- The Washington Times - Monday, May 10, 2004

Opponents of assisted suicide say the revelation that a depressed Oregon cancer patient was prescribed lethal drugs under that state’s Death With Dignity Act is reason to shut down the nation’s only legal assisted-suicide program.

The case of Michael P. Freeland, which echoes many warnings of assisted-suicide opponents and flouts many promised safeguards, was made public last week at the annual meeting of the American Psychiatric Association.

“The APA people were outraged that the hospital sent someone home who was suicidal, knowing he had suicide means at home,” said Dr. N. Gregory Hamilton, a psychiatrist and past president of Physicians for Compassionate Care (PCC), yesterday.

Mr. Freeland died Dec. 5, 2002, of lung cancer that had been diagnosed in 2000. He had been prescribed a fatal dose of barbiturates 18 months before his death but had not taken them.

Critics say the lethal prescription was improper, because Mr. Freeland, 64, had a “long history of depression and suicide attempts.” In the last year of his life, he was twice declared mentally incompetent and he kept a huge weapons cache at home.

Oregon intended the assisted-suicide law to apply to patients of sound minds with less than six months to live.

“Assisted-suicide activists promised voters that depressed patients with serious illnesses would never be given doses of lethal drugs. They said there were safeguards. But, as this case proves, there are no effective safeguards for the vulnerable and mentally ill,” said the Portland-based PCC, which opposes assisted suicide.

But Darcy Niemeyer of the Oregon Department of Human Services defended the program.

“The law was set up carefully to ensure that people who participate do so with the ability to make rational judgments about their health care,” Mrs. Niemeyer said yesterday in a telephone interview.

She added that the state’s assisted-suicide program “relies on physicians” to let the state know “whether they think there are any psychological or emotional barriers” that should block someone from participating in the program.

In this case, Mrs. Niemeyer said, neither of the two doctors involved in making the decisions “thought this was true,” and so they “went ahead and prescribed” the lethal drugs.

The continuation of Oregon’s assisted-suicide program is in jeopardy, as a result of a lawsuit before the 9th U.S. Circuit Court of Appeals brought by the U.S. Attorney General’s Office.

In oral arguments last May, Justice Department lawyers said that prescribing controlled narcotics to terminally ill patients violates the federal Controlled Substances Act, which limits the use of the drugs to medical purposes.

Dr. Hamilton said “assisted suicide is not a medical procedure,” thus Oregon’s program “should be shut down. … A state cannot unilaterally exempt itself from federal law.”

He made his public presentation of the Freeland case at the APA meeting Friday in New York, using Mr. Freeland’s medical and psychiatric records, which the patient had released to Dr. Hamilton before dying and authorized to make public.

The records showed that thoughts of suicide had “haunted” Mr. Freeland since his early 20s, after his mother killed herself. Mr. Freeland attempted suicide shortly afterward, PCC said.

In a telephone interview yesterday, Dr. Hamilton said Mr. Freeland was hospitalized at age 63 for depression with suicidal and homicidal thoughts.

His psychiatric discharge report, dated Jan. 30, 2002, said, “The guns are now out of the house, which resolves the major safety issue.” This was a reference to the 32 firearms, including a machine gun, and “thousands of rounds of ammunition” that had been found in his home, Dr. Hamilton said.

Although the weapons were gone, the discharge report said Mr. Freeland still kept “safely at home” the drug overdose he had received to kill himself in 2001 from a doctor participating in Oregon’s assisted-suicide program.

Noting that another psychiatrist and a judge had found Mr. Freeland mentally incompetent in 2002, Dr. Hamilton said, “Even after he was found incompetent, no one tried to get those drugs back.”

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