DOJ RULING PROTECTS PATIENTS, PAIN CARE
By N. Gregory Hamilton, M.D.
Published in the Portland Tribune, December 21, 2001
Assisted suicide isn't about individual rights. It's about money
health maintenance organizations, among other things. That's only
one reason why the U.S. Department of Justice ruling disallowing
the use of federally controlled substances for assisted suicide is
a good one.
By enforcing federal law uniformly, the Justice Department will
defend the lives of seriously ill Oregonians equally with those of
all other Americans. Over 70 Oregon patients have been given overdoses,
all of them using federally controlled substances, all of them because
of psychological and social concerns, none of them primarily because
of pain. Some were diagnosed with depression, yet given overdoses
The Justice Department ruling stops these abuses. But a court has
stayed the protective ruling, while it deliberates state and federal
Meanwhile, patients frightened by exaggerated and demeaning portrayals
of the dying process remain at risk.
While assisted-suicide proponents tout taking an overdose as an
individual "right," the reality is that HMOs have become involved.
That's what happened to Kate Cheney, who had coverage with Kaiser
A psychiatrist determined that Cheney was demented and under pressure
from her family. That made her ineligible for assisted suicide. The
HMO, however, allowed doctor shopping until her family found a psychologist
to claim she was eligible for assisted suicide, despite dementia
and the pressure from others. This frail woman was given an overdose,
cheaper by far than any care she could have gotten.
Another HMO admitted to paying for assisted suicide, while limiting
benefits available for hospice at a stingy $1,000. Kathryn Tucker
of Compassion in Dying even claimed in court that Oregon patients
can rightfully be given overdoses to save money. The Justice Department
ruling will protect patients from such misuses of federally controlled
substances. And it's high time.
No one needs assisted suicide: 99.9% of Oregonians die just fine
without it. And the other 0.1% could, too, given the wonderful palliative
Oregon should learn from the rest of the country. Washington,
California, Michigan, and Maine all defeated assisted suicide initiatives
in recent years. Liberal supreme courts in Florida and Alaska,
like the U.S. Supreme Court, found assisted suicide too dangerous
for the depressed and vulnerable. Bipartisan state legislatures
across the country have rejected assisted suicide.
And Michigan put Jack Kevorkian in prison where he belongs.
While protecting Oregon citizens against abuses, the Justice Department
ruling explicitly protects aggressive pain management as legitimate
medical care even if it may increase the likelihood of death in rare
This wording should reassure all doctors and patients. Instead,
however, assisted-suicide activists are launching a misleading scare
campaign. They are making irresponsible claims that the Justice
Department ruling might somehow have a "chilling effect" on pain
Such scare tactics, reprehensible anytime, are even more egregious
during this time of national apprehension. Making these unfounded
claims may frighten unsuspecting patients, when the carefully worded
Justice Department ruling says the exact opposite of what assisted-suicide
activists claim. Aggressive
pain management is legitimate medical care! Everyone should be
reassured about that.
The Justice Department ruling protects our citizens and protects
aggressive pain care. It is a good ruling. And, fortunately, no state
can unilaterally exempt itself from federal law.
We should fully expect the courts, now or on appeal, to uphold this
careful and balanced approach to preventing the misuse of federally
controlled substances for assisted suicide.
N. Gregory Hamilton, MD
Physicians for Compassionate Care
December 21, 2001