. SHOWS, Mr. SKELTON, Mr. SMITH of Texas, Mr. SMITH
of New Jersey, Mr. SPENCE, Mr. STEARNS, Mr. TANCREDO, Mr. TERRY,
Mr. WALSH, Mr. WAMP, and Mr. WELDON of Florida) introduced the fol-
lowing bill; which was referred to the Committee on Commerce, and in
addition to the Committee on the Judiciary, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
A BILL
To amend the Controlled Substances Act to promote pain
management and palliative care without permitting as-
sisted suicide and euthanasia, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Pain Relief Promotion
Act of 1999’’.
TITLE I—USE OF CONTROLLED SUB-
STANCES CONSISTENT WITH THE
CONTROLLED SUBSTANCES ACT
SEC. 101. REINFORCING EXISTING STANDARD FOR LEGITI-
MATE USE OF CONTROLLED SUBSTANCES.
Section 303 of the Controlled Substances Act (21
U.S.C. 823) is amended by adding at the end the fol-
lowing:
‘‘(i)(1) For purposes of this Act and any regulations
to implement this Act, alleviating pain or discomfort in
the usual course of professional practice is a legitimate
medical purpose for the dispensing, distributing, or admin-
istering of a controlled substance that is consistent with
public health and safety, even if the use of such a sub-
stance may increase the risk of death. Nothing in this sec-
tion authorizes intentionally dispensing, distributing, or
administering a controlled substance for the purpose of
causing death or assisting another person in causing
death.
‘‘(2) Notwithstanding any other provision of this Act,
in determining whether a registration is consistent with
the public interest under this Act, the Attorney General
shall give no force and effect to State law authorizing or
permitting assisted suicide or euthanasia.
‘‘(3) Paragraph (2) applies only to conduct occurring
after the date of enactment of this subsection.’’.
SEC. 102. EDUCATION AND TRAINING PROGRAMS.
Section 502(a) of the Controlled Substances Act (21
U.S.C. 872(a)) is amended—
(1) by striking ‘‘and’’ at the end of paragraph
(5);
(2) by striking the period at the end of para-
graph (6) and inserting ‘‘; and’’; and
(3) by adding at the end the following:
‘‘(7) educational and training programs for
local, State, and Federal personnel, incorporating
recommendations by the Secretary of Health and
Human Services, on the necessary and legitimate
use of controlled substances in pain management
and palliative care, and means by which investiga-
tion and enforcement actions by law enforcement
personnel may accommodate such use.’’.
TITLE II—PROMOTING
PALLIATIVE CARE
SEC. 201. ACTIVITIES OF AGENCY FOR HEALTH CARE POL-
ICY AND RESEARCH.
Part A of title IX of the Public Health Service Act
(42 U.S.C. 299 et seq.) is amended by adding at the end
the following section:
‘‘SEC. 906. PROGRAM FOR PALLIATIVE CARE RESEARCH
AND QUALITY.
‘‘(a) IN GENERAL.—The Administrator shall carry
out a program to accomplish the following:
‘‘(1) Develop and advance scientific under-
standing of palliative care.
‘‘(2) Collect and disseminate protocols and evi-
dence-based practices regarding palliative care, with
priority given to pain management for terminally ill
patients, and make such information available to
public and private health care programs and pro-
viders, health professions schools, and hospices, and
to the general public.
‘‘(b) DEFINITION.—For purposes of this section, the
term ‘palliative care’ means the active total care of pa-
tients whose prognosis is limited due to progressive, far-
advanced disease. The purpose of such care is to alleviate
pain and other distressing symptoms and to enhance the
quality of life, not to hasten or postpone death.’’.
SEC. 202. ACTIVITIES OF HEALTH RESOURCES AND SERV-
ICES ADMINISTRATION.
(a) IN GENERAL.—Part D of title VII of the Public
Health Service Act (42 U.S.C. 294 et seq.), as amended
by section 103 of Public Law 105–392 (112 Stat. 3541),
is amended—
(1) by redesignating sections 754 through 757
as sections 755 through 758, respectively; and
(2) by inserting after section 753 the following
section:
‘‘SEC. 754. PROGRAM FOR EDUCATION AND TRAINING IN
PALLIATIVE CARE.
‘‘(a) IN GENERAL.—The Secretary, in consultation
with the Administrator for Health Care Policy and Re-
search, may make awards of grants, cooperative agree-
ments, and contracts to health professions schools, hos-
pices, and other public and private entities for the develop-
ment and implementation of programs to provide edu-
cation and training to health care professionals in pallia-
tive care.
‘‘(b) PRIORITIES.—In making awards under sub-
section (a), the Secretary shall give priority to awards for
the implementation of programs under such subsection.
the evaluation of programs implemented under subsection
(a) in order to determine the effect of such programs on
knowledge and practice regarding palliative care.
‘‘(f) PEER REVIEW GROUPS.—In carrying out section
799(f) with respect to this section, the Secretary shall en-
sure that the membership of each peer review group in-
volved includes one or more individuals with expertise and
experience in palliative care.
‘‘(g) DEFINITION.—For purposes of this section, the
term ‘palliative care’ means the active total care of pa-
tients whose prognosis is limited due to progressive, far-
advanced disease. The purpose of such care is to alleviate
pain and other distressing symptoms and to enhance the
quality of life, not to hasten or postpone death.’’.
(b) AUTHORIZATION OF APPROPRIATIONS; ALLOCA-
TION.—
(1) IN GENERAL.—Section 758 of the Public
Health Service Act (as redesignated by subsection
(a)(1) of this section) is amended in subsection
(b)(1)(C) by striking ‘‘sections 753, 754, and 755’’
and inserting ‘‘section 753, 754, 755, and 756’’.
(2) AMOUNT.—With respect to section 758 of
the Public Health Service Act (as redesignated by
subsection (a)(1) of this section), the dollar amount
specified in subsection (b)(1)(C) of such section is
deemed to be increased by $5,000,000.
SEC. 203. EFFECTIVE DATE.
The amendments made by this title take effect Octo-
ber 1, 1999, or upon the date of the enactment of this
Act, whichever occurs later.
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