STUDY FINDS PAIN WENT UP SHARPLY AMONG DYING IN LATE '97

PORTLAND, Ore. (AP) -- Family members of patients dying in hospitals
reported a sharp increase in the level of pain suffered by their loved ones
during the last two months of 1997, according to a statewide study.

Researchers can't explain why the levels increased, but some medical
leaders believe it's related to the threat of federal sanctions against
doctors who help terminally ill patients die under the state's
physician-assisted suicide law.

"What made it happen? Is it still happening? We don't know," said Dr. Susan
Tolle, an expert in end-of-life care at Oregon Health Sciences University
in Portland who led the study.

The phenomenon began in November, the month after the Death With Dignity
Act took effect. Voters rejected by a 60 percent to 40 percent margin
repealing the law, first approved by voters in 1994.

The preliminary finding is being released in the Oregon medical community
in hopes of turning around what researchers called a "worrisome trend."

"It's one possibility that it's physicians who were holding back in
palliative care, and if that's the case, we could do our part to get the
word out to physicians" to give better care to dying patients, said
Kathleen Haley, executive director of the Oregon Board of Medical
Examiners. The organization's fall newsletter includes news of the finding.

Congress is considering legislation that would block the assisted-suicide
law. A Senate version of the bill would prohibit doctors from prescribing
controlled drugs for suicides. The bill's chances of passage have dimmed as
lawmakers push to adjourn by the weekend.

Tolle said several factors could explain the study's results. Publicity
from the political campaign over assisted suicide may have given families
heightened expectations about pain control, she said. Doctors may have been
worried about a threat earlier this year from the Drug Enforcement
Administration to punish doctors who aid in suicides. Or it may have been
nurses or pharmacists who were concerned about providing large doses of
pain medication and possibly hastening death.

Haley said that the preliminary finding is surprising in that Oregon is
perceived as a leader in end-of-life care and that this finding could
indicate a "step backward."

Part of the study, called "Barriers to Care for the Dying," included
interviews with 475 families three months after the death of a loved one in
Oregon. Complete results of the study will not be released for another year.

For most of 1997, families reported relatively constant levels of moderate
to severe pain during the patient's last week of life. The levels of pain
were similar for people who died at home, in a long-term care center or in
a hospital.

But with deaths occurring in hospitals last November or December, family
members reported severe to moderate pain significantly more often than at
any other time during the year, Tolle said.

Tolle said analysis of the patients' medical records and interviews with
their care providers will show the true causes for the finding.

But Ann Jackson, who heads the Oregon Hospice Association, contends that
the DEA scrutiny and the increase in reported pain are related.

"I think that it's very likely that there's a connection here," Jackson said.

1998 Oregon Live LLC

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Checked-by: Pat Dolan