[105th Congress Public Law 12]
[From the U.S. Government Printing Office]
<DOC>
[DOCID: f:publ12.105]
Public Law 105-12
105th Congress
An Act
To clarify Federal law with respect to restricting the use of Federal
funds in support of assisted suicide. <<NOTE: Apr. 30, 1997 - [H.R.
1003]>>
Be it enacted by the Senate and House of Representatives of the
United States of America <<NOTE: Assisted Suicide Funding Restriction
Act of 1997. 42 USC 14401 note.>> in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Assisted
Suicide Funding Restriction Act of 1997''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings and purpose.
Sec. 3. Restriction on use of Federal funds under health care programs.
Sec. 4. Restriction on use of Federal funds under certain grant programs
under the Developmental Disabilities Assistance and Bill of
Rights Act.
Sec. 5. Restriction on use of Federal funds by advocacy programs.
Sec. 6. Restriction on use of other Federal funds.
Sec. 7. Clarification with respect to advance directives.
Sec. 8. Application to District of Columbia.
Sec. 9. Conforming amendments.
Sec. 10. Relation to other laws.
Sec. 11. Effective date.
Sec. 12. Suicide prevention (including assisted suicide).
SEC. 2. <<NOTE: 42 USC 14401.>> FINDINGS AND PURPOSE.
(a) Findings.--Congress finds the following:
(1) The Federal Government provides financial support for
the provision of and payment for health care services, as well
as for advocacy activities to protect the rights of individuals.
(2) Assisted suicide, euthanasia, and mercy killing have
been criminal offenses throughout the United States and, under
current law, it would be unlawful to provide services in support
of such illegal activities.
(3) Because of recent legal developments, it may become
lawful in areas of the United States to furnish services in
support of such activities.
(4) Congress is not providing Federal financial assistance
in support of assisted suicide, euthanasia, and mercy killing
and intends that Federal funds not be used to promote such
activities.
(b) Purpose.--It is the principal purpose of this Act to continue
current Federal policy by providing explicitly that Federal funds may
not be used to pay for items and services (including assistance) the
purpose of which is to cause (or assist in causing) the suicide,
euthanasia, or mercy killing of any individual.
SEC. 3. RESTRICTION <<NOTE: 42 USC 14402.>> ON USE OF FEDERAL FUNDS
UNDER HEALTH CARE PROGRAMS.
(a) Restriction on Federal Funding of Health Care
Services.--Subject to subsection (b), no funds appropriated by
Congress for the purpose of paying (directly or indirectly) for the
provision of health care services may be used--
(1) to provide any health care item or service furnished for
the purpose of causing, or for the purpose of assisting in
causing, the death of any individual, such as by assisted
suicide, euthanasia, or mercy killing;
(2) to pay (directly, through payment of Federal financial
participation or other matching payment, or otherwise) for such
an item or service, including payment of expenses relating to
such an item or service; or
(3) to pay (in whole or in part) for health benefit coverage
that includes any coverage of such an item or service or of any
expenses relating to such an item or service.
(b) Construction and Treatment of Certain Services.--Nothing in
subsection (a), or in any other provision of this Act (or in any
amendment made by this Act), shall be construed to apply to or to affect
any limitation relating to--
(1) the withholding or withdrawing of medical treatment or
medical care;
(2) the withholding or withdrawing of nutrition or
hydration;
(3) abortion; or
(4) the use of an item, good, benefit, or service furnished
for the purpose of alleviating pain or discomfort, even if such
use may increase the risk of death, so long as such item, good,
benefit, or service is not also furnished for the purpose of
causing, or the purpose of assisting in causing, death, for any
reason.
(c) Limitation on Federal Facilities and Employees.--
Subject to subsection (b), with respect to health care items and
services furnished--
(1) by or in a health care facility owned or operated by the
Federal government, or
(2) by any physician or other individual employed by the
Federal government to provide health care services within the
scope of the physician's or individual's employment,
no such item or service may be furnished for the purpose of causing, or
for the purpose of assisting in causing, the death of any individual,
such as by assisted suicide, euthanasia, or mercy killing.
(d) List of Programs to Which Restrictions Apply.--
(1) Federal health care funding programs.--Subsection (a)
applies to funds appropriated under or to carry out the
following:
(A) Medicare program.--Title XVIII of the Social
Security Act.
(B) Medicaid program.--Title XIX of the Social
Security Act.
(C) Title xx social services block grant.--Title XX
of the Social Security Act.
(D) Maternal and child health block grant
program.--Title V of the Social Security Act.
(E) Public health service act.--The Public Health
Service Act.
(F) Indian health care improvement act.--The Indian
Health Care Improvement Act.
(G) Federal employees health benefits program.--
Chapter 89 of title 5, United States Code.
(H) Military health care system (including tricare
and champus programs).--Chapter 55 of title 10, United
States Code.
(I) Veterans medical care.--Chapter 17 of title 38,
United States Code.
(J) Health services for peace corps volunteers.--
Section 5(e) of the Peace Corps Act (22 U.S.C. 2504(e)).
(K) Medical services for federal prisoners.--
Section 4005(a) of title 18, United States Code.
(2) Federal facilities and personnel.--The provisions of
subsection (c) apply to facilities and personnel of the
following:
(A) Military health care system.--The Department of
Defense operating under chapter 55 of title 10, United
States Code.
(B) Veterans medical care.--The Veterans Health
Administration of the Department of Veterans Affairs.
(C) Public health service.--The Public Health
Service.
(3) Nonexclusive list.--Nothing in this subsection shall be
construed as limiting the application of subsection (a) to the
programs specified in paragraph (1) or the application of
subsection (c) to the facilities and personnel specified in
paragraph (2).
SEC. 4. RESTRICTION <<NOTE: 42 USC 14403.>> ON USE OF FEDERAL FUNDS
UNDER CERTAIN GRANT PROGRAMS UNDER THE DEVELOPMENTAL
DISABILITIES ASSISTANCE AND BILL OF RIGHTS ACT.
Subject to section 3(b) (relating to construction and treatment of
certain services), no funds appropriated by Congress to carry out part
B, D, or E of the Developmental Disabilities Assistance and Bill of
Rights Act may be used to support or fund any program or service which
has a purpose of assisting in procuring any item, benefit, or service
furnished for the purpose of causing, or the purpose of assisting in
causing, the death of any individual, such as by assisted suicide,
euthanasia, or mercy killing.
SEC. 5. RESTRICTION <<NOTE: 42 USC 14404.>> ON USE OF FEDERAL FUNDS BY
ADVOCACY
PROGRAMS.
(a) In General.--Subject to section 3(b) (relating to construction
and treatment of certain services), no funds appropriated by Congress
may be used to assist in, to support, or to fund any activity or service
which has a purpose of assisting in, or to bring suit or provide any
other form of legal assistance for the purpose of--
(1) securing or funding any item, benefit, program, or
service furnished for the purpose of causing, or the purpose of
assisting in causing, the suicide, euthanasia, or mercy killing
of any individual;
(2) compelling any person, institution, governmental entity
to provide or fund any item, benefit, program, or service for
such purpose; or
(3) asserting or advocating a legal right to cause, or to
assist in causing, the suicide, euthanasia, or mercy killing of
any individual.
(b) List of Programs to Which Restrictions Apply.--
(1) In general.--Subsection (a) applies to funds
appropriated under or to carry out the following:
(A) Protection and advocacy systems under the
developmental disabilities assistance and bill of rights
act.--Part C of the Developmental Disabilities
Assistance and Bill of Rights Act.
(B) Protection and advocacy systems under the
protection and advocacy for mentally ill individuals
act.--The Protection and Advocacy for Mentally Ill
Individuals Act of 1986.
(C) Protection and advocacy systems under the
rehabilitation act of 1973.--Section 509 of the
Rehabilitation Act of 1973 (29 U.S.C. 794e).
(D) Ombudsman programs under the older
americans act of 1965.--Ombudsman programs under the
Older Americans Act of 1965.
(E) Legal assistance.--Legal assistance programs
under the Legal Services Corporation Act.
(2) Nonexclusive list.--Nothing in this subsection shall be
construed as limiting the application of subsection (a) to the
programs specified in paragraph (1).
SEC. 6. RESTRICTION <<NOTE: 42 USC 14405.>> ON USE OF OTHER FEDERAL
FUNDS.
(a) In General.--Subject to section 3(b) (relating to construction
and treatment of certain services) and subsection (b) of this section,
no funds appropriated by the Congress shall be used to provide, procure,
furnish, or fund any item, good, benefit, activity, or service,
furnished or performed for the purpose of causing, or assisting in
causing, the suicide, euthanasia, or mercy killing of any individual.
(b) Nonduplication.--Subsection (a) shall not apply to funds to
which section 3, 4, or 5 applies, except that subsection (a), rather
than section 3, shall apply to funds appropriated to carry out title 10,
United States Code (other than chapter 55), title 18, United States Code
(other than section 4005(a)), and chapter 37 of title 28, United States
Code.
SEC. 7. CLARIFICATION <<NOTE: 42 USC 14406.>> WITH RESPECT TO ADVANCE
DIRECTIVES.
Subject to section 3(b) (relating to construction and treatment of
certain services), sections 1866(f) and 1902(w) of the Social
Security Act shall not be construed--
(1) to require any provider or organization, or any employee
of such a provider or organization, to inform or counsel any
individual regarding any right to obtain an item or service
furnished for the purpose of causing, or the purpose of
assisting in causing, the death of the individual, such as by
assisted suicide, euthanasia, or mercy killing; or
(2) to apply to or to affect any requirement with respect to
a portion of an advance directive that directs the purposeful
causing of, or the purposeful assisting in causing, the death of
any individual, such as by assisted suicide, euthanasia, or
mercy killing.
SEC. 8. APPLICATION <<NOTE: 42 USC 14407.>> TO DISTRICT OF COLUMBIA.
For purposes of this Act, the term ``funds appropriated by
Congress'' includes funds appropriated to the District of Columbia
pursuant to an authorization of appropriations under title V of the
District of Columbia Self-Government and Governmental Reorganization Act
and the term ``Federal government'' includes the government of the
District of Columbia.
SEC. 9. CONFORMING AMENDMENTS.
(a) Medicare Program.--
(1) Funding.--Section 1862(a) of the Social Security Act (42
U.S.C. 1395y(a)) is amended--
(A) by striking ``or'' at the end of paragraph (14);
(B) by striking the period at the end of paragraph
(15) and inserting ``; or''; and
(C) by inserting after paragraph (15) the following
new paragraph:
``(16) in the case in which funds may not be used for such
items and services under the Assisted Suicide Funding
Restriction Act of 1997.''.
(2) Advance directives.--Section 1866(f) of such Act (42
U.S.C. 1395cc(f)) is amended by adding at the end the following
new paragraph:
``(4) For construction relating to this subsection, see section 7 of
the Assisted Suicide Funding Restriction Act of 1997 (relating to
clarification respecting assisted suicide, euthanasia, and mercy
killing).''.
(b) Medicaid Program.--
(1) Funding.--Section 1903(i) of the Social Security Act (42
U.S.C. 1396b(i)) is amended--
(A) by striking ``or'' at the end of paragraph (14);
(B) by striking the period at the end of paragraph
(15) and inserting ``; or''; and
(C) by inserting after paragraph (15) the following
new paragraph:
``(16) with respect to any amount expended for which funds
may not be used under the Assisted Suicide Funding Restriction
Act of 1997.''.
(2) Advance directives.--Section 1902(w) of such Act (42
U.S.C. 1396a(w)) is amended by adding at the end the following
new paragraph:
``(5) For construction relating to this subsection, see section 7 of
the Assisted Suicide Funding Restriction Act of 1997 (relating to
clarification respecting assisted suicide, euthanasia, and mercy
killing).''.
(c) Title XX Block Grant Program.--Section 2005(a) of the Social
Security Act (42 U.S.C. 1397d(a)) is amended--
(1) by striking ``or'' at the end of paragraph (8);
(2) by striking the period at the end of paragraph (9) and
inserting ``; or''; and
(3) by adding at the end the following:
``(10) in a manner inconsistent with the Assisted Suicide
Funding Restriction Act of 1997.''.
(d) Maternal and Child Health Block Grant Program.--Section 501(a)
of the Social Security Act (42 U.S.C. 701(a)) is amended by adding at
the end the following:
``Funds appropriated under this section may only be used in a manner
consistent with the Assisted Suicide Funding Restriction Act of 1997.''.
(e) Public Health Service Act.--Title II of the Public Health
Service Act (42 U.S.C. 201 et seq.) is amended by adding at the end
thereof the following new section:
``SEC. 246. RESTRICTION <<NOTE: 42 USC 238o.>> ON USE OF FUNDS FOR
ASSISTED SUICIDE, EUTHANASIA, AND MERCY KILLING.
``Appropriations for carrying out the purposes of this Act shall not
be used in a manner inconsistent with the Assisted Suicide Funding
Restriction Act of 1997.''.
(f) Indian Health Care Improvement Act.--Title II of the Indian
Health Care Improvement Act (25 U.S.C. 1621 et seq.) is amended by
adding at the end the following new section:
``limitation on use of funds
``Sec. 225. Amounts <<NOTE: 25 USC 1621x.>> appropriated to carry
out this title may not be used in a manner inconsistent with the
Assisted Suicide Funding Restriction Act of 1997.''.
(g) Federal Employees Health Benefit Program.--Section 8902 of title
5, United States Code, is amended by adding at the end the following:
``(o) A contract may not be made or a plan approved which includes
coverage for any benefit, item, or service for which funds may not be
used under the Assisted Suicide Funding Restriction Act of 1997.''.
(h) Military Health Care Program.--Section 1073 of title 10, United
States Code, is amended by adding at the end the following: ``This
chapter shall be administered consistent with
the Assisted Suicide Funding Restriction Act of 1997.''.
(i) Veterans' Medical Care Program.--
(1) In general.--Subchapter I of chapter 17 of title 38,
United States Code, is amended by adding at the end the
following new section:
``Sec. 1707. Restriction on use of funds for assisted suicide,
euthanasia, or mercy killing
``Funds appropriated to carry out this chapter may not be used for
purposes that are inconsistent with the Assisted Suicide Funding
Restriction Act of 1997.''.
(2) Clerical amendment.--The table of sections at the
beginning of such chapter is amended by inserting after the item
relating to section 1706 the following new item:
``1707. Restriction on use of funds for assisted suicide, euthanasia, or
mercy killing.''.
(j) Health Care Provided for Peace Corps Volunteers.--Section 5(e)
of the Peace Corps Act (22 U.S.C. 2504(e)) is amended by adding at the
end the following: ``Health care may not be provided under this
subsection in a manner inconsistent with the Assisted Suicide Funding
Restriction Act of 1997.''.
(k) Medical Services for Federal Prisoners.--Section 4005(a) of
title 18, United States Code, is amended by inserting ``and to the
extent consistent with the Assisted Suicide Funding Restriction Act of
1997'' after ``Upon request of the Attorney
General''.
(l) Developmental Disabilities and Bill of Rights Act.--
(1) State plans regarding developmental disabilities
councils.--Section 122(c)(5)(A) of the Developmental
Disabilities Assistance and Bill of Rights Act (42 U.S.C.
6022(c)(5)(A)) is amended--
(A) in clause (vi), by striking ``and'' after the
semicolon at the end;
(B) in clause (vii), by striking the period at the
end and inserting ``; and''; and
(C) by adding at the end the following clause:
``(viii) such funds will be used consistent
with
section 4 of the Assisted Suicide Funding
Restriction Act of 1997.''.
(2) Legal actions by protection and advocacy
systems.--Section 142(h) of such Act (42 U.S.C. 6042(h)) is
amended by adding at the end the following new paragraph:
``(3) Limitation.--The systems may only use assistance
provided under this chapter consistent with section 5 of the
Assisted Suicide Funding Restriction Act of 1997.''.
(3) University affiliated programs.--Section 152(b)(5) of
such Act (42 U.S.C. 6062(b)(5)) is amended by adding at the end
the following: ``Such grants shall not be used in a manner
inconsistent with section 4 of the Assisted Suicide Funding
Restriction Act of 1997.''.
(4) Grants of national significance.--Section 162(c) of such
Act (42 U.S.C. 6082(c)) is amended--
(A) by striking ``and'' at the end of paragraph (4);
(B) by striking the period at the end of paragraph
(5) and inserting ``; and''; and
(C) by adding at the end the following new
paragraph:
``(6) the applicant provides assurances that the grant will
not be used in a manner inconsistent with section 4 of the
Assisted Suicide Funding Restriction Act of 1997.''.
(m) Protection and Advocacy for Mentally Ill Individuals Act of
1986.--Section 105(a) of the Protection and Advocacy for Mentally Ill
Individuals Act of 1986 (42 U.S.C. 10805(a)) is
amended--
(1) in paragraph (8), by striking ``and'' at the end;
(2) in paragraph (9), by striking the period and inserting
``; and''; and
(3) by adding at the end thereof the following new
paragraph:
``(10) not use allotments provided to a system in a manner
inconsistent with section 5 of the Assisted Suicide Funding
Restriction Act of 1997.''.
(n) Protection and Advocacy Systems Under the Rehabilitation Act of
1973.--Section 509(f) of the Rehabilitation Act of 1973 (29 U.S.C.
794e(f)) is amended--
(1) in paragraph (6), by striking ``and'' after the
semicolon at the end;
(2) in paragraph (7), by striking the period at the end and
inserting ``; and''; and
(3) by adding at the end the following paragraph:
``(8) not use allotments provided under this section in a
manner inconsistent with section 5 of the Assisted Suicide
Funding Restriction Act of 1997.''.
(o) Legal Services Program.--Section 1007(b) of the Legal Services
Corporation Act (42 U.S.C. 2996f(b)) is amended--
(1) by striking ``or'' at the end of paragraph (9);
(2) by striking the period at the end of paragraph (10) and
inserting ``; or''; and
(3) by adding after paragraph (10) the following:
``(11) to provide legal assistance in a manner inconsistent
with the Assisted Suicide Funding Restriction Act of 1997.''.
(p) Construction <<NOTE: 42 USC 14401 note.>> on Conforming
Amendments.--The fact that a law is not amended under this section shall
not be construed as indicating that the provisions of this Act do not
apply to such a law.
SEC. 10. RELATION <<NOTE: 42 USC 14408.>> TO OTHER LAWS.
The provisions of this Act supersede other Federal laws (including
laws enacted after the date of the enactment of this Act) except to the
extent such laws specifically supersede the provisions of this Act.
SEC. 11. EFFECTIVE <<NOTE: 42 USC 14401 note.>> DATE.
(a) In General.-- The provisions of this Act (and the amendments
made by this Act) take effect upon its enactment and apply, subject to
subsection (b), to Federal payments made pursuant to obligations
incurred after the date of the enactment of this Act for items and
services provided on or after such date.
(b) Application to Contracts.--Such provisions shall apply with
respect to contracts entered into, renewed, or extended after the date
of the enactment of this Act and shall also apply to a contract entered
into before such date to the extent permitted under such contract.
SEC. 12. SUICIDE PREVENTION (INCLUDING ASSISTED SUICIDE).
(a) Purpose.--The <<NOTE: 42 USC 295 note.>> purpose of this
section is to reduce the rate of suicide (including assisted suicide)
among persons with disabilities or terminal or chronic illness by
furthering knowledge and practice of pain management, depression
identification and treatment, and issues related to palliative care and
suicide prevention.
(b) Research and Demonstration Projects.--Section 781 of the Public
Health Service Act (42 U.S.C. 295) is amended--
(1) by redesignating subsection (e) as subsection (f); and
(2) by inserting after subsection (d) the following new
subsection:
``(e) Research and Demonstration Projects on Suicide Prevention
(Including Assisted Suicide).--
``(1) Research.--The Secretary may make grants to and enter
into contracts with public and private entities for conducting
research intended to reduce the rate of suicide (including
assisted suicide) among persons with disabilities or terminal or
chronic illness. The Secretary shall give preference to research
that aims--
``(A) to assess the quality of care received by
patients with disabilities or terminal or chronic
illness by measuring and reporting specific outcomes;
``(B) to compare coordinated health care (which may
include coordinated rehabilitation services, symptom
control, psychological support, and community-based
support services) to traditional health care delivery
systems; or
``(C) to advance biomedical knowledge of pain
management.
``(2) Training.--The Secretary may make grants and enter
into contracts to assist public and private entities, schools,
academic health science centers, and hospitals in meeting the
costs of projects intended to reduce the rate of suicide
(including assisted suicide) among persons with disabilities or
terminal or chronic illness. The Secretary shall give preference
to
qualified projects that will--
``(A) train health care practitioners in pain
management, depression identification and treatment, and
issues related to palliative care and suicide
prevention;
``(B) train the faculty of health professions
schools in pain management, depression identification
and treatment, and issues related to palliative care and
suicide
prevention; or
``(C) develop and implement curricula regarding
disability issues, including living with disabilities,
living with chronic or terminal illness, attendant and
personal care, assistive technology, and social support
services.
``(3) Demonstration projects.--The Secretary may make grants
to and enter into contracts with public and nonprofit private
entities for the purpose of conducting demonstration projects
that will--
``(A) reduce restrictions on access to hospice
programs; or
``(B) fund home health care services, community
living arrangements, and attendant care services.
``(4) Palliative medicine.--The Secretary shall emphasize
palliative medicine among its funding and research
priorities.''.
(c) Report <<NOTE: 42 USC 295 note.>> by General Accounting
Office.--Not later than 1 year after the date of enactment of this Act,
the Comptroller General of the United States shall submit to the
Congress a report providing an assessment of programs under subsection
(e) of section 781 of the Public Health Service Act (as added by
subsection (b) of this section) to conduct research, provide training,
and develop curricula and of the curricula offered and used by schools
of medicine and osteopathic medicine in pain management, depression
identification and treatment, and issues related to palliative care and
suicide prevention. The purpose of the assessment shall be to determine
the extent to which such programs have furthered knowledge and practice
of pain management, depression identification and treatment, and issues
related to palliative care and suicide prevention.
Approved April 30, 1997.
LEGISLATIVE HISTORY--H.R. 1003:
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HOUSE REPORTS: No. 105-46, Pt. 1 (Comm. on Commerce).
CONGRESSIONAL RECORD, Vol. 143 (1997):
Apr. 10, considered and passed House.
Apr. 16, considered and passed Senate.
WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 33 (1997):
Apr. 30, Presidential statement.
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