X-Message-Number: 8810
Date: Wed, 19 Nov 1997 12:20:57 -0700
From: David Brandt-Erichsen <>
Subject: Oregon update

From the PORTLAND OREGONIAN
(weds Nov 19/97)

PHARMACY PANEL AFFIRMS SUICIDE DISCLOSURE

Upholding a rule that doctors must identify
prescriptions for assisted-suicide drugs heats up a
dispute between pharmacists and physicians

Patrick O'Neill of The Oregonian staff

----------

The state Board of Pharmacy dug in its heels
Tuesday by letting stand a ruling that
doctors must specify when prescriptions are
for terminally ill patients who want to
commit suicide.

The decision intensifies a disagreement
between pharmacists and doctors about
Oregon's newly reaffirmed physician-assisted
suicide law.

At the heart of the conflict is the
pharmacists' right to refuse to take part in
a suicide and doctors' right to protect
patient confidentiality and their own
privacy.

Oregon's law allows doctors and other health
care workers to choose not to participate in
a suicide if it violates their ethics.

Pharmacists, who would fill prescriptions for
life-ending medication under the law, say
they also should have the chance to refuse to
participate.

But the law doesn't spell out how pharmacists
would know whether they were filling a
prescription for a dose of drugs to be used
in a suicide.

Early this month, the pharmacy board approved
an emergency rule requiring doctors to
specify in writing the purpose of a
prescription written to help a patient commit
suicide.

Doctors resent the rule as a breach of
patient confidentiality. Two weeks ago, the
Oregon Medical Association's governing body
announced opposition to the pharmacists' rule
and threatened court action.

On Tuesday, during a telephone conference
meeting of the Oregon Board of Pharmacy,
members decided to keep the rule intact.

Helen Noonan-Harnsberger, a pharmacy board
member, said the rule protects pharmacists.

As for patient confidentiality, board members
concluded that by their nature, prescriptions
reveal much about patients' medical
conditions. A prescription for AZT, an AIDS
treatment drug, plainly indicates a patient
is infected with the AIDS virus, for
instance.

Jim Kronenberg, Oregon Medical Association
spokesman, said Tuesday that his organization
"is very sympathetic with their (the
pharmacists') problem" but hadn't ruled out
court action.

Representatives of the association and the
pharmacy board are scheduled to meet Friday
to try to resolve the issue.

If talks aren't successful, "some kind of
injunction would be a strategy we would have
in mind," Kronenberg said.

Doctors are worried that their participation
in an assisted suicide might become public.
That could make them the target of protests
by assisted-suicide opponents, much in the
same way that doctors who perform abortions
are targeted by anti-abortion groups.

Early this month, the federal Drug
Enforcement Agency provided another reason
for physicians' uneasiness. Thomas A.
Constantine, DEA administrator, wrote a
letter to two congressmen, warning that
doctors who prescribe medicine under the
assisted-suicide law would violate the
federal Controlled Substances Act.

Although Constantine's boss, Attorney General
Janet Reno, has not decided whether the DEA
might intervene in assisted suicide, doctors
fear the prescriptions could present a paper
trail for DEA discipline.

Sen. Ron Wyden, D-Ore., talked with Reno on
Tuesday to make a case against federal
intervention in Oregon's assisted-suicide
law.

"She mostly listened," Wyden said. "She
seemed anxious to get our arguments laid out.
And I stressed that the people of Oregon
wanted an answer quickly."

Since Constantine's letter was disclosed,
Wyden and other Democratic members of
Oregon's congressional delegation have
complained that the DEA policy would strip
states of their rights to regulate doctors'
conduct.

Reaction to the letters has prompted Reno to
order a review of the policy by the
Department of Justice, which oversees the
DEA. The review panel is scheduled to meet
Thursday with Oregon officials, including
representatives of Wyden, Gov. John Kitzhaber
and state Attorney General Hardy Myers.

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