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Dear PCC member:
Please consider the following evidence taken directly from the Drug Enforcement Agency (DEA) statistics. In states where laws prohibiting assisted-suicide have passed, there has been no "chilling effect." Furthermore, the Pain Relief Promotion Act will specifically promote (in all fifty states) appropriate and, if needed, aggressive pain relief for all patients who would be helped by such supportive treatment. Please share this information with anyone who may find it of interest.
William L. Toffler MD
National Director, PCC


The most recent DEA figures on per capita morphine use show Oregon with the highest per capita consumption of morphine, at 2332 grams per 100,000 population. Kansas is a very close second, with 2287. Regarding Oregon itself, two comments are in order. First, these figures do not indicate what the morphine is used for. The Oregon Health Division says it does not know how many unreported assisted suicides or cases of active euthanasia may be occurring in the state due to the greater freedom physicians feel they have under the new assisted suicide law; some of these cases may use large doses of morphine, as did one of the 15 reported cases in 1998. Second, the per capita consumption now (2332) is slightly less than it was during the first half of 1998 (2385), when Oregon physicians were allegedly operating under the "chilling effect" of threatened DEA action; from June to December 1998, after attorney general Janet Reno rescinded the DEA's interpretation of federal law and told Oregon it had a right to use controlled substances for assisted suicide, the per capita rate fell from 2385 to 2160.

Regarding other states:

- Of the top ten states, seven have specific statutes against assisted suicide (Kansas, Florida, Arizona, New Hampshire, Tennessee, Louisiana and Missouri). One state bans the practice by common law (Vermont), and one has no law (Nevada).

- A legal vacuum on assisted suicide is certainly no guarantee of free-wheeling pain control practices. The ranking in morphine use for the other three states with no clear law on assisted suicide are 35th (Wyoming), 46th (Utah) and 48th (Hawaii).

- The second-ranking state, Kansas, is an interesting case. Kansas strengthened its ban on assisted suicide in 1998, adding civil penalties to the existing criminal penalties so family members and others can sue a doctor who assists a suicide. Kansas was 35th in morphine use in 1997, the year before the civil ban; 11th in the first half of 1998, before the civil ban passed; 7th for the entire year of 1998; and is now second highest.

- Louisiana passed its ban in 1995. It was 41st in morphine use in 1994, the year before the ban; it is now 9th among states.

- Tennessee passed its ban in 1993. It was 16th in morphine use in 1992, the year before the ban; it is now 8th.

November 15, 1999 (update will follow when new figures available).


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