PCC PHYSICIANS FOR COMPASSIONATE CARE NEWS
Affirming An Ethic That All Human Life is Inherently Valuable
Vol.3, No.4, Winter 2001-2000 __________________________________________
William M. Petty, MD, New PCC President
Doctor William Petty was elected as the new president of PCC.
Dr. Petty is a highly regarded oncologic surgeon. He has been vice
president of PCC since its beginning days and is one of the founding
members of our organization. He had the foresight to be among the
parties who filed the first legal case against the assisted suicide
law in Oregon in 1994. As well as being well informed on the problems
of assisted suicide in Oregon, he is an expert in palliative care
and has organized the PCC yearly Compassionate Care Conferences,
which have been cosponsored by Providence Health Care System.
Outgoing PCC president, Doctor Gregory Hamilton, will remain active
in PCC as Senior Scholar for the organization. Doctor Petty has asked
him to continue in his role of spokesman to the media. Dr. Kenneth
Stevens, Professor and Chairman of Radiation Oncology at Oregon Health
Sciences University, will take Dr. Petty’s place as vice president.
ALASKA COURT WILL DECIDE ON ASSISTED SUICIDE APPEALS CASE
Plaintiff’s Attorneys Claim the Current Alaska Law that Prohibits
Assisted Suicide is “Restrictive” and Defies the State’s “Privacy
Physicians for Compassionate Care’s Supreme Court Brief Demonstrates
that Assisted Suicide is Not a “Private Act”: It Endangers
The case, Kevin Sampson and Jane Doe vs. State of Alaska,
before the Alaska Supreme Court, was filed in 1998. The plaintiff’s
have both died and the Superior Court of Alaska decided against the
plaintiff’s; however, the case was appealed and was heard by
the Alaska Supreme Court in November, 2000.
The plaintiff’s attorney argued that an Alaska state law that
sanctions anyone who becomes accomplice to another person’s
suicide is too “restrictive,” claiming that the law is
against Alaska’s Privacy Act, and therefore, may be unconstitutional.
The Alaska law (AS 11.41.120) is a strong deterrent to assisted
suicide, because it is a felony for any person, including a doctor,
to become an accomplice in another person’s suicide. The law
states any person who “intentionally aids another person to
commit suicide” is in effect guilty of manslaughter.
Eric Johnson, Assistant Attorney General, defended the Alaska law
and pointed out that seriously ill individuals would be subject to
social and economic pressures. “We as a society value equality,
and that means valuing disabled lives (the same) as others,” Johnson
told the Anchorage Daily News after the hearing.
The assisted-suicide activist group, Compassion in Dying, was joined
by the American Civil Liberties Union in promoting the acceptance
of assisted suicide in Alaska. Both groups submitted briefs supporting
assisted suicide, claiming it is a “private act.”
Physicians for Compassionate Care, in its Amicus Curiae supporting
the Superior Court in its ruling to protect the status of Alaska
law (AS 11.41.120), pointed out that, “assisted suicide is
not a private action, but takes place in a complex medical, social
and economic setting. The social and institutional nature of doctor-assisted
suicide subjects the discouraged or anxious patient to influence
The Alaska Supreme Court is expected to make a decision on the case
sometime during the first half of 2001.
Brief of Amicus Curiae, Physicians for Compassionate Care
in Support of Appellee, State of Alaska
Summary of Argument
The following is an excerpt from the “Summary Argument” of
PCC’s Amicus Curiae, which is the formal legal argument presented
to the Alaska Supreme Court concerning the appeals case of Kevin
Sampson and Jane Doe vs. State of Alaska.
“Experience with doctor-assisted suicide in the state of Oregon,
as in the Netherlands, reveals that assisted suicide allowed in the
medical setting is not a private act. Doctor-assisted suicide takes
place in a complex medical, social, and economic system, making the
individual patient vulnerable to adverse influence. It creates
conditions allowing family members and others to pressure the patient
to commit assisted suicide, as has already happened in Oregon. Institutionalization
of assisted suicide unfairly discriminates against vulnerable individuals
and puts seriously ill individuals contemplating suicide at dangerous
and unequal risk of death by failing to provide equal protection
of their lives. If Alaska were to relinquish its right to prohibit
physician-assisted suicide, one vulnerable class of individuals,
those labeled ‘terminally ill,’ would thereby be devalued
and would no longer be afforded the same protection against assisted
suicide which other Alaskans enjoy. This failure to assure equal
protection would result in some of the depressed and mentally infirm
who are labeled terminally ill receiving assisted suicide instead
of medical care, which has already happened in Oregon, and as is
common in the Netherlands, even among those who are not labeled ‘terminally
“Institutionalization of assisted suicide not only has an
effect on a particular individual who may feel like giving up on
it also has a harmful effect on society and its general welfare and
puts other individuals at risk. The harmful effect on society derives
from the fact that physician-assisted suicide is not a private act,
but takes place in a complex medical, social, and economic system.
Within this delicate, interactional context, as observed in the Code
of Medical Ethics, Sec. 2.211, overthrowing laws protecting the public
against doctor-assisted suicide is destructive to the doctor patient
relationship, proves impossible to control, and poses serious societal
risks. It creates an economic environment with institutional incentives
suicide over medical care. It is impossible to adequately monitor,
as demonstrated by failed attempts to monitor the experience in Oregon.
Lacking adequate monitoring, it is impossible to regulate and control.
“Any illusion that assisted suicide could be confined to self-administered
oral overdose quickly dissipates once the practice is allowed. Lethal
injection must necessarily also be allowed for those who cannot quickly
swallow the contents of 90 or so capsules it takes to commit assisted
suicide or who have failed in their assisted-suicide attempt, as
has been demonstrated in the case of Patrick Matheny in Oregon and
previously in the Netherlands. The inevitability of the introduction
of lethal injection or infusion, once the protection against assisted
suicide is overridden for one class of patients, makes it even more
clear that institutionalized assisted suicide gives power and control
to the doctor and to a complex medical, economic, and social system,
not to an individual in an hypothetically ‘private’ and ‘autonomous’ act.”
“Once a patient involves a physician in assisted suicide,
it becomes abundantly clear that the assisted suicide is not a ‘private’ and
fully ‘autonomous’ action. Doctor-assisted suicide takes
place in a complex medical, social and economic setting and opens
discouraged or anxious patients to adverse influence and coercion.
It discriminates against a vulnerable class of individuals, those
labeled ‘terminally ill.’ It further endangers the mentally
ill and infirm and/or alcoholics and other groups with a differentially
high suicide rate. And, it endangers not only the individual contemplating
assisted suicide, but also proves harmful to society. It is destructive
to the doctor-patient relationship, is impossible to control and
poses serious societal risks. Clearly, Alaska has the right and the
responsibility to uphold its laws protecting its citizens against
the danger doctor-assisted suicide poses to vulnerable individuals
and to the general welfare of society.”
PCC Senior Scholar, Dr. Gregory Hamilton, composed the testimony
used in the “Brief of Amicus Curiae, Physicians for Compassionate
Care in Support of Appellee, State of Alaska.” Each point of
fact is documented with extensive references, which can be found
in the full testimony on the
PCC website (www.pccef.org).
Hope After Pain Relief Promotion Act Stalled
U.S. Senate Democratic leadership allowed Sen. Ron Wyden’s,
D-Ore, maneuvers to stall the Pain Relief Promotion Act (PRPA),
despite bipartisan and majority support of this bill designed to
The PRPA would have gone a long way to protect doctors and patients
by making it clear for the first time in federal law that aggressive
pain management is legitimate medical care even if in rare instances
it might lead to an increased risk to the patient. It provided for
$5,000,000 per year for five years in federal grants for education
and research about improved pain treatment and palliative care. And
it re-clarified that assisted suicide is not a legitimate medical
use of federally controlled substances. States which have passed
laws similar to the PRPA have increased the per capita morphine use
in their state by an average of 50% in the next year, demonstrating
that doctors are reassured by such laws.
There is hope, however, that Oregon patients will once again be
protected and cared for when they become suicidal, that they will
no longer be handed a drug overdose by those few doctors who use
controlled substances for the non-medical purpose of suicide. On
a campaign stop in Oregon last May, President-elect Bush, told Oregonians
he agreed with Drug Enforcement Administration Chief, Thomas Constantine’s
interpretation of the Controlled Substances Act (CSA). Constantine
clearly stated that Oregon assisted-suicide doctors could not exempt
themselves from federal law, which does not allow federally controlled
substances to be used for any non-medical purpose, including suicide.
President-elect Bush clarified that he would be willing to enforce
the CSA the way it was written.
One of the factors that made the PRPA necessary during the previous
administration was the unilateral move by US Attorney General, Janet
Reno, who overruled Drug Enforcement Administration Chief, Thomas
Constantine’s intent to enforce the CSA. She did so after Constantine
had correctly pointed out that assisted suicide is not a legitimate
medical use of controlled substances and therefore is not allowed.
Reno announced that the Justice Department would not suspend the
DEA license of doctors who participated in assisted suicide under
the Oregon assisted-suicide law. Doctors in Oregon, unlike doctors
in any other state, were then, in effect, made exempt from federal
monitoring under the CSA, if, and only if they participate in patient
suicides by prescribing drug overdoses. Federally controlled substances
remained disallowed for non-medical purposes for all other physicians
across the nation.
There is an obvious distinction between the non-medical use of drugs
for assisted suicide and that of the legitimate medical purpose of
pain relief. The intended result of pain care is a comfortable patient.
The intended result of giving a drug overdose is a dead patient.
While the time frame is unclear, there is every indication that
the new administration will stand by the DEA’s interpretation
of the CSA, namely that Oregon doctors are not exempt from federal
law regarding controlled substances.
P.O. Box 6042
Portland, Oregon 97228
PCC News Editor: Catherine Hamilton