Posted on: Friday, November 9, 2001

Editorial
Ashcroft suicide stand mustn't halt pain relief

U.S. Attorney General John Ashcroft's crusade against Oregon's physician-assisted suicide law does more than just quash the ability of the terminally ill to speed up death.

It also has the potential to frighten doctors who have no involvement with assisted suicide from prescribing "reasonable" doses of narcotics to patients in severe chronic pain.

Under Ashcroft's directive, doctors who use federally prescribed drugs to help patients die face suspension or loss of their license.

That could mean Drug Enforcement Administration agents will be monitoring prescription decisions, with an eye on determining whether the physician meant to ease pain or induce death.

And that's enough to send chills down the spine of the most liberal doctor. After all, the line between prescribing drugs to relieve pain and to hasten death isn't always clear.

In response to Ashcroft's directive, Oregon has sued the U.S. government, challenging the attorney general's authority to bar doctors from prescribing federally controlled drugs.

A federal judge yesterday put the Ashcroft order on hold at least until Nov. 20 and will consider extending his ruling. He should.

In the meantime, however, other states that have considered legalizing physician-assisted suicide, including Hawai'i, may hold off to see how the battle in Oregon shapes up.

In fact, the issue may start to resemble the nation's medical marijuana debate in which states or municipalities have passed pro-medical marijuana laws that the federal government won't recognize.

Under Oregon's Death with Dignity Act, which passed in 1994 and took effect in 1997, doctors may provide — but not administer — a lethal prescription to terminally ill adult state residents.

Prior to the law, Oregon's Board of Medical Examiners placed strict constraints on the prescription of narcotics.

"In those days, doctors were frightened away from providing adequate pain relief," recalls Michael Garland, associate director of the Center for Ethics and Health Care with the Oregon Health and Science University. Garland is in Hawai'i this week to visit the Governor's Executive Office on Aging.

Ashcroft's directive is misguided and should be set aside. Until that happens, let's hope it does not intimidate physicians in Hawai'i and around the nation from prescribing adequate relief for those held hostage by pain.