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The following letter was submitted to The New England Journal of Medicine.

February 15, 2002

Letters to the Editor
The New England Journal of Medicine
10 Shattuck Street
Boston, MA 02115
E-mail address:

To the Editor:

Doctor Steinbrook’s (February 7) apology for Oregon’s law legalizing doctor-assisted suicide noted, “Oregon ranks first among the states in use of morphine.” His attempt to demonstrate that assisted suicide led to improved pain care unfortunately resorts to using facts in a misleading fashion. The author should have employed the past tense. Oregon did rank first, but in 1990, four years before it passed the doctor-assisted suicide law. But since the law passed, it has not been ranked first in yearly morphine use.

Doctor Steinbrook emphasized that between 1997 and 2000 per capita morphine use in Oregon increased by about 50 percent, according to Drug Enforcement Administration data. But he neglected to mention that according to the same source between 1994 and 1997 morphine use more than doubled. During those years, a federal injunction forbid implementation of the Oregon experiment in death. Clearly, having the federal government forbid use of the Oregon law between 1994 and 1997 had no “chilling effect” on morphine prescription. And allowing assisted suicide between 1997 and 2000 gave it no great boost. Rhodes Island had a far more impressive increase, over 150%, in a single year, just after it strengthened its ban on assisted suicide.

Doctor Steinbrook ended his section on pain care by referring to a newspaper editorial, as if it were a medical authority. While we have grown accustomed to newspapers “spinning” data, we still expect authors in medical journals to tell the whole truth.

N. Gregory Hamilton, M.D.
2250 N.W. Flanders, # 306
Portland, Oregon 97210
(503) 275-1293


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