 |
|
|
|
|
|
|
|
|
|
Site Navigator |
|||||||||
Also see a sidebar by Elizabeth Manning: What’s So Hard About a Painless Death? |
|||||||||
 |
|||||||||
Oregonian reporter Mark O'Keefe has become part of the story with his coverage of Measure 16. |
|||||||||
Though Oregon became the first state in the nation to legalize assisted suicide in 1994, the issue first surfaced on ballots in Washington in 1991 and California in 1992.Coming just weeks after the mass Heaven's Gate suicide, Qutub's grisly performance was great political theater. It was also a bunch of malarkey. |
|||||||||
Both the ultra-conservative Oregon Citizens Alliance and Pat Robertson's Christian Coalition have filed political action committees with the secretary of state to support the repeal of Measure 16. |
|||||||||
 |
|||||||||
Oregonian publisher Fred Stickel has made his opposition to assisted suicide clear. |
|||||||||
In 1994, assisted-suicide supporters were outspent $1.5 million to $600,000
|
|||||||||
 |
|||||||||
In the House, Gresham Republican Ron Sunseri carried the ball for Right to Life in the quest to repeal the Death With Dignity Act. |
|||||||||
|
When the Oregon Medical Association opposed doctor-assisted suicide
Oregon psychiatrists voted last month to remain neutral on whether Measure 16 should be repealed. |
|||||||||
 |
|||||||||
Catholic Conference lobbyist Robert Castagna was the man behind the scenes for anti-suicide forces in Salem. |
|||||||||
|
|
|
|
|
 |
||||
WONDER WHY YOU'RE VOTING ON ASSISTED SUICIDE AGAIN? SLOPPY REPORTING IN THE OREGONIAN AND LEGISLATIVE TRICKERY. Sen. Eileen Qutub rarely smiles inside the Capitol, and she was particularly grim-faced on June 9, when she rose to speak on the Senate floor. Holding up a large plastic bag and a bottle full of pills, the Beaverton Republican said these were the tools of Measure 16, the physician-assisted suicide law approved by voters in 1994. The plastic bag, Qutub intoned, is to put over your head when the pills don't work. Armed with dramatic props and frightening half-truths, Sen. Eileen Qutub led the Senate opposition to the Death With Dignity Act."Why repeal this flawed act?" Qutub asked rhetorically. "Because we have new information. Studies in the Netherlands, the only country which has published its findings with physician-assisted suicide and euthanasia...revealed that there is a 20 to 30 percent failure rate of orally ingested barbiturates, even though as many as 90 pills may have to be ingested. "In many cases," she emphasized, "the result was a lingering, painful death, accompanied by severe vomiting, excessive bleeding from erosion of the stomach lining, lung abscesses, esophageal tears with bleeding, kidney failure, choking, pulmonary edema and permanent brain damage." Coming just weeks after the mass Heaven's Gate suicide, in which 39 San Diego cult members used plastic bags and barbiturate cocktails to chase a comet, Qutub's grisly performance was great political theater. It was also a bunch of malarkey. No study in the Netherlands or anywhere else has ever documented the litany of agony and failure Qutub described. In fact, neither Qutub nor any other legislator ever laid eyes on the study she cited. But it is the lever the Legislature used to send the Death With Dignity Act back to voters. On Nov. 4, Oregonians will be asked to vote yes or no on Measure 51. A yes vote means you want to repeal the Death With Dignity Act. A no vote means you are standing with the 51 percent of voters who decided in 1994 to let terminally ill people request a life-ending prescription from their doctors. An Oregonian poll released Sunday does not bode well for opponents of physician-assisted suicide. With one month left before mail ballots go out, 64 percent of Oregonians favor keeping Measure 16 on the books. Just 32 percent say the law should be repealed. In the early part of the 1994 campaign, polls showed overwhelming public support, but as church dollars flowed in, support slowly dropped. It seemed Oregon was following the pattern of California and Washington, where similar measures had failed a few years earlier. The Oregon law, however, had one big difference. The California and Washington initiatives would have allowed patients to choose lethal injection, which is a turn-off for a lot of people. Anti-suicide forces in those states played on the fear that some rogue doctors or greedy relatives might inject people against their will, running TV commercials that implied doctors would kill people without their consent. Authors of Oregon's Measure 16 sidestepped that land mine by prohibiting lethal injection and focusing on oral prescriptions that require the patients to take the medication themselves. In the end, even though they were outspent 3-to-1, Measure 16 supporters clung to their early advantage, squeaking by 51-49. Three years later, we're getting ready to vote again. The Legislature has a long history of messing with voter-approved initiatives, but never before have lawmakers simply bounced the identical issue back for a revote. To do so with the Death With Dignity initiative--perhaps the most thoroughly debated measure in state history--required some tricky political footwork. Legislators had to come up with something new. Something that hadn't been debated in the first campaign. That something turned out to be the Myth of the 25 Percent Failure Rate. The seed of the 1997 strategy to repeal Measure 16 was sown in December 1994, one month after the election, when Mark O'Keefe, a religion reporter for The Oregonian, wrote a story that said a quarter of those people who would take life-ending medication under Measure 16 can expect a slow, lingering death. O'Keefe came to The Oregonian in the summer of 1994 from Norfolk, Va., where he wrote about religion for the Virginian-Pilot, the same paper that groomed Oregonian editor Sandra Rowe, who arrived in Portland a year earlier. O'Keefe, a clean-shaven Episcopalian who attended Pat Robertson's Regent University school of communications, was assigned to cover Measure 16 on his very first day at The Oregonian. "My life has been rather interesting ever since," O'Keefe said last Wednesday, during a speech he presented on assisted suicide to the Northwest Healthcare Roundtable. He has traveled to the Netherlands, covered U.S. Supreme Court arguments--even journeyed to the desert to interview death-and-dying guru Elisabeth Kubler-Ross. From almost the beginning of O'Keefe's tenure, Death With Dignity supporters have complained about his reportage, writing numerous letters to Oregonian editors, alleging that O'Keefe's body of work over the past three years has clearly favored religious and anti-suicide arguments in the debate over doctor-assisted suicide. Longtime Oregonian publisher Fred Stickel, a Catholic, has strongly opposed Measure 16 since the beginning and has used his editorial page to push his crusade against assisted suicide. The paper has published 13 anti-suicide commentaries this year alone and is the only newspaper in Oregon--other than the Catholic Sentinel--that has supported the Legislature's decision to send the Death With Dignity Act back to voters. It was O'Keefe's reporting, however, that gave suicide opponents their ammunition for the re-vote and their 1997 campaign mantra: "Pills Don't Work." His Dec. 4, 1994, story, titled "Dutch Researcher Warns of Lingering Deaths," says, "One in four Oregonians who try to kill themselves under Measure 16 is likely to experience a lingering death that could go on for hours, maybe days, says a study from a leading euthanasia doctor from The Netherlands." O'Keefe's article was based on a phone interview with Dr. Pieter Admiraal, considered the father of euthanasia in the Netherlands. Admiraal was part of a study team gathering information from Dutch doctors on the use of drugs between 1987 and 1993 to end the lives of terminally ill people in the Netherlands. "The study," O'Keefe wrote, "quantified what Dutch physicians have known for years. Drugs work slowly for some people. The study showed that while 75 percent of patients die within three hours, the remainder can last two days or longer." O'Keefe's main point was that the Hollywood image of a lightning-quick suicide pill doesn't yet exist. Some people can take a couple of days to die from a lethal dose of barbiturates, which can be painful for family members sitting at the bedside listening to labored breathing and death rattles. O'Keefe's story was technically accurate. Some people do die more slowly than others after taking a lethal dose of barbiturates. His wording, however, leaves the impression that up to a quarter of people take days to die, particularly the statement that "while 75 percent of patients die within three hours, the remainder can last two days or longer." On the contrary, Admiraal's study showed that 96 percent of the 87 people he studied died within five hours of taking life-ending medication. The other 4 percent died within two days. Interestingly, the study O'Keefe referred to hadn't been written at the time of his story. It was not published until 1995, and was not translated into English until last week. As of last Wednesday, O'Keefe acknowledged he had still not seen a translated copy of the study he's written so much about. Admiraal, in a letter written to Death With Dignity supporters July 25, tried to correct the spin O'Keefe's reporting--and subsequent interpretations--put on his work. "I realize that the article written by Mark O'Keefe in The Oregonian about an interview he had with me in the Netherlands in 1994 has been used to 'prove' that there should be a 25 percent failure rate in using oral lethal drugs," Admiraal wrote. "Let's face the facts.... After an oral dose of 9 grams of barbiturate (three times the lethal dose), EVERY patient will die.... A period of 24 hours or longer will be very exceptional." In the aftermath of the 1994 election, O'Keefe's "lingering death" story dropped like an acorn in the forest, hardly noticed at first. Catholic and Right to Life activists had turned their attention from the polls to the courts, promptly winning a decision in U.S. District Court that kept Measure 16 from going into effect. With the matter in the hands of lawyers and judges, the 1995 Legislature came and went without ever addressing the measure. As 1997 unfolded, however, it began to look like the courts might let Measure 16 go into effect. The Ninth U.S. Circuit Court of Appeals dismissed the earlier ruling in February, clearing the way for Measure 16 to take effect. That meant the Legislature was either going to have to set up procedures to guide and oversee physician-assisted suicide, or it was going to have to find a way to delay, repeal or refer. In the process of that search, O'Keefe's story took on a life of its own. When the House Judiciary Subcommittee on Family Law convened hearings this February on physician-assisted suicide, the stated goal was to iron out details in Measure 16 that would make it possible to implement. Death With Dignity supporters were suspicious of the hearings from the outset. The six-member subcommittee was stacked with conservative legislators who were morally opposed to the concept of physician-assisted suicide. After 16 hours of testimony spread over several days, subcommittee chairman Ron Sunseri--a fire-and-brimstone Republican from Gresham--threw up his hands. The subcommittee could not implement the Death With Dignity Act, Sunseri claimed, because legislators had recently come across "new information" showing that sedatives prescribed by doctors in the Netherlands fail to kill people 25 percent of the time. "We can't fix a 25 percent failure rate," Sunseri said flatly. A search of Judiciary Committee records, however, showed that legislators had no study to back up Sunseri's claim of 25 percent failure. All they had were references to the study and O'Keefe's 1994 article. Bill Taylor, who keeps track of Judiciary Committee records, admitted he was surprised when he couldn't find the report that was at the center of the Judiciary Committee's logic for sending Measure 16 back. Taylor suggested calling O'Keefe for a copy of the study. Robert Castagna, chief lobbyist for the Catholic Conference, also suggested calling O'Keefe, after admitting he had never seen the failure-rate study. Even Rep. John Minnis, Judiciary Committee chairman, expressed surprise when told in June that no one seemed able to find the study so often quoted before his committee. Even Death With Dignity supporters, who had been beaten over the head with the study, admitted they were unprepared to respond. It wasn't until September, three months after the Legislature finished its work, that they mounted a challenge to the failure-rate argument. On May 13, 1997, the House approved HB 2954, sending the Death With Dignity Act back to the ballot for repeal. The Senate concurred on the day of Qutub's speech. The referral to voters sidestepped the opposition of Gov. John Kitzhaber, who had threatened to veto a repeal of the assisted-suicide law. Legislative referrals are not subject to the governor's approval. It might be understandable that the Legislature would play fast and loose with the truth--even on an issue as sensitive as assisted suicide. It seems out of character, however, for doctors to obfuscate scientific research. But that's exactly what happened when the Oregon Medical Association, which had remained neutral on the issue in 1994, took a position that reads like an anti-Measure 16 political ad. In a resolution passed overwhelmingly by 122 members of the OMA's house of delegates on April 27, the OMA stated, "Whereas proponents and opponents alike have determined physician-assisted suicide, as provided for in Measure 16, to be an uncertain procedure, which fails 25 percent of the time, often resulting in a prolonged death and increased suffering for patients, families and physicians...be it resolved that the OMA will oppose legalization of physician-assisted suicide as provided for in Measure 16." With the OMA's resolution in hand, legislators had all the ammunition they needed to pass the referral two weeks later. Dr. Gerrit Kimsma, a Dutch researcher who has written articles based on the 1994 Admiraal report, sent a letter on July 3 "to the people of Oregon," on behalf of Measure 16 supporters. In the letter, Kimsma refutes the view held by the OMA. "In the course of the on-going debate about physician-assisted suicide in the United States," Kimsma wrote, "a particular claim has been made by the opposition...that in cases of physician-assisted suicide in The Netherlands the established failure rate is 25 percent. This is implied to mean that in 25 percent of the cases...through orally applied means, the effect would not be death. Instead, there would be widespread reawakening of suffering patients or some form of continued coma. "This claim has no foundation whatsoever, is misleading and completely wrong," Kimsma states. "There are no scientific data nor hearsay to support it." Under questioning, OMA doctors will now admit that the "25 percent failure rate" is a matter of interpretation. "I define a lingering death as a failure," says Dr. N. Gregory Hamilton, one of the OMA delegates who signed the OMA resolution and a spokesman for the anti-Measure 16 campaign. "We never said the patients don't die." "When we're talking about a failure rate, it doesn't mean the patients don't die," concedes Dr. Benneth Husted, an osteopath who is campaigning for a repeal of Measure 16. "It has to be interpreted in terms of how long it takes to die." Professional campaigners hired to repeal Measure 16 don't like to admit that their campaign slogan "Pills Don't Work"--billed as being based on scientific fact--is a matter of interpretation. Yes on 51 campaign materials are riddled with the unsubstantiated claim that 25 percent of patients don't die, and that they suffer. "The recommended dose of 60 to 100 pills fails to cause death in 25 percent of all assisted-suicide cases," screams one leaf in a 40-page press packet distributed to reporters last week. The statement goes on to say that oral barbiturates "often lead to convulsions, vomiting and brain damage." Admiraal, in his letter last month, makes clear that none of the patients in his study suffered those alleged complications. "During that time the patient is in a deep coma without awareness and so without suffering," Admiraal wrote. "The latter is very important to realize for the family." O'Keefe bristles at the suggestion that he has contributed to the Myth of the 25 Percent Failure Rate. He agrees that opponents of physician-assisted suicide have twisted his original reporting, but says he can't help it. "Whether this is a failure rate or not is a matter of people's interpretation of what I wrote," O'Keefe said last Wednesday. "I can't control how they interpret it. "For political reasons people take situations and use them in ways that play to their political advantage. It doesn't surprise me in the least that both sides are putting their own spin on what Admiraal's figures mean. That's politics." "[The Oregonian has] given the entire issue the credibility it has," says Barbara Coombs Lee, the chief sponsor of Measure 16. "No one was talking about failure rates until The Oregonian article. The pinnacle is Qutub's speech on the floor of the Senate. That's when the issue reached its peak of exaggeration. But where did it originate? Mark O'Keefe's reporting. If O'Keefe's original story was guilty of being less than clear, editorial-page writers for The Oregonian seem to have abandoned all pretense of factual reporting. In a June 8 column, editorial writer David Reinhard described a list of supposed suffering that wasn't found in O'Keefe's reporting or Admiraal's study: "We now know that Measure 16's drugs-only regime fails up to 25 percent of the time," he states wrongly. "The pills don't always kill, leaving patients to wallow in vomit and experience convulsions, brain damage, persistent coma or vegetative states and lingering death." Reinhard, interviewed Monday, denied that he has ever given the impression that the pills fail to kill. "It would be stupid to suggest these people don't die," Reinhard said. "Of course they die." In a May 8 editorial, however, Reinhard was unambiguous: "Should Oregon doctors be allowed to give terminally ill patients drugs that will end their lives in only three cases out of four?" There may be good reasons for opposing physician-assisted suicide, but the Myth of the 25 Percent Failure Rate isn't one of them. It's undoubtedly true that--given different metabolisms and conditions--some people are going to die more slowly or less peacefully than others. But the claims made by the opposition are out of all proportion to the actual study that generated it. It's nothing new for special interests and politicians to team up on a campaign of half-truths to achieve some end. But the Myth of the 25 Percent Failure Rate is worse than most campaign distortions because it was created by special interests and elected officials, given credence by doctors and circulated by a few members of the state's most influential daily newspaper--people voters generally look to for help in deciding measures of great import. O'Keefe, when asked whether it wasn't somehow more egregious for legislators to spin information than campaigners, didn't really see a difference between policy and politics. "You could argue that the campaign began in the Legislature," he said. |
||||