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: letters@nejm.org
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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