A Dose of Sober Realism in Oregon.(euthanasia)

Editor's note. The following takes on additional urgency in light of the decision by an appeals court panel that U.S. Attorney General cannot sanction or hold Oregon doctors criminally liable for prescribing lethal dosages of drugs, under Oregon's "Death with Dignity" Act. (See story, page 6.)

For years, there have been warnings that legalizing assisting suicide risks denying suicidal individuals who are psychologically ill the treatment they need. Advocates of legalized assisting suicide have retorted that "safeguards," such as those found in Oregon's 1994 "Death with Dignity" law, will screen out suicide attempts that are based on psychological imbalance as distinct from those involving so-called "rational suicide."

Now, a paper delivered by Oregon psychiatrist Dr. N. Gregory Hamilton at the May 6, 2004, meeting of the American Psychiatric Association alleges that an Oregon man with lung cancer was given a lethal prescription even though he had a history of psychological problems, including depression, alcoholism, and previous suicide attempts that long antedated his cancer diagnosis. Delivered at a symposium on ethics and end-of-life care, Hamilton's paper was based on medical records and interviews with the patient.

BACKGROUND

Michael Freeland was haunted by thoughts of suicide since his early 20s when his mother shot herself. Shortly after his mother's suicide, Freeland attempted suicide himself.

In March 2000, his doctor diagnosed him, at age 62, with lung cancer. According to the New York Times, "Dr. Hamilton said Mr. Freeland came into contact with the couple [Dr. Hamilton and his wife] because he mistakenly dialed their organization in 2000 after receiving his diagnosis of terminal cancer, thinking that he could get information about ending his life. Instead, Dr. Hamilton said, the three began a two-year relationship in which the Hamiltons helped Mr. Freeland receive treatment for depression and other medical problems."

In early 2001, however, a lethal prescription was prescribed for Mr. Freeland, although he was not actually "terminally ill" and did not die for another year and a half. Dr. Hamilton reported in his paper that Mr. Freeland was subsequently admitted to a hospital psychiatric ward for evaluation for "possible suicidal or homicidal ideation." He was diagnosed with depression and probable intermittent delirium, as well as an adjustment disorder. A social worker home visit found his house uninhabitable because of its state of disorder, rodent feces, fireplace ashes protruding two feet into the living room, and lack of food and heat - - and found 32 firearms with thousands of ...