Your Nov. 1 editorial "The Assisted-Suicide Ban" laments the House's recent passage of the Pain Relief Promotion Act of 1999 (S. 1272, H.R. 2260), arguing that states' rights should trump federal legislation when it comes to federally regulated substances such as those used in Oregon to terminate patients' lives. The editorial asserts that "federal interest is minimal" in this life-and-death issue and (unlike Roe v. Wade) should be left up to each of the 50 states.

First, let's admit that all of us are willing to shift a bit along the continuum of federal vs. states' rights in order to protect human life. Such vital issues include slavery, abortion and now assisted suicide and euthanasia. The federal government has a constitutional interest in and a moral mandate to protect human life. It also must judiciously and effectively exercise its power to protect civil liberties, which are gravely endangered by assisted suicide and euthanasia.

Giving doctors the right to kill always leads to the loss of individual liberty. The most extreme example of this had its roots in pre-war Germany, where many doctors and others embraced the notion of a "life unworthy of life." Understandably, assisted-suicide proponents would never compare their own motives and methods to the Nazi euthanasia experiment. Many are doubtless motivated by sincere though misplaced compassion. Whatever the motivation, the result of legalizing death is always the same--the loss of civil liberties and life.

In contemporary Holland, where courts began winking at assisted suicide and euthanasia more than a decade ago, doctors now fiercely guard their power and autonomy in putting patients to death. Even when the Dutch government's own report revealed that thousands of patients were being put to death involuntarily by doctors who deemed their lives "unworthy of life," physicians and politicians defend the practice. They argue that many of the involuntarily terminated patients were deemed to be on the verge of death, so they simply were given overdoses of painkillers as a calculated "mercy."

Despite ostensibly stringent regulations, even when abuses are unearthed, Dutch courts have been loath to convict these doctors. The courts have actually expanded the reach of medical killing to include patients who are not even suffering from terminal disease or physical pain. As a result, the authority of Dutch physicians now borders on omnipotence.

How does compassion turn into calculated killing? How can carefully crafted regulations produce a medical autocracy?

The answers are readily apparent--especially in a health care system with intense financial pressures. Any HMO, government bureaucrat or physician who gets paid for saving on patient care is keenly aware that killing is far cheaper than caring.

Assisted suicide proponents are eager to cast physician and family members in the role of catalysts--not active participants. In reality, though, each of these parties can easily play a coercive role in a patient's "choice." By highlighting the hopelessness of a disease, by raising the suicide option, by stressing the benefits of early termination, a physician can strongly influence a vulnerable patient toward an early death. Unscrupulous heirs can subtly prey upon a relative's desire to not "burden" the family. Unwilling family caretakers can complain of the stress of long-term care. Considering that each of these parties can reap a hefty financial benefit from the patient's early death, abuse is certain.

With such peril to our lives and civil liberties, it is entirely appropriate that the federal government should assert an interest in this vital issue.

--Jonathan Imbody

The writer is director of policy

and ethics at the

Christian Medical & Dental Society.