Pubdate: Thu, 2 Jul 1998
Source: Oregonian, The 
Contact:  
Website: http://www.oregonlive.com/ 
Author: Patrick O'Neill, The Oregonian staff

OPPOSING GROUPS OBJECT TO BAN ON DRUG USE IN ASSISTED SUICIDES

* The AMA and the Compassion in Dying Federation oppose the congressional
legislation for different reasons

Congressional legislation that would outlaw drugs for use in
physician-assisted suicide is drawing opposition from the American Medical
Association, a staunchly anti-suicide organization, as well as from groups
that support the practice.

The bill, scheduled for a hearing July 14 before the Constitution
subcommittee in the U.S. House of Representatives, would ban the use of
narcotics in assisted suicides. And it would establish a medical review
board within the Drug Enforcement Administration to determine whether a
physician had violated the ban.

The bill, introduced June 5 by Rep. Henry Hyde, R-Ill., is intended to gut
the Oregon law that allows physicians to prescribe life-ending medication
for terminally ill patients who have less than six months to live. A Senate
version of the bill was introduced June 9 by Sen. Don Nickles, R-Okla.
Oregon's law has been in effect since Oct. 27, 1997.

It's unusual that the AMA, which opposes assisted suicide, and the
Compassion in Dying Federation, which has promoted it, should be on the same
side of the issue. But each organization opposes the legislation for
different reasons.

AMA sees chilling effect

The AMA, one of the most powerful lobbying groups in the nation, fears that
it would exert a "chilling effect" on physicians who prescribe painkilling
medication for dying patients.

Compassion in Dying sees it as a direct threat to assisted suicide.

Dr. Thomas Reardon, a Portland physician and president-elect of the American
Medical Association, said Wednesday that the organization would support
congressional efforts to ban assisted suicide outright.

"We're unalterably opposed to physician-assisted suicide," he said. "But
with this bill, you'd do much more harm than good."

Reardon said the AMA has begun an educational campaign, encouraging doctors
to administer pain medication aggressively for terminally ill patients.

For years, physicians across the country have risked censure from state
licensing boards for giving enough narcotics to ease the pain of dying
patients. During the past few years, particularly in Oregon, the trend has
begun to reverse itself as health-care workers and society in general have
recognized the necessity for better care of the terminally ill.

He advocates better care

"If we do a much better job on care at the end of life, we think patients
will not feel the need for physician-assisted suicide," Reardon said. "We
are opposed to anything that would have a chilling or dampening or
inhibiting effect on that."

Reardon referred to the bill's medical review board as a tribunal that would
be involved in inquisitions of doctors who prescribe painkilling medication
for terminally ill patients.

"We think that's wrong," Reardon said.

Doctors frequently write prescriptions for medications that, if taken all at
once, would be lethal, he said.

"We'll write prescriptions for 100 digitalis, 100 Valium, 100 beta
blockers," he said. "What do you think would happen if a patient took them
all at once? Physicians don't intend them to be lethal. They intend them to
be therapeutic.

"We oppose physician-assisted suicide on ethical grounds, and we still stand
for that," he said. "However, we also oppose using the DEA as an enforcement
method."

Barbara Coombs Lee, director of Compassion in Dying Federation and a chief
petitioner for Oregon's physician-assisted suicide law, said she, too,
opposes the bill.

"My take is that it's a pretty audacious attempt (by Congress) to substitute
their own moral judgment for that of Oregonians," she said. "It's an attempt
to usurp a state's power and replace the local regulatory mechanism through
the Board of Medical Examiners and other state authorities with federal power."

Like Reardon, Lee raises the specter of the Drug Enforcement Administration
looking over doctors' shoulders as they prescribe painkillers to dying patients.

"It will have a chilling effect on the prescribing of controlled
substances," she said. "It gives these drug police the power to inquire,
prescription by prescription, and ask, 'What did you prescribe that for?'
It's very intrusive."

Ann G. Jackson, executive director of the Oregon Hospice Association, said
the consequences of the bill could be devastating.

"All of us who have been looking at these issues from across the country are
concerned about the dampening effect on pain and symptom management for the
terminally ill," she said. "Even though there is the caveat that dying
patients won't be denied drugs, even if they hasten death, that's subject to
interpretation by whoever's looking at it."

Jackson said Oregon leads the nation in the medical use of morphine. But she
said Oregon and other states could see the use of morphine drop sharply if
the bill becomes law.

"Regardless of what your position is on assisted suicide, broadening the
authority of the DEA is probably harmful," she said.

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Checked-by: Melodi Cornett