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Ashcroft’s odd targets

By Ellen Goodman, Boston Globe, Globe Staff, 11/15/2001

Let me see if I have this straight.

We have terrorists on the loose, anthrax wafting through the mail, and the Justice Department is in hot pursuit of … terminally ill patients?

We have another plane crash to investigate, a network of foreign “sleepers” apparently eluding the FBI, and Attorney General John Ashcroft is taking aim at … the state of Oregon?

What’s going on here? The rest of us are worried about suicide bombers. He’s worried about doctor-assisted suicide. Who is Ashcroft’s public enemy No. 1: Oncologist bin Laden?

It was bizarre enough last month when federal law enforcement officers began a crackdown on cannabis clubs in California that provide medical marijuana to AIDS and cancer patients. I chalked that up to reefer madness.

Then Ashcroft, using the same legal ploy, decided to go after an Oregon law permitting and regulating assisted suicide. He issued a blunt directive to the Drug Enforcement Administration that doctors would lose their licenses to prescribe federally controlled drugs if they prescribed them for assisted suicides. Doctors obeying the state law would be breaking the federal law.

Is it possible that the attorney general took the president too seriously about getting back to “normal”? Politics as usual?

Assisted suicide has been on the national agenda since Jack Kevorkian used carbon monoxide – not a controlled substance, by the way – on his first patient. He jump-started a passionate argument about the right to die and a deep conversation about the need for compassionate care at the end of life.

Oregon was the first state to pass a careful law allowing doctors to provide, though not administer, a lethal prescription to patients with less than six months to live who wanted the drugs and were judged capable of making that choice. The voters passed this referendum in 1994 and again by a wider margin in 1997. Since then, only 70 Oregonians have chosen assisted suicide. But more have found comfort in having the option.

Now it appears that elections make little impression on Ashcroft. After all, the former senator lost one in 2000 to the late Mel Carnahan, only to gain a Cabinet seat for his conservative views.

Remember back in 1997 when the Supreme Court ruled that there wasn’t any right to die in the Constitution but encouraged state experiments? Ê In Chief Justice Rehnquist’s words, “Our holding permits this debate to continue as it should in a democratic society.”

But the attorney general ordered the DEA to do what Congress, the courts, and the voters didn’t do: stop the debate and upend the state law. A group of doctors and patients have won a temporary injunction, Ê but the whole mess goes to court next Tuesday.

Ashcroft is not the only opponent of assisted suicide who frames it as a “prolife” issue. But there is something particularly perverse in applying “prolife” politics and “rescue” rhetoric to patients who are dying.

Richard Holmes, one of the patients in the suit, told a reporter, “I’d love to stay alive. … But I’ve also had enough medical diagnosis to know this, that my days are numbered.” Near the end of a long battle with liver cancer, he wants to be able to choose that number.

Of course no one needs a barbiturate to end his life. “I could do myself in a lot of other ways. I’ve got three guns in the house,” he says. But isn’t this where we came in?

Scare tactics will not only frighten doctors away from prescribing drugs for patients considering suicide. It will frighten doctors away from giving patients an alternative: enough painkillers to make their Ê last days bearable.

In his order, Ashcroft writes blithely, confidently, that there are “distinctions between intentionally causing a patient’s death and Ê providing sufficient dosages of pain medication necessary to eliminate Ê or alleviate pain.”

But that is not nearly as clear to doctors who use, say, morphine in a delicate balance between relieving pain and hastening death. As we lie Ê dying, do we want our own doctors worrying that DEA agents are counting how many painkillers make a criminal?

Every study will tell you that dying patients are more terrified of pain than death. Surely the attorney general of the United States should be fighting terror, not promoting it.