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Flu Pandemic?; Supreme Court Considers Oregon's Death With Dignity Act

Aired October 05, 2005 - 11:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


DARYN KAGAN, CNN ANCHOR: This just in to CNN. We are getting word -- excuse me -- of a suicide car bomb in the south of Baghdad in the city of Hilla. No word on exactly how many casualties, but we are getting that word, and we're working on getting more information. We understand it took place just outside of a Shiite mosque in the town of Hilla, Iraq.
More on that just ahead. Right now, a look at what's happening now in the news.

President Bush is focusing on Iraq this morning. Secretary of Defense Donald Rumsfeld went to the White House for a briefing. He brought along the new Joint Chiefs Chairman Peter Pace, as well as the man who helped get Iraq's security forces up to speed.

Under international pressure, Iraq's parliament scrapped a new and controversial election rule today. It would have made approval of the new constitution a virtual certainty. Minority Sunnis threatened to boycott the vote if the change was not revoked.

We are up to the letter 'T.' Tropical Storm Tammy coming to life off the Florida coast today. Top winds are about 40 miles an hour. The storm is expected to quickly move to Georgia with heavy rain. Forecasters say it won't be over water long enough to grow into a hurricane.

And police are charging three people with last Friday's murder spree in Georgia. Six Mexican immigrants were killed during home invasions. Police believe some of the suspects may be part of a gang that has robbed immigrant farm workers in South Georgia.

Washington is suddenly worried about a flu pandemic. The government reportedly estimates that up to two million deaths in the U.S. could happen if this disease hits this country. Avian, or bird flu, has infected millions of chickens and other fowl in Southeast Asia. For now, the virus is mostly a bird-to-bird illness.

But more than 100 people have gotten sick, and about half of those have died. Experts fear the virus will keep mutating. That may one day allow one day the virus to easily spread from person to person. Time is needed to come up with a vaccine. Quarantine might be the only way to stop the outbreak. President Bush says he could use the military to enforce a quarantine, but Congress would have to change a law that bars U.S. troops from a police role.

(BEGIN VIDEO CLIP) GEORGE W. BUSH, PRESIDENT OF THE UNITED STATES: If we had an outbreak somewhere in the United States, do we not then quarantine that part of the country? How do you then enforce a quarantine? One option is the use of military that's able the plan and move. So that's why I put it on the table.

(END VIDEO CLIP)

To New York now. Dr. David Nabarro is the United Nations avian flu coordinator.

Doctor, good morning. Thanks for being here with us.

You believe it's not a matter of if, but when this turns into a widespread flu pandemic?

DR. DAVID NABARRO, U.N. AVIAN FLU COORDINATOR: Well, we certainly believe there will be another pandemic before long. They come in cycles, and we're due for one about now. The likely contender for the virus that will cause the flow is this one that's currently affecting the birds in Asia particularly. H5N1 it's called.

O'BRIEN: Why this one, doctor?

NABARRO: Well, it's the virus currently causing a major epidemic. And when you've got an epidemic in the birds, the chances of it moving to humans is particularly likely, perhaps foreign intermediate hosts.

O'BRIEN: And why do you think it will turn into an out of control spread around the globe?

NABARRO: All viruses mutate. They divide very rapidly, and their genetic material reasserts itself. What we think may happen is that this genetic material come into a human flu virus and form a new mutant strain. This has happened before. It's how pandemics occur. And so we are being prudent and getting ready for it in case it happens.

O'BRIEN: And as we saw with SARS, this really is a global community the way people travel.

NABARRO: We cannot assume that a flu pandemic will remain isolated in one part of the globe. The only way in which any country, including the United States, can keep itself safe is by approaching this as a global issue.

O'BRIEN: And you're saying sacrifices are a must. How big of sacrifices?

NABARRO: Well, I want to be clear on this, that we say getting prepared is a must, and making difficult decisions is absolutely essential.

O'BRIEN: Like what? What's a difficult decision? NABARRO: Well, already we've seen that those countries that have got large poultry populations are having to kill large flocks of birds at the first sign of illness. They're also having to completely change the way in which people and birds interrelate, stopping trafficking of live animals and changing the way markets work. These are sacrifices for the chicken farmers, and then there will be more sacrifices if the flu comes to the human population.

O'BRIEN: And what about the idea that President Bush was talking about yesterday of bringing military in quarantining a geographic area of a country if you see an outbreak.

NABARRO: Well, it's really a very sensible thing, I think, for a head of state to be indicating that this is a possibility so that the people are prepared to start talking about it. When we've got a serious illness, we've few options available. You either vaccinate people against it, you give them drug treatments so you can conquer it, or you isolate them so that they can't spread it.

We don't know that drug treatment is necessarily going to work. We're not sure our vaccines are going to work, because we don't know how the virus is going to mutate. The right thing to do is to prepare people for the possibility of quarantining. That's how we'll keep countries working and the world working.

O'BRIEN: It is a story that goes. Dr. David Nabarro, thank you for your expertise today.

NABARRO: Thank you very much. Goodbye.

O'BRIEN: We're going to look back right now to the early 20th century. A few virus is believed to have jumped then from birds to humans, estimating that about half the people on the planet got sick.

Here now, our senior medical correspondent, Dr. Sanjay Gupta.

(BEGIN VIDEOTAPE)

DR. SANJAY GUPTA, CNN SR. MEDICAL CORRESPONDENT: The so-called Spanish flu struck in the final months of World War I, rapidly killing more people than died in that entire bloody war.

JOHN BARRY, AUTHOR, "THE GREAT INFLUENZA": This disease killed more people in 24 weeks than aids has killed in 24 years.

GUPTA: As many as 100 million people perished worldwide, and the suffering was horrific.

BARRY: Your skin could turn so dark blue from lack of oxygen that one physician reported that he had difficulty telling African- American troops from white troops. People could bleed from -- not only from their mouth and nose, but even from their eyes and ears.

LAURIE GARRET, FLU RESEARCHER: The only thing I can think of that could take a larger human death toll than virulent pandemic influenza would be thermonuclear war. GUPTA: And Laurie Garret, who studies the flu, is worried it could all happen again.

GARRET: The problem with flu is it is orders of magnitude more contagious than the dreaded Ebola virus, than smallpox, than just about anything except common cold.

GUPTA: A single sneeze ejects millions of flu viruses into the air, and the virus can live as long as two days even on a cold surface like a door knob. In some ways we're better off than in 1918. Antibiotics can stop pneumonia complications. But anti-flu drugs such as Tamiflu or Relenza offer just partial protection. There's an experimental vaccine against bird flu, but no one really knows if it will work. And remember, back in 1918, the virus couldn't hitch a ride on a plane.

GARRET: It circumnavigated Earth three times in 18 months, when there was no commercial air travel. There were a lot fewer human beings. We did not have a globalized economy. Americans rarely went outside of America. Now look at us.

GUPTA: Today's deadly bird flu is literally less than 24 hours away.

Dr. Sanjay Gupta, CNN, Atlanta.

(END VIDEOTAPE)

KAGAN: And we have more information for you now on that bombing that took place in Hilla, in Iraq, just south of Baghdad. Happened this evening, this evening Wednesday, in terms of Iraq time. We are finding right now the latest numbers: 10 dead, 30 wounded. We originally heard that it was a car bomb. Now we're hearing this is an explosion that took place inside a Shiite mosque. Not sure exactly what type of explosion, if it was a car bomb or if it was a suicide bomber. But we are hearing word that part of the Shiite mosque was destroyed in the blast. Once again, at least 10 dead and 30 wounded in this explosion inside a Shiite mosque in Hilla, Iraq, just south of Baghdad.

More on that just ahead as the information becomes available.

Also voters in Oregon have twice decided in favor of doctor- assisted suicide, and we'll get more on that story just ahead. So why is the Supreme Court getting involved, essentially deciding who gets to choose the right to die? One man's personal story when CNN LIVE TODAY returns.

(COMMERCIAL BREAK)

KAGAN: A live picture there for you, Washington, D.C. The U.S. Supreme Court, the first major case to come before new Chief Justice John Roberts. It's an emotionally-charged one, assisted suicide. In the spotlight, Oregon's law that allows doctors to help terminally ill patients end their lives. The Bush administration says the law allows the use of controlled substances. Oregon is the only state that lets dying patients obtain lethal doses of medication from their doctors.

More than 200 people in Oregon have used the state's so-called Death with Dignity Act to end their lives, and it's an issue that still stirs debate, intense debate, in Oregon.

With more on that, here's our special correspondent Frank Sesno.

(BEGIN VIDEOTAPE)

FRANK SESNO, CNN SPECIAL CORRESPONDENT (voice-over): It's a good day for Greg Yaden, so he's off to enjoy one of his favorite pastimes. But at 59, he knows he hasn't got much fishing left. You see, about a year ago, Greg collapsed after a business trip. He ended up in the hospital. The diagnosis, acute myeloid leukemia. Chemotherapy bought some time, but doctors could not find what Greg needed most, a suitable bone-marrow donor. The disease is moving fast now, and Greg measures his future in death.

GREG YADEN, TERMINALLY ILL PATIENT: Yes, I'm scared, but I'm also accepting it. I would be terrified if I didn't have some say in how this was going to end.

SESNO: Greg is taking charge of his death. He showed me the room where he plans to die.

YADEN: All my friends can come up and visit and that sort of thing. We'll have Hospice up here.

There are a series of questions...

SESNO: And read from this form he signed, requesting a lethal dose of barbiturates.

YADEN: I understand the full import of this request, and I expect to die when I take the medication to be prescribed. I'm not going to take it unless I'm really, really, really losing it. And so, it's not going to be, oh, gosh, I'm committing suicide. It's like, oh, God, please release me from this, I just can't take this anymore. You know, give me some help here.

SESNO: Greg's help comes from his fellow Oregonians who twice have voted for the state's Death with Dignity Act, the only such law in the country. It allows a doctor to write a lethal prescription if a patient is certified, mentally competent, and within six months of death from disease.

Between 1997 and 2004, 208 terminally ill Oregonians took their lives in this way, the vast majority saying they wanted some autonomy at the end, as does Greg.

YADEN: If there was any question I could live, I'd be fighting tooth and nail. I would fight tooth and nail. But the work of fate, whatever, you know, I don't. I don't.

UNIDENTIFIED MALE: This is not what we need.

SESNO: Greg's prescription, Oregon's law, has triggered a debate has passionate as it is eternal. Who controls life and death?

For 38 years, Dr. Kenneth Stevens has been a radiation oncologist in Oregon. He believes the Death with Dignity Act breaks faith with patients and his profession.

DR. KENNETH STEVENS, "AGAINST RIGHT TO DIE": What I see with the suicide is that a patient is basically saying, I want to die. Breathing is my symptom, and the cure for that breathing is to cause my death, and that is not what medicine is about.

SESNO: The United States Justice Department agrees. In 2001, under Attorney General John Ashcroft, it challenged Oregon's law, and lost, but the government appealed, so now the Supreme Court will decide.

Greg Yaden doesn't know if he'll still be around when it is argued, BUT he has a message for everyone involved, especially the justices who will hear the case.

YADEN: I would just ask what business is it of yours? Do you know what I've gone through? Do you know what I'm going through?

SESNO: Missy, Greg's partner for 12 years, is right there with him.

MISSY HECTOR, GIRLFRIEND: And the ferns are doing good.

SESNO: They faced the disease and his decision together.

HECTOR: He's terminal. He's not changing what's going to happen to him. He's just hastening it in a manner to give him peace of mind.

UNIDENTIFIED MALE: Looking at today's patient list...

SESNO: Dr. Nick Gideons (ph), director of a family health clinic with more than 2,000 patients, is not Greg's doctor, but he has written seven lethal prescriptions and been present at five deaths.

UNIDENTIFIED MALE: I won't deny that I've cried at times around this. But it's been a tremendous privilege. I feel that I've relieved suffering in a very palpable, real way for patients. And I think I've also helped families honor their family members' final wishes in the face of terrible illness.

SESNO: The Supreme Court will determine whether doctors like Gideons can continue to write prescriptions, or whether they're in violation of the Controlled Substances Act. Gideons is well aware of the legal and moral arguments, and the Hippocratic Oath, I noticed, that hangs on the wall.

(on camera): I will give no deadly medicine to anyone if asked, nor suggest any such counsel.

UNIDENTIFIED MALE: If I can provide aid in having the good death that they hope for, I don't feel I'm breaking any of the oath or -- our goal is to help patients in any way that we can. STEVENS: I could not do it. I would become an executioner rather than a healer.

SESNO: And you've been their radiologist?

(voice-over): Dr. Steven's opposition to Oregon's law isn't just professional, it's also very personal. Shortly before his first wife died of cancer in 1982, her doctor suggested an extra large dose of morphine.

STEVENS: As I helped my wife to the car, she said, Ken, he wants know kill myself. And it really devastated her that her doctor, her trusted doctor, would basically feel that her life is no longer of value.

SESNO: None of this changes the way Greg Yaden or those close to him, including his brother Dave, see things.

DAVE YADEN, BROTHER: For those who say we should be in the business of living. Well, my brother's dying, period. He's going to be dead. He ought to have a chance to do that in a way that gives him as much comfort and the rest of us as possible.

SESNO: Greg doesn't know if he'll swallow the bitter liquid at the end, but he sees it as an insurance policy he'll use if he must.

YADEN: We'll call ahead and say we have an expected death. They won't then send an ambulance with sirens screaming and bells ringing. And so -- my neighbors don't know, we're close. So, just go to sleep.

SESNO (on camera): On your terms.

YADEN: On my terms.

(END VIDEOTAPE)

KAGAN: We're going to have more on this emotional issue of doctor-assisted suicide coming up in our next hour. We'll hear from Jay Sekulow, chief counsel for the American Center for Law and Justice. Also from Robert Rabin (ph), a lobbyist for the group Compassion and Choices, and our thanks to Frank Sesno for that piece.

We're going to check on weather. There's Another tropical storm out there. It's called Tammy. Also business. The markets weren't looking so hot earlier today. We'll see if they picked things up. That's coming up next.

(COMMERCIAL BREAK)

KAGAN: Actress Lindsay Lohan and her female passenger suffered minor injuries in this traffic accident in West Hollywood. Authorities say Lohan was trying to flee about 30 photographers when she collided with a van. Lohan had a similar mishap trying to evade a photographer last May.

(WEATHER REPORT)

(WEATHER REPORT)

KAGAN: Coming up in our third hour of CNN LIVE TODAY, they have made a lot of music, but could they now make the history books? Bono and Bob Geldof, both up for perhaps the most prestigious prize in the world. More on CNN LIVE TODAY after a quick break.

(COMMERCIAL BREAK)

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