PHYSICIANS FOR COMPASSIONATE CARE NEWS
Affirming An Ethic That All Human Life is Inherently Valuable
Vol.3, No.1, Spring 2000
Senator Gordon Smith Supports Pain Relief Promotion Act
BILL PASSES SENATE JUDICIARY COMMITTEE
Passage Sends a Message of Hope to the Seriously Ill
On April 25, 2000, Oregon Senator Gordon Smith, in a dynamic testimony
before the Senate Judiciary Committee, urged the Senate to pass the
Pain Relief Promotion Act (PRPA). Smith told the committee that he
was acutely aware that his position placed him in conflict with a
majority of his constituents, “But on a matter of this magnitude--a
matter of life and death--I have failed to find comfort with a troubled
conscience. But more, I am loathe to let down the hundreds of thousands
of Oregonians who, though a minority, heard my answers (in opposition
to assisted suicide), and now count on the integrity of my word.”
Smith went on to explain that the federal government has for years
governed and controlled deadly drugs in interstate commerce to ensure
public health and safety. “For a state--even my beloved home
state of Oregon--to unilaterally act to use federal drugs for lethal
purposes is an open invitation to the nation to reclaim and reassert
its law. Oregon has no more right to write federal law than the federal
government has to write Oregon law,” Smith said.
After the Tuesday hearing, Physicians for Compassionate Care representatives,
Drs. Edwards, Hamilton and Petty, and Catherine Hamilton, thanked
Senator Smith in person for his courageous statesmanship.
Two days later, on April 27th, the PRPA passed out of committee,
in a 10 to 8 vote. It is expected to come to the senate floor for
a vote in the next couple of weeks. Senator Nickles, chief sponsor
of the bill, hopes to have 60 senators on board by that time.
"This is a victory for the seriously ill in the entire nation and
sends a message of hope," said Doctor Gregory Hamilton, President
of PCC. “The PRPA will provide funding for improved pain treatment
and palliative care for all Americans. And it will protect those
patients in the state of Oregon, who are seriously ill and suicidal,
and have been offered suicide by some doctors," Hamilton said. "It
is unconscionable that these vulnerable citizens have been given
the means to commit suicide with federally controlled substances
by doctors who hold federal DEA licenses, since suicide is not a
medical purpose and therefore is not an appropriate use of these
powerful federally controlled drugs. For years, these drugs have
been regulated by federal law. Oregon assisted suicide activists
have attempted to overstep federal regulations, which already prevent
the use of these drugs for any such non-medical purposes. For this
reason, the PRPA insures that doctors will use federally controlled
substances to kill pain and not to kill patients," Hamilton said.
A Policy of Containment
Wesley Smith, attorney for the International Anti-Euthanasia Task
Force and author of “Forced Exit: The Slippery Slope From Assisted
Suicide to Legalized Murder,” congratulated Physicians for
Compassionate Care for taking the lead in the nationwide effort to
educate the public about the dangers of assisted suicide. According
to Smith, since the time Oregon legalized assisted suicide, six states
have either outlawed assisted suicide or increased the civil penalty
if a person is charged with assisting a suicide. None have followed
Oregon. “Setbacks like these take the wind out of the sails
of the pro-death movement. And these defeats are largely due to the
educational efforts of Physicians for Compassionate Care,” Smith
“We have information on the assisted suicide experiment in
Oregon that would never have come to light, if not for the presence
of Physicians for Compassionate Care.” Smith went on to cite
examples, such as the Kate Cheney case, where “death doctors
colluded in the patient’s assisted suicide despite the presence
of family pressure, despite diagnosis of growing dementia, and despite
the fact that her own doctor found her ineligible for assisted suicide
because of these factors. We know assisted suicide drugs failed in
Oregon; they have caused distress in those present, family members
have been forced to ‘help’ end the life of the family
member; others have called 911 for resuscitation after the overdose
was taken.” Smith says these suicides are taking place in a
health care environment that limits care and has financial incentives
for doctors to provide the least expensive alternative.
Smith encouraged Physicians for Compassionate Care members to adopt
a policy of containment while they work to eliminate assisted suicide
in Oregon. “If assisted suicide doesn’t grow beyond Oregon,
it will not be able to sustain itself,” Smith said. “If
we can contain it in Oregon, it will die there, like slavery died
in the South.”
Following Smith’s slavery analogy back in time, he says it
was because slavery was outlawed in the north, that it was contained
in the south. And the battle for slave and free states began. The
values that allowed slavery to exist were antagonistic to free states,
and slavery inevitably had to expand to survive. Smith quoted Abraham
Lincoln as saying: “We can’t be half free and half slave.” Smith
likened assisted suicide to slavery. “We can’t have half
the country burdened by the chains of assisted suicide and the other
half of free of it. Assisted suicide must expand to exist. If we
can contain it in Oregon, we can focus our attack there and take
the assisted suicide movement apart link by link.”
How can you contain assisted suicide in Oregon? Educate. Educate.
Educate. Smith’s suggestions include: Write letters to the
editors or editorials that demonstrate the abuses of assisted suicide
in Oregon; submit articles to states such as Maine, Alaska, Montana,
and California, where assisted suicide groups are working through
voter initiatives, the courts, and the legislatures; respectfully
call reporters when they don’t give the complete or accurate
story, be they local or national, to tell them what they left out
and ask them why they didn’t write the whole story; call the
talk show hosts; talk about the problem inherent with medical killings
to family, friends, people at the grocery store, anyone and everyone.
At least 43 people have killed themselves in two short years. “We
have to be willing to stand up for the lives of those individuals
who are seriously ill, for those whose lives are threatened in Oregon
if they become depressed and suicidal,” Smith said. “Doctors
can post signs declaring their office an ‘assisted suicide
free zone’ or post the Hippocratic oath so it is visible in
your waiting room,” Smith suggests, “and continue to
say killing patients is wrong.”
The Oregon Report: What’s Hiding Behind the Numbers?
By Catherine Hamilton, M.A.
The Oregon Health Division did it again. It hid the human tragedy
of assisted suicide behind 22 pages of statistics. While the health
division is known for doing a yeoman's job in general epidemiologic
reporting, it is quickly establishing a track record of secrecy on
assisted suicide and assisted suicide alone.
Oregon’s health division received national attention last
year when both Dr. Kathleen Foley from the famed Sloan Kettering
Cancer Institute and head of Project on Death in America and Dr.
Herbert Hendin of New York Medical College noted, "The report is
marked by its failure to address the limits of the information it
has available, overreaching its data to draw unwarranted conclusions" (The
Oregon Report: Don't Ask, Don't Tell, Hastings Center Report, May-June,
1999, p. 37).
But that was last year. What about this year?
The 1999 report hides even more information from the public than
last year's. It hides results of Oregon's failed experiment in assisted
suicide behind meaningless questions, misleading numbers and unwarranted
In fact, the Oregon Health Division didn’t publish the first
known case of a failed assisted-suicide attempt, but the public has
the right to know.
The case I describe has been discussed only in hushed tones in pro-assisted-suicide
circles, in the back halls of hospitals and hospices.
On December 3, 1999, at Portland Community College, during a class
titled, “Physician Assisted Suicide: Counseling Patients/Clients,” attorney
Cynthia Barrett discussed one of Oregon’s failed attempts.
Barrett, who describes herself as an elder law attorney and a friend
of assisted suicide activist Coombs Lee, was talking about the many
details that must be completed in the process of assisted suicides.
In mid-sentence, Barrett broke from her outlined handout and gave
an example. “The man was at home; there was no doctor there,” she
said. The eight or nine students in the small classroom, were silent,
waiting to hear more. Barrett went on: “The wife was there.
Other family were there. He took the prescription. After he took
it, he began to have some physical symptoms,” Barrett said.
She did not explain what the symptoms were. “The symptoms were
hard for his wife to handle. Well, she (the wife) called 911,” Barrett
exclaimed, with shock in her voice. “The guy ended up being
taken by 911 to a local Portland hospital. Revived. In the middle
of it. And taken to a local nursing facility.” She said, “I
don’t know if he went back home. He died shortly--some period
of time after that time.”
I asked, “So he had completed all the paperwork and he was
using Oregon’s assisted suicide law?”
Barrett said that’s what she understood.
I wondered aloud, “But he wasn’t part of the report,
the Oregon report?”
“I’m not sure of that,” Barrett said.
“Maybe George knows,” I asked.
George Eighmey, the executive director of the Compassion in Dying
Federation, was sitting in the front row. He quickly said, “He
wasn’t one of our patients.”
During break that afternoon, I heard footsteps coming toward me
on the tiled floor.
I looked up. Eighmey was walking toward me, swinging his arms. He
said in a loud voice that I should not use the information I had
heard in the class, that I should not “go to the media,” that
the class was confidential.
Apparently, those who arrange suicides, those who give patients
lethal prescriptions, and even those in the Oregon Health Division,
don’t feel Oregonians have a right to know about the failure
of the suicide experiment.
Barrett said another important thing during her lecture at Portland
Community College, she said: “...if you have a psychological
disorder or depression causing impaired judgment you’re not
suppose to be able to use this law.” At least it was one of
the things the people of Oregon were promised.
Yet, there is the case of Kate Cheney, an 85-year-old woman with
growing dementia, who was originally declared ineligible for assisted
suicide because of her cognitive impairments and because she appeared
to be pressured by her family. According to an October 17, 1999 Oregonian
article, Mrs. Cheney couldn’t remember recent events and people
she knew, including the name of her doctor, nor could she remember
when she was diagnosed with cancer, even though it was only a few
But, when the doctor said she was not eligible for assisted suicide,
neither his diagnosis nor his opinion were treated as the safeguard
that it was supposed to be. The “so-called” safeguard
didn’t protect this impaired, vulnerable woman from falling
victim to family pressure. Mrs. Cheney’s daughter sought another
opinion. The second evaluation also acknowledged memory deficits
and said the “choices of the patient may be influenced by
her family’s wishes and the daughter was somewhat coercive.” Nevertheless,
the doctor approved the suicide. One might ask the question: Just
how demented and how much pressure must the patient be under before
they will be protected from assisted suicide?
With the life of Kate Cheney, the final call came down to a single
Kaiser doctor/administrator who decided she was a good candidate
for assisted suicide.
Regrettably, Mrs. Cheney took an overdose of drugs given to her
by Kaiser Permanente, a fully capitated HMO with a profit sharing
plan for its doctors. As predicted, there is no protection for the
depressed, demented or those under pressure, once killing in the
medical setting is legalized. And the Oregon Health Division, which
has responsibility to report on this experiment in death, left these
detail out of their report.
Neither did the division include in their report another failed
attempt of assisted suicide in Oregon. The case of Patrick Matheny,
who had ALS. Unfortunately, in this case a second attempt was made
and when that failed, we were told that a family member “helped” Patrick
Matheny die when he couldn’t swallow the oral medication provided.
Patrick Matheny’s brother-in-law told The Oregonian in a March
11, 1999 article, “I think the process needs to be looked at.
If we’re going to do this, then it needs to be set up in a
way in which each individual can accomplish it. It doesn’t
go smoothly for everyone...For Pat, it was a huge problem. It would
not have worked without help.” The brother-in-law would not
say what happened in the trailer that morning, how he “helped” Patrick
die. “I know in my heart that I did the right thing,” he
But how did Patrick Matheny die? We will never know. The body was
cremated the next day and the case wasn’t investigated. Regardless,
his case pointed out a flaw in the assisted suicide plan that relies
on oral medication. Oregon authorities responded to questions about
the case by suggesting lethal injections, infusions and gases, despite
the promises to the people of Oregon that this would never happen.
Sheriff Paul Burgett commented, “It would be unlawful to say
that we’re not going to allow disabled people to make the same
sorts of decisions and have the same rights as people who have the
physical ability to accomplish their objectives.”
Oregon’s Deputy Attorney General David Schuman backed him
up with a letter in which he stated that the Americans with Disabilities
Act could be used to claim that patients with trouble swallowing
deserve equal access to assisted suicide.
Schuman’s letter makes clear what is at stake: The possibility
that lethal injection, where the patient no longer has control, could
become part of the assisted suicide plan.
As predicted by many, legalization of assisted suicide brings failed
suicides and the deaths of vulnerable people under pressure of family.
And it ushers in lethal injections, and with them involuntary euthanasia.
By interviewing only those people who have a stake in justifying
their contribution to the suicide of a seriously ill person, such
as assisted-suicide doctors and family members, the Oregon Health
Division has made sure that information about the economic context
of assisted suicide, failed attempts, assessments of the adequacy
of pain care, and the lack of protections for the mentally ill, will
not come to light.
The health division could have done meaningful research by releasing
full medical records with identifying data blackened out to independent
researchers. It could have done prospective studies, including objective
assessments of the adequacy of pain care and treatment of depression
provided, not just the pro forma consultations orchestrated by assisted-suicide
Oregonians were assured the problem cases presented here wouldn’t
happen with doctor-assisted suicide. These are the very types of
problems the public expected the Oregon Health Division to address
in its yearly report. Yet, here are three cases where problems occurred
and nothing was reported. The Oregon Health Division discredits itself
by failing to reveal important information.
Coombs Lee claimed that the number of people in Oregon who fell
victim to assisted suicide was "statistically insignificant." In
our view, however, no human being is insignificant. Each and every
person is equal and valuable. Every suicide is tragic.
The moment we start calling individual people who die by lethal
overdose “statistically insignificant,” we dehumanize
and devalue all human beings.
This article was previously published in Brainstorm magazine, March,
N. Gregory Hamilton, MD
William M. Petty, MD
Mark Kummer, MD
Miles J. Edwards, MD
William L. Toffler, MD
Pamela J. Edwards, MD
Thomas Pitre, MD
Kenneth R. Stevens, MD
Paul D. Stull, MD
Gerald B. Ahmann, MD
Thomas Comerford, MD
Carl R. Jenson, MD
Marvin M. John, MD
Robert DuPriest, MD
Richard M. Thorne, MD
George Middlekauf, MD
P.O. Box 6042
Portland, Oregon 97228
PCC News Editor: Catherine Hamilton