The NewsHour with Jim Lehrer

JIM LEHRER: Good evening. I'm Jim Lehrer. On the NewsHour tonight the Supreme Court arguments over doctor-assisted suicide as reported by Stuart Taylor, debated by two doctors, excerpts from Madeleine Albright's secretary of state confirmation hearings, and some historical perspective on political scandal from Haynes Johnson, Michael Beschloss, Doris Kearns Goodwin, and Suzanne Garment. It all follows our summary of the news this Wednesday. NEWS SUMMARY

JIM LEHRER: The Supreme Court heard arguments today on the right to doctor-assisted suicide. Lower federal courts had thrown out laws in New York and Washington State that prohibited the practice. Today Justice Department lawyers argued that legalizing assisted suicide could lead to abuses. Lawyers on the other side said terminally ill patients should be able to relieve their pain and suffering. Representatives of both spoke to reporters outside the Supreme Court.

DR. NANCY DICKEY, American Medical Association: If we begin to trivialize what life is, that there's some group of lives that don't have to be protected, then there are a great many people who would be at risk, that there would be economic pressures, there would be family pressures, social pressures to say perhaps you ought to consider the easier way, to choose death with dignity or assisted suicide. And we think that the state has a right and the profession has a right to try to protect those people from dying prematurely.

DR. TIMOTHY QUILL, Assisted Suicide Advocate: Are we better off with an open system subject to regulation, or are we better off with a secret system, as we currently have, where you have to hedge your intentions and where when people get help they get help in secret, no second opinions, no reassurance that every stone had been turned? It is conceivable that an open system would actually improve care for the dying because we would ensure that all palliative options have been tried before we'd ever engage with a patient on this kind of an act.

JIM LEHRER: The Supreme Court is expected to rule on this case by July. We'll have more on the story right after the News Summary. Madeleine Albright pledged today to work with Congress and America's allies. She spoke at her confirmation hearing to be secretary of state. She told the Senate Foreign Relations Committee NATO expansion, U.S. payments to the United Nations, and arms control will be among her top priorities. Albright's comments were interrupted by heckling. Protesters said U.S. sanctions against Iraq were punishing children. Committee Chairman Jesse Helms voted the demonstrators be taken out of the room by capital police.

MADELEINE ALBRIGHT, Secretary of State-Designate: I am as concerned about the children of Iraq as any person in this room. Who is not concerned about the children of Iraq is Saddam Hussein, who has used his people as a pawn in order to try to break what is a legitimate sanctions regime that was imposed on his country as a result of his aggression into Kuwait.

JIM LEHRER: We'll have extended excerpts from today's hearings later in the program. The House Ethics Committee met behind closed doors today to consider the charges against House Speaker Newt Gingrich. They heard from outside counsel and worked on a timetable for a public hearing. Gingrich, re-elected speaker yesterday, has admitted breaking House rules by using tax-exempt funds for political purposes. He also admitted giving inaccurate information to the Ethics Committee. The committee must recommend a penalty by January 17th. A vote on the punishment is scheduled for the full House by January 21st. Russian President Yeltsin was hospitalized today. A spokesman said he had developed the first signs of pneumonia and will be in a Moscow hospital for several days. Yeltsin had heart bypass surgery in November. The Serbian government acknowledged today that an opposition coalition won municipal elections in Neese, Serbia's second largest city. The decision was announced on state television. Neese was one of fifteen cities where the victories of opposition candidates were annulled by the Milosevic government. The news triggered more demonstrations in Belgrade. People on foot and in cars created a traffic jam downtown. Lines of riot police also blocked streets in an effort to control the situation. Protests have been going on for seven weeks. And that's it for the News Summary tonight. Now it's on to doctor-assisted suicide, the Albright hearings, and some scandal history. FOCUS - ASSISTED SUICIDE

JIM LEHRER: We do go first tonight to today's doctor-assisted suicide arguments before the Supreme Court and to Elizabeth Farnsworth.

ELIZABETH FARNSWORTH: The Supreme Court today considered one of the most difficult questions of this term: Should the court declare a constitutional right for physicians to help terminally ill patients commit suicide? Two cases are before the court, one from Washington State and the other from New York. They are among the most closely watched appeals since 1992, when the Supreme Court reaffirmed the constitutional right to an abortion. Dozens of groups and individuals have filed friend of the court briefs. We begin our coverage with this backgrounder on the Washington case from Rod Minott of KCTS-Seattle.

JINNY TESIK: This is one of my favorite pictures of him in Egypt on a camel. That was again during the war.

ROD MINOTT: Jinny Tesik remembers a time when her father, Lon Fletcher, was a healthy, active man. A paratrooper in the Second World War, he had survived heavy combat, but years later there was another battle he would not overcome.

JINNY TESIK: Here you can begin to see the difference in him with emphysema. But look at the difference of his eyes and his face. It's just, you know, he's a very changed person.

ROD MINOTT: Years of heavy smoking left him short of breath and tethered to an oxygen bottle.

JINNY TESIK: I don't think that there was as much pain involved as there was just total disability for a man who'd been pretty active. Honestly, he wasn't getting up out of his chair. His body was wasting away.

ROD MINOTT: Tesik says her father wanted to end his life, but his doctor refused to prescribe a lethal dose of pills. As a result, she was forced to help him stockpile medication, guessing at how much the 76-year-old man would need to commit suicide successfully.

JINNY TESIK: He wasn't afraid. He was really ready. And about 5 or so in the afternoon he said for me to go now. And that was hard- -to walk away from him, to know that he was going to have to do this by himself. And I came back maybe five hours later, and I didn't know what I was going to find. I was scared because not that I was afraid to find him dead, but I was afraid to find him still alive. And he wasn't. And I was very, very grateful for that.

ROD MINOTT: Tesik said she couldn't be with her dying father, nor would the doctor prescribe a lethal dose of pills because under Washington State law assisting in a suicide is illegal. Originally passed in the 19th century, the statute makes assisted suicide a felony, punishable by up to five years in prison. No charges were ever brought against Tesik, but she and others are now hoping a landmark lawsuit will overturn the state's ban, as well as similar laws across the country that bar physician-assisted suicide.

WOMAN ON PHONE: Compassion in Dying. This is Kim.

ROD MINOTT: The Washington State lawsuit was filed in 1994 by a Seattle based group, Compassion in Dying, which counsels terminally ill patients on how to take their own lives. The case is brought on behalf of four physicians and three terminally ill patients who are now deceased. Last spring federal appeals courts upheld lawsuits filed by Compassion in Dying in both Washington State and New York. In its decision in the Washington State case, the 9th Circuit Court said the ban was a denial of due process under the 14th amendment of the U.S. Constitution. The court ruled there is a constitutionally protected liberty interest in determining the time and manner of one's own death. Kathryn Tucker is an attorney for Compassion in Dying.

KATHRYN TUCKER, Attorney, "Compassion in Dying": The 9th Circuit's ruling is quite narrow. The case is quite narrow, limited to mentally competent terminally ill patients who would choose to have a dignified and humane death by self-administering medications for the purpose of ending their life.

ROD MINOTT: The 9th Circuit ruling also relied heavily on past U.S. Supreme Court decisions that have expanded liberty rights on abortion. Last fall the U.S. Supreme Court agreed to hear challenges to both the 9th and 2nd Circuit Court rulings which struck down laws that bar doctor-assisted suicide. At heart is the question of whether the terminally ill have a constitutionally protected right to end their own lives. Kathryn Tucker argues they do.

KATHRYN TUCKER: Our Constitution protects liberty, and our claim is that this kind of a decision is an intensely personal decision, and it's a decision about your own body and the own--your own life. And so for the state to intrude into and control that decision is a deprivation of liberty.

ROD MINOTT: But critics say there is no such legal right, and they warn of possible abuses if physician-assisted suicide is legalized.

CHRISTINE GREGOIRE, Washington State Attorney General: I felt that this issue was such a watershed constitutional issue that the best I could do was get it before the court.

ROD MINOTT: Christine Gregoire is attorney general for the state of Washington. She's urging the Supreme Court to reverse the 9th Circuit ruling.

CHRISTINE GREGOIRE: You simply ask the U.S. Supreme Court to find a liberty interest in assisted suicide. Then to whom? To the terminally ill, what's your definition of terminally ill? To adults only? Why just adults? Why not children as well? To only the mentally competent? Well, what's the constitutional argument to say only to the mentally competent? And at what point do you say you have two physicians that see you to say you're mentally competent versus three versus one, I mean, who sets the parameters, who sets the regulations?

ROD MINOTT: Gregoire argues that if anyone is going to decide that issue, it should be the state and not the federal government.

CHRISTINE GREGOIRE: And we are arguing this is not the province of the court to be telling the state how to view these issues. It's a legislative matter. It's a matter for the citizens of our respective states to say when they want assisted suicide if they do and under what circumstances.

ELIZABETH FARNSWORTH: Watching today's Supreme Court hearing was NewsHour regular Stuart Taylor, correspondent for the "American Lawyer" and "Legal Times." Welcome, Stuart.

STUART TAYLOR, The American Lawyer: Nice to be here.

ELIZABETH FARNSWORTH: Let's get one thing clear. This is about- -the Supreme Court heard these cases that are about a doctor giving a patient, who is an adult, competent person, medication to take their own lives, right? This is not about a doctor administering an injection to somebody who's wasting away?

STUART TAYLOR: That's exactly what it's about. And a patient-- the lower courts held it would--this right would only apply if the patient was terminally ill and mentally competent, and that the patient would administer the medication him or herself. This case, it relates to large issues of other kinds, but strictly speaking, that's what it's about.

ELIZABETH FARNSWORTH: Okay. We just heard about the case in Washington State. Tell us about the New York case.

STUART TAYLOR: In the New York case it was rather similar--three doctors who want to be able to help their patients end their lives with dignity and with less pain. And three patients who were terminally ill and wanted that kind of help and who have all died since the litigation began sued to strike down a New York law that bars anyone from assisting in a suicide, anyone including a physician. All 50 states have laws like this, unless one accepts Oregon, which recently repealed it by referendum, but that's tied up in litigation. In any event, that case went up to the U.S. Court of Appeals for the 2nd Circuit, and they struck down the law in a three-nothing vote, but by a different rationale, a substantially different rationale than the 9th Circuit and the case we just heard about. The 2nd Circuit judge, who wrote the opinion, Roger Minor, a Reagan appointee, by the way, rejected the logic the 9th Circuit had adopted in an opinion by Steven Reinhardt, a very liberal Carter-appointed judge, and said we don't find a due process liberty right. He said the Supreme Court has shown some reluctance to go too far in lawmaking by inventing new rights, and we think that would go too far; however, you got to the same result by looking at the equal protection clause of the Constitution. And his reasoning went like this: the state of New York and many states recognize a right for a patient to terminate life support systems, to bring on his own death by telling the doctor pull the plug. We think, said Judge Minor, that that situation is not rationally distinguishable from the patient who isn't on a life support system but is in agonizing pain and wants to die and wants the doctor to give him a pill or an injection or prescribe something so that he can end his own suffering. In essence, he found that there's a discrimination in New York law between allowing people to pull the plug but not allowing people to get doctors' assistance in prescribing lethal medication. And on that basis he struck, the 2nd Circuit struck down the New York law.

ELIZABETH FARNSWORTH: That's one precedent the Justices could look at, their decision that allowed pulling the plug, so to speak. What other precedents could they be looking at and using to make this big decision?

STUART TAYLOR: Well, pulling the plug is largely thought to be a constitutional right now based on a 1989 decision, Nancy Cruzan Vs. Missouri, in which five of the Justices seemed to say, although the opinions were a little murky, that there's something like a constitutional right to refuse medical treatment, including refusing life support systems or pulling the plug. The--there are no other right-to-die type precedents the Supreme Court has decided. As we said earlier, the abortion precedents are an important part of the analysis here because they represent the farthest extension the court has been willing to take so far down the road of looking at the vague reference to liberty in the due process clause of the 14th amendment and using that to create rights that had never been recognized. And, in fact, in this case, as in the original abortion case, they're being called upon to strike down the laws of just about every state in these practices of the law throughout history.

ELIZABETH FARNSWORTH: What arguments did you hear today?

STUART TAYLOR: Well, the arguments, first at bat were the states, the attorney general of New York, Dennis Vaco, and William Williams, who's an assistant attorney general from Washington, saying in essence why their law should be reinstated and why the lower courts were wrong. And the essence of their argument was that recognizing a right to doctor-assisted suicide, particularly a constitutional right, which freezes it in stone in a way so that the states can't change it, goes against a traditional respect and state interest in protecting life, which is a paramount constitutional interest, and opens up large possibilities of abuse of families, doctors, insurance companies, perhaps pressuring people to take lethal medication to avoid costs, to avoid suffering, so that maybe we wouldn't really hold the line at terminal illness or at competent people. Maybe people would be pushed into this by cost pressures and the like, and erasing a longstanding ethical line between a right to refuse unwanted medical treatment, a right to be left alone, in essence, and on the other hand, a right to have a doctor actually actively help you kill yourself.

ELIZABETH FARNSWORTH: And what about the other side, what was that argument?

STUART TAYLOR: The various groups seeking assisted suicide represented by Kathryn Tucker, who we saw earlier, and Lawrence Tribe, a law professor at Harvard Law School, and a Supreme Court litigator, who is attacking the New York law, the essence of their argument was that at the very heart of constitutionally protected liberty is the right to make intimate individual choices in the most important phases of life. And they stress the abortion precedents in this regard. And they say what could be more important than the choice as to how to die for a terminally ill patient, particularly when that that is combined with the understandable desire to avoid dying in agonizing pain. And they say that the Constitution ought to protect that right. They also stress that they think the state laws are outmoded and irrational in allowing people to have the plug pulled and to die in suffering, or in what Mr. Tribe called a barbiturate coma induced by what he called terminal sedation. Apparently, according to him it's a widespread practice, to put people basically in a coma through sedation so that when they're starved to death by having the plug pulled, they won't suffer too much. And he stressed that if that's allowed, I mean, why should we have a barbaric thing like that going on, was part of his suggestion, when it could be done so much more, with so much more dignity and so much less pain, simply by giving a lethal medication.

ELIZABETH FARNSWORTH: Could you tell from the Justices' questions how they were leaning?

STUART TAYLOR: I think you could get some feeling for it. I wouldn't venture a continent prediction in a case of this importance. I don't think--I think they're going to be thinking about it and talking it, and I wouldn't be surprised if they talked about this case more than about most. But you could certainly sense from the questioning that the Justices in the middle who the plaintiffs really need to get the votes of in order to establish a right to physician-assisted suicide, Justice O'Connor, Souter, Ginsburg, and Kennedy, for example, all had very great concerns about opening Pandora's box, about creating a new constitutional right, opening up a huge realm of very difficult questions as to what's terminal illness, what if somebody wants to come in who's depressed and 46 years old and in pain but not about to die and says hey, I have a right to end my suffering too? They also, all four of the people I mentioned, stressed that in Justice O'Connor's words this is an issue that affects all of us. This isn't something that just affects some discreet minority like a racial minority somewhere that might not be fairly represented in the democratic process. Why can't we leave it to the legislatures to work this out? They know more about it than we do. They are more flexible than we are. Their laws can be changed from year to year. Our constitutional precedents are supposed to be of some permanence, and so I had the sense that it's a very up hill battle for those seeking to establish a right to physician-assisted suicide.

ELIZABETH FARNSWORTH: Well, Stuart Taylor, thanks very much.

STUART TAYLOR: Thank you.

JIM LEHRER: Now the medical side of this debate. Margaret Warner has that story.

MARGARET WARNER: To debate the medical and ethical issues raised by today's Supreme Court cases we have two physicians. Dr. Ira Byock is a practicing hospice doctor in Missoula, Montana, who specializes in caring for patients in the last months of their lives. He's also president of the American Academy of Hospice & Palliative Medicine. Dr. Marcia Angell is the executive editor of the "New England Journal of Medicine." She wrote a recent editorial supporting physician-assisted suicide. For the record, Dr. Angell has said that the editorial reflected her own position and not necessarily that of the Journal. Welcome both of you. Dr. Angell, you support a patient's right to have a physician assist him or her in suicide. Give us the medical and ethical dimensions of that from your perspective.

DR. MARCIA ANGELL, New England Journal of Medicine: Well, it seems to me almost self-evident that a dying patient who is suffering unbearably should have the option to end his life. And most such patients will require the assistance of a doctor to do so humanely and with dignity. We're not talking about forcing such patients to end their lives, and we're not talking about requiring doctors to help them. We're merely saying that there should be this choice, that they should be able to exercise the option.

MARGARET WARNER: And you said that patients needs a doctor to do this. Why?

DR. MARCIA ANGELL: Well, in most cases patients will want a doctor. Not every patient knows how to get hold of the pills or how many pills he should take. They're afraid of botching the job. And, of course, the very illegality of it means that it's often done badly. It's often done violently. The doctor's been with the patient this far in a terminal illness. And I think the doctor has an obligation to help the patient in whatever way seems appropriate all the way through the lingering illness.

MARGARET WARNER: Dr. Byock, you think this is a very bad idea. Why?

DR. IRA BYOCK, American Academy of Hospice and Palliative Medicine: Well, I think it mischaracterizes the experience of dying. Dying is not easy and it's not fun but the suffering that people experience can be alleviated. I've been doing hospice work for some 18 years, and I've yet to meet a patient whose physical suffering could not be dramatically improved. There is not this wealth of people whose suffering, whose pain and breathlessness and the like we cannot treat. There is, however, a large amount of patients whose suffering is not adequately treated. That's true. The fact is that medical care for the dying at the present time is frankly terrible. And that's not only supported by anecdotes that we all, clinically and through our own lives, but a number of research studies now show that care of the dying is largely deficient. This is not the time to begin expanding the power of physicians. The other thing is that patients now do not often have a physician who sees them through a long illness. Our system is significantly broken, and I'm afraid that while there's a crisis in end-of-life care in America, its roots are being left untouched by what is being proffered as sort of a quick fix to what is a very serious and deep problem.

MARGARET WARNER: Dr. Angell, I want you to respond to those points, but first let me just ask you as a factual matter, what are the dimensions of this crisis in end-of-life care? Does the medical community have any idea how many physicians, for instance, are asked by their patients for help in committing suicide?

DR. MARCIA ANGELL: Well, assisted suicide is a crime in most states in this country, and it's very hard to get accurate statistics about a crime. People aren't going to respond to a question like: Did you commit a crime? The best evidence we have comes from a survey of Washington State physicians that found that about 12 percent of them have been asked, or said they have been asked by their patients to help them end their lives, and about 1/4 of those said that they had complied with these requests. We also know that many doctors give very large doses of morphine at the end of life, ostensibly to relieve pain and breathlessness, but also in many cases to hasten death. There's a lot of subterfuge and doublespeak here. And, of course, it is legally permissible to withdraw life support from dying patients.

MARGARET WARNER: And was Lawrence Tribe, as we just heard described in the arguments today, was he right when he said, from your experience, that a lot of doctors do prescribe tremendous barbiturates say to patients, then withdraw the life support, and the patient dies in this coma?

DR. MARCIA ANGELL: That happens.

MARGARET WARNER: Do you agree, Dr. Byock, with what she just said, that a lot of this, that it goes on to this extent, and that it does go on sort of under the table?

DR. IRA BYOCK: I agree that a number of patients are interested in suicide, and thoseof us who practice in end-of-life care hear requests all the time. We respond to those requests. When a person voices an interest in suicide, I want to know why, what the source of their suffering, what the nature of their suffering is. If it's pain, we need to treat that. If it's something else, if it's some fractured relationship that is unhealed in their life, or if it's some existential question, there is care for that as well. This is not an easy matter, but it can be done. And it takes more than a doctor and his or her patients. It takes a team of people working in a system to do it, but it can be done. It's true that we use morphine and other opiate-like medications, narcotic medications to treat pain, and it works effectively. It can be done in all cases. We can't always take away pain, but we can make it tolerable.

MARGARET WARNER: Are you saying that you think really that you disagree with the premise that even the patient has the right to say, I know you can do a lot of things for me, but I've reached the end of the road and I want to go?

DR. IRA BYOCK: Well, it's--there are some limits appropriately on the doctor-patient relationship. We put limits on the doctor- patient relationship in a number of different matters as well, appropriately. We're talking about medical practice and policy in a social context. We have a social context now where we know that in advanced cancer, for instance, as much as 40 or 50 percent of patients do not get adequate basic pain relief at the end of life by World Health Organization standards. We also have a system that routinely punishes patients and families financially simply for being seriously ill and not dying quickly enough. We have a country that three years ago said there was no right to health care, and now it seems the wrong time to expand the medical profession's right to assisted suicide and declare there's a constitutional right to die when you're sick enough.

MARGARET WARNER: All right. Dr. Angell, respond to the first point he's made actually a couple of times, which is there really shouldn't be any need for this; that doctors could manage pain better, that there are plenty of other alternatives other than suicide.

DR. MARCIA ANGELL: Well, I certainly agree that our care of the dying is inadequate and that comfort care should be better, and we should redouble our efforts to treat patients' symptoms at the end of life aggressively. But this is not mutually exclusive with permitting physician-assisted suicide in those cases when good comfort care is inadequate. Right now we have neither good comfort care nor the availability of assisted-suicide. I think we should have both--good comfort care for most dying patients and the availability of assisted-suicide for the relatively few patients for whom comfort care is inadequate.

MARGARET WARNER: So from your experience do you think that even if comfort care were better there would still be people seeking this?

DR. MARCIA ANGELL: Oh, absolutely. Not all pain can be relieved, and other symptoms, such as breathlessness and nausea and weakness are even harder to treat. And we know that there are patients at the end of life who are having good comfort care who still wish to end their lives.

MARGARET WARNER: Let me go back to the other argument you made and just get you to expand on it a little bit, when you talked about financial pressures. Do you--are you saying that you think if this were to happen that there would be financial--pressures on patients to choose this option from people other than themselves?

DR. IRA BYOCK: Well, there already are pressures. People who are approaching the end of their lives see the medical bills. They see then shortly thereafter the default statements. Our system routinely pauperizes people in the process of caring for them, so it seems like it's a self-determination because they will ask for the help themselves, but they do it out of the sense of being a burden to themselves and then their families. It's--our system is broken. It can be fixed, by the way. The roots of this problem are complex, but there is a solution available, and it involves making truly excellent end-of-life care available. I have been working in this realm for a long time. I have yet to see the patient whose suffering we could not make significantly better. It involves more than just morphine and more than just a doctor. It involves a real commitment on the part of a system to address the needs of people. People suffer from the pain, obviously, when it's untreated. They suffer from the sense of being a burden, of being hopeless. They also suffer from isolation. So in addition to good medical care, it involves companionship, sitting with people in a caring way, perhaps in silence, but perhaps oiling their skin and massaging them and just letting them know we're around and here and will be with them, care that can honor, even celebrate, the person in their passing. That takes it out of just the realm of medicine. I'm afraid that this quick fix that's being offered will act as an escape valve, allowing the profession of medicine, which really needs some real remedial help right now, a way to continue to avoid the deep roots of the problem.

DR. MARCIA ANGELL: This isn't about the profession of medicine. This is about patients, about individuals who have to make these judgments for themselves. We can't say, oh, yes, we can take care of you, we can make your pain go away; tell us that your pain has gone away. The pain may still be there. The dyspnea, the hopelessness may still be there. My father committed suicide at the age of 81. He had cancer of the prostate, metastic cancer of the prostate. He had received hospice care. He found it inadequate. He was suffering not so much from pain but from these other symptoms- -from nausea, from weakness, from hopelessness. And he decided it was time to end his life. He did so, in fact, the day before he was scheduled to be admitted to the hospital. He did so then because he thought he would lose the chance once he got in the hospital. And so he took a pistol, and he shot himself. I don't think that this should have had to happen. I would rather have seen him have the option of taking pills that had been legally prescribed for him by a doctor, have them at his bedside, rather than the pistol, and take them later, if and when he wanted to.

MARGARET WARNER: All right. Dr. Angell and Dr. Byock, thank you. We'll have to leave it there.

DR. IRA BYOCK: Thank you.

JIM LEHRER: Still to come on the NewsHour tonight, the Albright confirmation hearings and scandal as history. FOCUS - MADAM SECRETARY

JIM LEHRER: Now Madeleine Albright's hearings before the Senate Foreign Relations Committee. Kwame Holman reports.

KWAME HOLMAN: Madeleine Albright came before the Senate Foreign Relations Committee this morning as the first woman to be nominated secretary of state. Her confirmation, considered very likely, would make her only the second foreign born secretary of state in the last 25 years. Albright is the daughter of a Czech diplomat forced to flee the Communist takeover his country in 1948. She grew up in Colorado, graduated from Wellesley College, and married and later divorced newspaper heir Joseph Medill Patterson Albright. The mother of three grown daughters, she earned a Ph.D. in public law and government from Columbia University. Albright, who has worked both on Capitol Hill and in the White House National Security Agency, was joined this morning by the man she is to replace, Secretary of State Warren Christopher.

WARREN CHRISTOPHER, Secretary of State: As far as we can tell from looking at the history books this is the first time an outgoing secretary of state has ever had the honor of introducing his nominated successor to this committee. And for that particular privilege I'm very grateful to you, Madeleine, for asking me. All who know Amb. Albright admire her keen intellect, her moral strength, and her powerful sense of history born of personal experience. Millions, of course, have been touched by her plain- spoken eloquence. She's the master of the one-liner. The one for which I have particular affection is her contention that at times Warren Christopher seems almost life-like. [laughter among group] I'm confident that Amb. Albright will be a great secretary of state, one who will make history as she advances our nation's interest and upholds our ideals around the world. Indeed, of course, Madeleine's already made history by being what I predict will be the first of many outstanding women to be chosen for this by office.

KWAME HOLMAN: With that, Christopher exited the committee room for the last time as secretary of state. An indication of the solid bipartisan support Albright enjoys came from conservative Republican Committee Chairman Jesse Helms, who warmly welcomed Albright even as he criticized some of President Clinton's foreign policies.

SEN. JESSE HELMS, Chairman, Foreign Relations Committee: And I believe I'm in the ball park when I say that 62 men, including Sec. Christopher, have served as U.S. Secretary of State since the beginning of the republic. Jefferson, Madison, Monroe, John Quincy Adams, Buchanan of that group later went on to the presidency. That may portend something for you to look at. Many Americans--I among them--hope that the area of foreign policy in the next four years will not produce a sequel to the travail of the first four years. And that was a bipartisan folly. And it's quite revealing when this administration, as often it has, boasts that the invasion of Haiti was identified as a great foreign policy achievement. Now, I must be candid about that. Sending American soldiers in harm's way to a tiny Caribbean island with no vital national interest at stake, sending them to replace one group of thugs with another, does not seem to this Senator to be much of an accomplishment. In any event the Haiti excursion at last count has cost the American taxpayers in excess of $2 billion. Before recommending one penny of American taxpayer's money to foreign assistance programs or to multilateral development banks or to bureaucratic demands at home, I think you and we together should ask ourselves whether the expenditure or expenditures are truly in America's interest.

KWAME HOLMAN: Albright's statement to the committee spoke to those concerns.

MADELEINE ALBRIGHT: Over the past four years the Department of State has cut more than 2,000 employees, downgraded positions, closed more than 30 overseas posts, and deferred badly needed modernization. If confirmed, I will strive to fulfill my obligation to manage our foreign policy effectively and efficiently. I will work with this committee and the Congress to ensure that the American public gets full value for reach tax dollar spent, and I will also want to ensure that our foreign policy successfully promotes and protects the interests of the American people. As President Clinton said recently, the United States cannot and should not try to solve every problem, but where our interests are clear, our values are at stake, and where we can make a difference, we must act, and we must lead. During the past four years, the United States has been steadfast in supporting the peacemakers over the bomb throwers in historically troubled regions.

KWAME HOLMAN: Ranking Committee Democrat Joseph Biden asked Albright to spell out the administration's views on Russia and a new NATO that soon might include former Soviet satellite states.

SEN. JOSEPH BIDEN, [D] Delaware: Would you be kind enough to outline the likely scope or at least the direction the administration wishes to move in pursuing a proposed charter between NATO and the Russian Federation?

MADELEINE ALBRIGHT: We believe that it is very important to expand NATO to deal appropriately with the new countries, the new democracies in Central and Eastern Europe. But at the same time we fully understand that one of our key relationships is with Russia and that Russia, that we have to establish a relationship between NATO and Russia through a parallel system through this charter. I just have to tell you that the major goal of this is to make sure that we do not create new dividing lines in Europe because part of what we're trying to eliminate with the NATO expansion is to eliminate the artificial dividing line of the Cold War and, therefore, having a charter in which we detail that relationship between NATO and Russia is very important. We want to make sure that Russia does not believe that the NATO expansion is an adversarial idea against them and at the same time to make sure that Russia does not veto membership by any new country within NATO, because that decision has to be made by NATO members, themselves.

KWAME HOLMAN: Democrat Paul Wellstone had a question about U.S. policy on human rights in China.

SEN. PAUL WELLSTONE, [D] Minnesota: Is the United States prepared to make a strong fight for a resolution, which is critical of China at the upcoming session of the U.N. Human Rights Commission in Geneva? I mean, are we willing to take leadership on that?

MADELEINE ALBRIGHT: Senator, on that subject we are going to be assessing exactly where the human rights situation is at the time that the co-sponsorship comes up. The situation is not much better than at the time that we did this last year, but we will have to assess exactly where it is. And if it is not better, we are prepared, in fact, to co-sponsor that resolution. And the Chinese know that, and I think that the issue here is what in the remaining weeks, how they approach this situation.

KWAME HOLMAN: Georgia Republican Paul Coverdell wanted to know what Albright would do about the international drug trade.

REP. PAUL COVERDELL, [R] Georgia: I'm going to move to what I consider the singular greatest threat to the hemisphere, which is narcotics. I think there's broad and general agreement that we are not being successful in this struggle that is so damaging, whether it's damaging of consumption, as in our country, or corruption, as in many of the others. Sen. Dodd and I have on more than one occasion talked about a restructuring of this conflict, particularly among the five principals, the United States, Mexico, Bolivia, Colombia, and Peru.

MADELEINE ALBRIGHT: We are looking into various venues and possibilities of dealing with this subject. It's the No. 1 subject for us to really concentrate on because it undermines the fabric of all our societies and while we all got, you know, the nuclear threat was something that we heard about every five minutes during the Cold War, this is "a" threat that is, I believe, equally serious in terms of undermining what this country and the Latin American countries are about.

KWAME HOLMAN: The hearing ended with virtually no criticism of Madeleine Albright. The Foreign Relations Committee expects to move the nomination quickly, aiming for what's expected to be easy confirmation by the full Senate the day after the President is inaugurated. FINALLY - SCHOOL FOR SCANDAL

JIM LEHRER: Finally tonight some historical perspective on political scandals, most particularly as they relate to the case of Speaker Newt Gingrich. He's not the first congressman or speaker to have Ethics Committee and similar problems as we hear now from three NewsHour regulars: Presidential Historians Doris Kearns Goodwin and Michael Beschloss, Journalist/Author Haynes Johnson joined tonight by Suzanne Garment, resident scholar at the American Enterprise Institute, author of the book "Scandal, the Culture of Mistrust in American Politics." Suzanne Garment, where does the Gingrich matter rate right now on the scale of scandals?

SUZANNE GARMENT, American Enterprise Institute: As a scandal, it's pretty terrific. Anything that threatens the tenure of the Speaker of the House has to be rated as a major scandal. That's not to say that the offense involved is a major one. In fact, compared to other recent congressional scandals, it's pretty small potatoes.

JIM LEHRER: Do speakers through history, I mean, have they always been lightning rods like this, like Gingrich?

SUZANNE GARMENT: I'm going to have to defer to one of my colleagues. I don't remember another who was attacked in this way for ethics violations. Certainly, there have been--

JIM LEHRER: What about the--the one that's cited, of course, is Speaker Wright, Jim Wright.

SUZANNE GARMENT: Until--

JIM LEHRER: Until. Okay. I interrupted you.

SUZANNE GARMENT: That's all right. Until Newt Gingrich brought us the spectacle of Speaker Wright being hauled up before the Ethics Committee on violations that were a little bit obscure. Wright, of course, chose to resign from Congress altogether. Gingrich has given us another ending for now.

JIM LEHRER: And Haynes, all scandals--I hate to use that word "scandal," but I don't know--you--the title of your book--

SUZANNE GARMENT: Yeah. Go on--

HAYNES JOHNSON, Journalist/Author: It's a broad term.

JIM LEHRER: It's a broad term. It's a broad term, but these things all have different kinds of lives, and I recall reading the "Washington Post" over the weekend and particularly on Monday this had the smell of he's going, in other words, Gingrich is going. But he didn't go. He stayed, he fought, as have, it seems to me, many recent, more recently people are beginning to do that more than they used to, am I right about that?

HAYNES JOHNSON: Yes. And the news media, of course, feeds on these things, and all of a sudden it's all over the press. And sometimes they go and often they don't. And what you hope is they don't look back and see what you wrote or commented on at the time because they may survive and it may not be such a great scandal. The standard of scandal, as you were saying, has changed. The bar is different. I mean, it used to be easy, Jim, when you came to Washington as a young reporter here, you could say, well, it was personal behavior, drunkenness, you had to fall into the tidal basin almost or jump into Fannie Fox with the Argentine firecracker stripper with Wilbur Mills. That was a scandal of personal conduct. Then it was the old-fashioned corruption of cash. And now it's a different kind of thing. It's ethics that didn't used to be even part of the bar. I think Suzy would agree.

SUZANNE GARMENT: In fact, it's still very hard for us to explain exactly what the problem is.

HAYNES JOHNSON: Right.

JIM LEHRER: Put this in some historical perspective, Doris.

DORIS KEARNS GOODWIN, Presidential Historian: Well, there's been three different kinds of punishments meted out against congressmen and senators. The lightest one, actually, is the reprimand, which is what we're hearing they think will be recommended for--for Congressman Gingrich. And it seems that the reprimand has gone for financial misconduct, when somebody had a conflict of interest, or somebody didn't really report their campaign contributions in the right way. Barney Frank was also reprimanded. Now, his was different. His was bringing discredit on the House. And the interesting thing about his case is that the Ethics Committee voted for reprimand almost unanimously. It was Gingrich who said reprimand is not strong enough, I want him censured, which is the next level up. The reason censure is harder is that the person who censured--

JIM LEHRER: Refresh our memory on the Barney Frank case.

DORIS KEARNS GOODWIN: What Barney Frank had done presumably was to have a young man who was his live-in lover who was actually running a prostitute ring from his apartment, unknown to Barney Frank, but Barney had evidently sent a memo in about the incident- -the whole issue when it came up which wasn't completely truthful. He admitted that it wasn't truthful. They claimed he brought discredit on the House by so doing, but everybody was happy with a reprimand, except Gingrich. So Gingrich gets up and says we've got to have censure. And what censure means is that the person who was censured actually has to stand in the well of the House, facing the House, and get it in public. So it's much more of a humiliation. It's like treating him as a felon. They did not vote the censure, but, in fact, what happened is that Gingrich's anger at Barney Frank still remains as a poison in the House. Now, another kind of case where censure was brought had to do with sex. Sex seems to be the 20th century version of the 19th century physical assaults. In the old days, in the 19th century, people were censured and reprimanded for actually fighting with one another, pistols and fist fights. But in the 20th century- -

JIM LEHRER: Members of the Congress of the United States.

DORIS KEARNS GOODWIN: It was in the Congress. When two guys had a fist fight, they were both censured. Interestingly, another two guys had a dual, two congressmen. One of them was killed by the other guy, but the other guy somehow made it through a censure vote and stayed in. So there have been worse things than Gingrich has done, but the interesting thing in the case of Studds and Krane, two congressmen, Studds presumably had sex with a page ten years prior, a male page. Krane had sex with a female page. They were both like 17 years old, the pages. And in that case they recommended for censure but Gingrich came up and said censure's not enough; I want them expelled because the integrity of the House is in question. In that case they were censured; his vote for expulsion was not met. But I think his difficulty is he was the architect of Wright. They say that after Wright gave his very moving speech saying I hope we don't resort to cannibalism, Gingrich was seen whistling in the corridor. So I think part of the problem is there are memories in this institution, and Gingrich seems to have played too big a role in other people's troubles.

JIM LEHRER: Do you agree with that, Suzanne, that that has an element--playing an element in this?

SUZANNE GARMENT: It's part of it, certainly, but the escalation has been going on for so long that I don't think it's just a matter of Gingrich and Wright or Gingrich and Frank. The reason that Wright was such an appealing target for Republicans was that Democrats in Congress at that time were making great hay out of raising all kinds of scandal issues about the Republicans in the Executive Branch, so the two sides have been feeding off one another for some years.

JIM LEHRER: Let me call the standards issue that Haynes raised and how it's changed, what's your reading on that?

MICHAEL BESCHLOSS, Presidential Historian: The standard has changed and very much for the better. I think this is one of the happy stories about what's happened in American history. You look at this kind of punishment being considered for various members of the House and the Senate over 200 years. The interesting thing, you look at the 19th century and much of the 20th century, you don't see many people punished for financial malfeasance. And we know that this was a period--

JIM LEHRER: You had to kill somebody, in other words?

MICHAEL BESCHLOSS: You had to kill someone, and that guy was not even expelled. He was able to pass the test of his colleagues. This was 1838, William Graves, a Whig from Kentucky, and so that shows the fact that members of the House were very reluctant to punish their colleagues, especially in this case of money. We know now that there have been members of the Senate, earlier in American history who were essentially owned by railroads, took briefcases full of cash. Their colleagues knew that they cast votes that were essentially paid for. That is something that in the 1990's is really very much a thing of the past. These people are so much under scrutiny by their colleagues, by their enemies in some cases, by the press, that that's the kind of thing that we don't have under current standards of disclosure. So even among those people who may feel that the infraction we're talking about with Newt Gingrich is rather minor, that's a sign of the fact that we're a lot more ethically sensitive than we had been for most of our history.

JIM LEHRER: And so we're getting cleaner.

MICHAEL BESCHLOSS: I think we are getting cleaner.

JIM LEHRER: Or the infractions are getting smaller--

DORIS KEARNS GOODWIN: Well--

HAYNES JOHNSON: Well, I think Michael is right about that though. Even in the last generation it used to be the scandal was cash. You got paid off, bag men. When Mark Twain in the 20th century wrote that wonderful book about the gilded age and the corruption of it, and he watched Congress being given--Credit Mobia case--the founding of the railroads West. And the congressmen and senators were all on the take. They got the stock, and they gave them the land grants--

MICHAEL BESCHLOSS: Including a Speaker of the House--

HAYNES JOHNSON: Exactly. And he--

JIM LEHRER: What happened to--sorry, go ahead.

HAYNES JOHNSON: Yeah. But I mean Twain's famous remark was there was no distinctly American criminal class except Congress. And that was because of the kinds of money behavior that he saw there.

JIM LEHRER: So what happened to Blane, for instance--

HAYNES JOHNSON: Blane 1876, a Republican was accused of financial corruption. He had been speaker. He was able to beat the rap, although there was an awful lot of evidence against him, so much so that he was able to be nominated for President in 1884. He did lose to Grover Cleveland.

JIM LEHRER: Yeah.

DORIS KEARNS GOODWIN: You know, Jim, the interesting relationship to cash is that Senator Talmadge was going along fine. He never had a single check that he had to use for cash.

JIM LEHRER: Democrat from Georgia, Democrat from Georgia, right?

DORIS KEARNS GOODWIN: He had never cashed a single check to cash because he got so much cash from his constituents continually over a long period of time, and it finally came out when his wife was divorcing him. And in the divorce proceedings she mentioned that he got bundles of cash for years from his constituents. He was finally censured for that. So cash still remains a problem.

SUZANNE GARMENT: And yet, as we congratulate ourselves--

JIM LEHRER: On being so clean and wonderful.

SUZANNE GARMENT: That's right. The fact that we're cleaner does not mean that we're more virtuous. And today Americans mistrust their congress people at least as much as they ever did.

JIM LEHRER: Now why? Explain why.

SUZANNE GARMENT: So the question is how can we be cleaner and feeling dirtier all the time? One is that the standards do keep on changing. No. 2 is that we know much more than we used to. No. 3 is that some things have gotten worse. For instance, campaign finance reform meant that you had to go out now and raise money from more people than you used to have to because of the contribution limits. This meant that congressmen spent more of their time and, indeed, spend more of their time fund-raising than they used to. They're cleaner. There's very little doubt of that. But the fund-raising process is much more on display than it ever was.

JIM LEHRER: And a dirty process is what you're saying.

SUZANNE GARMENT: Some people think of it as inherently dirty.

JIM LEHRER: Yeah.

MICHAEL BESCHLOSS: And also I think more consistent standards. You know, one of the reasons we have a House Ethics Committee is 1967 Adam Clayton Powell, the civil rights leader, Harlem congressman, was accused of having people on his payroll who were friends and relatives. He was prevented from sitting in the House. It was something that the Supreme Court later overruled, but there was a great uproar because that was a standard if you applied it to members of the House and Senate there would have been an awful lot of members of Congress getting expelled, so a House Ethics Committee was established to try to apply some more consistency over the years.

JIM LEHRER: There was no committee at that time. They just did it. That was just by the--by the vote of the House.

MICHAEL BESCHLOSS: For most of American history these things were handled by the Rules Committee of the House and Senate, and the idea was that if you had people who deal with these questions full-time, there's a little bit of a greater chance of fairness.

HAYNES JOHNSON: When you asked her a minute ago why it's happened, one reason is television and the press. And going back to the Watergate period and the last generation, we're highly more heightened about the prospect of "scandal," or abuse of power, or all these things, but it's more complicated because it isn't just, as we say, payoffs. It's how much money you have to raise. It's the revolving door. It's being able to be influenced working in an office and then cashing in and so the rules of lobbying keep getting changed, but it costs more and more to run for office. So you're in this situation.

JIM LEHRER: And is there an expectation now, Doris, that people are going to do the wrong thing, that once these start that, oh, well, there's going to be another shoe to drop, and there's going to be another shoe to drop, and there's going to be more heat, and there's going to be another story and boom, they're going to be gone, that's the story of scandal these days, right?

DORIS KEARNS GOODWIN: Oh, absolutely. I mean, that's what we've experienced in so many other facets of our life. What I find discouraging is that after Speaker Wright's problems, for example, and after the ABSCAM situations in the 1980's, where they actually found a congressman who on tape accepted a $50,000 bribe, and he was expelled, and Sen. Williams would have been expelled but he resigned, it seemed then that everybody was saying we've got to clean up campaign financing. That's why we're in this mess. Definitely, it will be done. The role of money in politics will be reduced. Well, now we have a situation where the combination of Gingrich's problems and the Democrats' problems with campaign finance and all that fund-raising during the election, everybody's saying it will be done, something will be done. I don't see any evidence that anything is being done. So that's where you have a feeling we're on a treadmill. No wonder the people are upset. They have a right to be.

JIM LEHRER: Well, now the other night or last night, to be exact, Suzanne Garment, Mike Barnicle of the "Boston Globe," said on this program that the people aren't upset about this Newt Gingrich case at all, they don't even care about it. It's totally irrelevant to their lives, and things like this, they see Gingrich and the Democrats almost the same way, and it's an irrelevancy in their lives.

SUZANNE GARMENT: Well, it's interesting that the polls showed a majority of people wanting Gingrich to be replaced as Speaker. Also, the same polls showed 75 percent of people saying that they thought what he had done was just like what all politicians do. So there is a heavy discounting going on.

HAYNES JOHNSON: But that's the most dangerous part because when you believe the worst about everybody, then you think it doesn't matter, it doesn't affect my life, and I get out of it, I don't vote, and, therefore, the problem gets worse in the long run. As Doris was saying about campaign money, it's worse today than it was 20 years ago, and after every cycle of elections, we say we're going to do something about it. We'll see.

JIM LEHRER: And yet the infractions are smaller, Michael.

MICHAEL BESCHLOSS: They are, but I think it does depress confidence in government. Look at what happened among the American people after Watergate. We've never really recovered from what we learned about what Richard Nixon had done. Now here we are in a situation where you have the Speaker of the House, chief elected officer of the House, and also the President of the United States, to some extent, under clouds. I think this could have the same effect.

JIM LEHRER: Thank you all four very much. RECAP

JIM LEHRER: Again, the major stories of this Wednesday, the U.S. Supreme Court heard arguments on the right to doctor-assisted suicide. Madeleine Albright won high praise at her Senate confirmation hearing to be secretary of state. And the House Ethics Committee held a closed session to plan public hearings on Speaker Gingrich's case. We'll see you online and again here tomorrow evening. I'm Jim Lehrer. Thank you and good night.