Federal
Register Notices > Notices
- 2001 > Dispensing of Controlled
Substances To Assist Suicide
[Federal Register: November 9, 2001 (Volume 66,
Number 218)]
[Rules and Regulations]
[Page 56607-56608]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr09no01-7]
DEPARTMENT OF JUSTICE
Office of the Attorney General
21 CFR Part 1306
[AG Order No. 2534-2001]
Dispensing of Controlled Substances To Assist
Suicide
AGENCY: Department of Justice.
[[Page 56608]]
ACTION: Interpretive rule.
SUMMARY: For the reasons provided in the
memorandum set forth below, the Attorney General has determined that
assisting suicide is not a "legitimate medical purpose'' within the
meaning of 21 CFR 1306.04
(2001), and that prescribing, dispensing, or administering federally
controlled substances to assist suicide violates the Controlled Substances
Act. Such conduct by a physician registered to dispense controlled
substances may "render his registration . . . inconsistent with the public
interest'' and therefore subject to possible suspension or revocation
under 21 U.S.C. 824(a)(4).
The Attorney General's conclusion applies regardless of whether state law
authorizes or permits such conduct by practitioners or others and
regardless of the condition of the person whose suicide is assisted. The
Attorney General recognizes, however, that pain management is a legitimate
medical purpose justifying a physician's dispensing of controlled
substances. Finally, the Attorney General's determination makes no change
in the current standards and practices of the DEA in any State other than
Oregon.
EFFECTIVE DATE: November 9, 2001.
FOR FURTHER INFORMATION CONTACT: Patricia
Good, Chief, Liaison and Policy Section, Office of Diversion Control, Drug
Enforcement Administration, Washington, D.C. 20537, telephone
202-307-7297.
SUPPLEMENTARY INFORMATION: The text of the
Attorney General's memorandum follows:
Memorandum for Asa Hutchinson, Administrator, The
Drug Enforcement Administration
From: John Ashcroft, Attorney General
Subject: Dispensing of Controlled Substances to Assist Suicide
As you are aware, the Supreme Court reaffirmed last
term that the application of federal law regulating controlled substances
is uniform throughout the United States and may not be nullified by the
legislative decisions of individual States. See United States v.
Oakland Cannabis Buyers' Coop., 532 U.S. 483 (2001). In light of this
decision, questions have been raised about the validity of an Attorney
General letter dated June 5, 1998, which overruled an earlier Drug
Enforcement Administration (DEA) determination that narcotics and other
dangerous drugs controlled by federal law may not be dispensed
consistently with the Controlled Substances Act, 21
U.S.C. 801-971 (1994 & Supp. II 1996) (CSA), to assist suicide in
the United States. Upon review of the Oakland Cannabis decision and
other relevant authorities, I have concluded that the DEA's original
reading of the CSA--that controlled substances may not be dispensed to
assist suicide--was correct. I therefore advise you that the original DEA
determination is reinstated and should be implemented as set forth in
greater detail below.
The attached Office of Legal Counsel opinion,
entitled "Whether Physician-Assisted Suicide Serves a "Legitimate
Medical Purpose'' Under The Drug Enforcement Administration's Regulations
Implementing the Controlled Substances Act'' (June 27, 2001) ("OLC
Opinion'') (attached) sets forth the legal basis for my decision.
- Determination on Use of Federally Controlled
Substances to Assist Suicide. For the reasons set forth in the OLC
Opinion, I hereby determine that assisting suicide is not a "legitimate
medical purpose'' within the meaning of 21
CFR § 1306.04 (2001), and that prescribing, dispensing, or
administering federally controlled substances to assist suicide
violates the CSA. Such conduct by a physician registered to dispense
controlled substances may "render his registration * * * inconsistent
with the public interest'' and therefore subject to possible
suspension or revocation under 21
U.S.C. 824(a)(4). This conclusion applies regardless of whether
state law authorizes or permits such conduct by practitioners or
others and regardless of the condition of the person whose suicide is
assisted.
I hereby direct the DEA, effective upon
publication of this memorandum in the Federal Register, to enforce and
apply this determination, notwithstanding anything to the contrary in
the June 5, 1998, Attorney General's letter.
- Use of Controlled Substances to Manage Pain
Promoted. Pain management, rather than assisted suicide, has long
been recognized as a legitimate medical purpose justifying physicians'
dispensing of controlled substances. There are important medical,
ethical, and legal distinctions between intentionally causing a
patient's death and providing sufficient dosages of pain medication
necessary to eliminate or alleviate pain.
- No Change in Current DEA Policies and
Enforcement Practices Outside Oregon. The reinstated determination
makes no change in the current standards and practices of the DEA in
any State other than Oregon. Former Attorney General Janet Reno's June
5, 1998, letter relating to this matter emphasized that action to
revoke the DEA registration of a physician who uses federally
controlled substances to assist a suicide "may well be warranted * * *
where a physician assists in a suicide in a state that has not
authorized the practice under any conditions.'' The reinstated
determination does not portend any increase in investigative activity
or other change from the manner in which the DEA presently enforces
this policy outside of Oregon.
- Enforcement in Oregon. Under 3 Oregon
Revised Statutes (O.R.S.) § 127.855 (1999), an attending physician
who writes a prescription for medication to end the life of a
qualified patient must document the medication prescribed. Under 3
O.R.S. § 127.865(1)(b) (1999), the State of Oregon's Health Division
must require any health care provider upon dispensing medication
pursuant to the Death with Dignity Act to file a copy of the
dispensing record with the Division. Those records should contain the
information necessary to determine whether those holding DEA
registrations who assist suicides in accordance with Oregon law are
prescribing federally controlled substances for that purpose in
violation of the CSA as construed by this Memorandum and the attached
OLC Opinion.
The Department has the authority to take
appropriate measures to obtain copies of any such reports or records
sent to the Oregon State Registrar. See 21
U.S.C. 876. When inspection of these documents discloses prohibited
prescription of controlled substances to assist suicide following the
effective date of this memorandum, then appropriate administrative
action may be taken in accordance with 21
CFR §§ 1316.41 to 1316.68 (2001).
Thus, it should be possible to identify the cases
in which federally controlled substances are used to assist suicide in
Oregon in compliance with Oregon law by obtaining reports from the
Oregon State Registrar without having to review patient medical records
or otherwise investigate doctors. Accordingly, implementation of this
directive in Oregon should not change the DEA's current practices with
regard to enforcing the CSA so as materially to increase monitoring or
investigation of physicians or other health care providers or to
increase review of physicians' prescribing patterns of controlled
substances used for pain relief.
- Distribution. Please ensure that this
Memorandum and the OLC opinion on which it is based are promptly
distributed to appropriate DEA personnel, especially those with
authority over the enforcement of the CSA in Oregon.
Attachment
Note: The attachment containing the Office of
Legal Counsel opinion dated June 27, 2001, does not appear in the Federal
Register. It is available from the Drug Enforcement Administration at the
address listed in FOR FURTHER INFORMATION CONTACT.
Dated: November 6, 2001.
John Ashcroft,
Attorney General.
[FR Doc. 01-28358 Filed 11-7-01; 12:43 pm]
BILLING CODE 4410-09-P
NOTICE: This is an
unofficial version. An official version of these publications may be obtained
directly from the Government Printing Office (GPO).
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