ASSISTED SUICIDE: Threats to Oregon Law Harm Care
The number of dying patients in Oregon hospitals whose families reported they were not getting adequate treatment for pain has increased along with the rise of legal threats against the state's assisted suicide law, according to study that the Center for Ethics in Health Care at Oregon Health Sciences University released Thursday. Based on interviews conducted from October through December 1998, researchers found that 54% of families reported that their loved ones had suffered moderate to severe pain in the last week of life while dying in a hospital. The study was done as a follow-up to research from November 1996 through September 1997 that found 34% of patients dying in hospitals, hospices and at home experienced pain in the last week of their lives.
Timing is Key
Because the study was not based on direct observation of dying patients, researchers acknowledged that it was unclear whether the increase in pain was attributable to physicians' fear of prescribing high levels of pain medication, patient expectations of more effective care or some "unknown reason." But the researchers noted that the increase in pain came during an "intense" public campaign to repeal the assisted suicide law and Drug Enforcement Agency warnings that physicians prescribing lethal doses of medications would be violating federal narcotics laws. The study will be published in next month's Western Journal of Medicine, but the findings were released Thursday as the Senate Judiciary Committee voted
Advocates, Critics Interpret Differently
One physician who supports the bill said it was "irresponsible" for the study's author to leak unpublished information that could influence the political process. The president of Oregon's Medical Association interpreted the reported jump in pain as "purely" an elevated expectation of pain control, prompted by increased public awareness resulting from debate over the assisted suicide law. But Ann Jackson, head of the Oregon Hospice Association, said she believed that the bill, along with the threats from the DEA, have caused physicians to "back off" pain prescriptions for fear of losing their licenses (Barnard, Associated Press, 4/28).