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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 and
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 anyway.

The Justice Department ruling stops these abuses. But a court has stayed the protective ruling, while it deliberates state and federal authority.

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 Permanente HMO.

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 care available.

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 instances.

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 care.

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
N.W. Portland
December 21, 2001


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