DEC. 2,1998
P ag e A 6
(Ehe $ J o rtla n b © h a e riie r
American Cancer Society in Oregon Urges Attorney General
Hardy Myers To Reject Tobacco Settlement
Portland-
Attorney General Hardy Myers
has been given less than a week by
the tobacco industry to accept or
reject O regon’s participation in the
largest legal settlement in the his­
tory o f the United States. If imple­
mented, this settlement will impact
the publ ic health, for better or worse,
for decades to come.
Due to the wholly inadequate re­
view period, the American Cancer
Society in Oregon urges Attorney
General Myers to reject the settle­
ment. Preliminary analysis o f the
agreement by public health experts
raises the following concerns:
The settlement allows tobacco
companies to continue marketing to
children as long as that is not their
primary intent.
The settlement does not hold the
industry accountable if youth smok­
ing increases. There are no look­
back provisions in the agreement to
financially punish tobacco com pa­
nies if they continue to market to
children.
The settlement permits the indus­
try to keep secret many ot its most
incriminating documents.
The amount o f financial compen­
sation to the state is inadequate.
The industry is paying nothing for
its past misconduct. Former US Sur­
geon General C. Everett Koop, former
FDA Commissioner David Kessler,
the New York Times and others have
pointed out that the size o f the settle­
ment will result in an insignificant
price increase that will not substan­
tially discourage youth smoking and
save lives.
The settlement does not restrict
vending machine sales, self-service
displays, internet sales, or in-store
advertising.
The exceptions in the settlement
to brand name sponsorship o f events
with significant youth appeal are so
broad as to undermine their effec­
tiveness.
The settlem ent perm it poster­
sized signs and placards in video
game arcades.
American Cancer Society in O r­
egon Urges Attorney General Hardy
Myers To Reject Tobacco Settle­
ment.
The settlement does not restrict
the industry from challenging the
regulatory efforts o f the FDA and
EPA, or to actively oppose ingredi­
ent disclosure efforts.
The settlement permits future
state lawsuits to redress past indus­
try m isconduct on second hand
smoke even though such claims were
not made in any o f the state suits
being settled. Similarly, the settle­
ment permits future state lawsuits to
redress past misconduct by indus­
try executives, attorneys, agents,
advertisers, distributors and retail­
ers even though none were defen­
dants in the suits being settled.
The settlement does not prevent
the industry from mounting new chal­
lenges after agreeing to dismiss its
pending legal actions related to un­
derage smoking and second hand
smoke.
The settlement does not restrict
the industry from lobbying state to
divert the settlement proceeds from
tobacco control uses.
These and other problems with the
settlement should be fully explored
by Attorney General Myers, with in­
put from the public health commu­
nity. IfthisisagooddealforO regon
today it will still be a good deal after
a thorough inspection by experts
whose motives, unlike the tobacco
industry’s, are not profit-driven.
Hundreds Die from Statement on Sodium Intake and High
Restraints at
P re ssu r^ ^ ^ ^ ^ ^ ^
Psychiatric
Facilities
Hartford, Connecticut -
H u n d re d s o f p e o p le h av e
d ie d a c ro ss the c o u n try from
re s tr a in ts at p s y c h ia tric f a c ili­
tie s , a c c o rd in g to th e H a rtfo rd
C o u ra n t N e w sp ap er.
T h e C o u ra n t in v e stig a te d all
p s y c h ia tr ic h o s p ita l d e a th s
s in c e 1 9 8 8 , a n d fo u n d 142
d e a th s w e re re la te d to th e u se
o f p h y s ic a l re s tra in ts o r m e ­
c h a n ic a l re s tra in ts . T he p a p e r
c o m m is s io n e d e x p e r ts fro m
H arv ard to rev iew the d a ta , and
th ey d e te rm in e d th a t h u n d re d s
m o re c a se s h a v e n o t b e e n re ­
p o rte d , an d th a t b e tw e e n 50
and 150 su ch d e a th s o c c u r in
p sy c h ia tric fa c ilitie s each year.
T h e d e ta ils o f th e d e a th in ­
c lu d e a n u m b e r th a t o c c u r
w ith in th e la st y e a r, in c lu d in g :
R o s h e lle C la y b o rn e , a 16-y ear
o ld g irl w ho w as p in n e d face
d o w n to th e g ro u n d by a d u lt
p s y c h ia tric w o rk e rs a t a f a c il­
ity in S an A n to n io , T ex as.
S h e c o m p la in e d
she
c o u ld n ’t b re a th , w e n t lim p ,
th e n u rin a te d , d e fe c a te d , and
v o m ite d b lo o d a f te r b e in g
given an in jectio n o f T horazine.
R a th e r th a n c h e c k h e r v ita l
s ig n s , w o rk e rs d ra g g e d h e r
so ile d b o d y in to a se c lu sio n
ro o m b a se d o n th e p rio r o rd e rs
o f a p sy c h ia trist. She w as la te r
fo u n d d ead th e re .
E d ith C a m p o s, a 1 5 -y e a ro ld
g irl w ho w as re s tra in e d b y an
a d u lt m ale a f te r a c o n fro n ta ­
tio n in w h ic h sh e w o u ld n o t
g iv e s ta f f a fa m ily p h o to sh e
w as c lu tc h in g . T h e a d u lt p s y ­
c h ia tric te c h n ic ia n la id a c ro ss
h e r b a c k w h ile sh e w as p in n e d
face d o w n , a n d sh e d ie d o f a s­
p h y x ia tio n .
A n d rew M cC lain , an 11-year
o ld b o y w h o d ie d o f a s p h y x ia ­
tio n a fte r a re s tra in t. H e w as
p in n e d face d o w n w ith arm s in
fro n t o f h is c h e st, w h ile a p s y ­
c h ia tric w o rk e r w as on to p o f
him.
T ris tra n S o v e rn , a 1 6 -y ear
o ld b o y w ho d ie d o f a s p h y x ia ­
tio n a fte r a re s tr a in t. H e w as
h e ld face d o w n on th e flo o r,
and a to w e l w as sh o v e d in h is
m o u th .
G a ry S h a n n o n , o f the C iti­
z en s C o m m issio n o f H u m an
R ig h ts, an o rg a n iz a tio n e s ta b ­
lish e d in 1969 b y th e C h u rc h o f
S c ie n to lo g y to in v e s tig a te a n d
e x p o se p s y c h ia tric v io la tio n s
o f h u m a n rig h ts , c a lle d fo r an
en d to th e r e s tr a in t d e a th s.
“We could put an end to
these deaths by holding the
psychiatrists who order the re­
straints and the psychiatric
workers who carry them out
criminally liable in the case of
any death.
A lso , standing orders,
whereby a psychiatrists orders
restraints, chemical injection,
and/or seclusion without see­
ing the patient should be ille­
gal •
The primary thing to keep in
mind with regard to these re­
straints deaths is that the rea­
so n th e y o c c u r is th a t som e p sy ­
c h ia tr is t o rd e re d a re s tra in t, a
d ru g g in g , o r a se c lu sio n th a t
w as n o t safe.
T he p s y c h ia tris ts sh o u ld be
h e ld c rim in a lly re sp o n sib le for
a n y s u c h d e a th s , a n d th e y
sh o u ld face lic e n sin g sa n c tio n s
a n y tim e so m eo n e in th e ir care
d ie s o f an u n safe p ro c e d u re th a t
w as c a rrie d out u n d e r th e ir o r­
d ers o f s u p e rv is io n .”
T he H a rtfo rd C o u ra n t n e w s­
p a p e r fu rth e r found:
23 d e a th s w as a sso c ia te d w ith
b e in g face dow n to the flo o r
r e s tra in ts
•2 0 d e a th s w ere a sso c ia te d
w ith b e in g le ft u n a tte n d e d in
m e c h a n ic al re stra in ts fo r h o u rs.
•33 p e rc e n t o f the d e a th s o c ­
c u rre d due to lack o f o x y g en
•2 6 p e rc e n t o f the deaths w ere
a t t r i b u t e d to h e a r t r e l a t e d
causes
T he C itiz e n s C o m m issio n o f
H u m an R ig h ts w as e s ta b lis h e d
in 1 9 6 9 b y th e C h u r c h o f
S c ie n to lo g y , and has a 3 0 -y e a r
h is to r y o f d e n o u n c in g h u m a n
r ig h ts v io la tio n s in th e fie ld
o f p s y c h ia tr y .
CCH R has been com ­
m e n d e d b y th e U n ite d N a tio n s
fo r th e ir w o rk , w h ic h h a s r e ­
s u lte d in n u m e ro u s re fo rm s in
th e f ie ld o f m e n ta l h e a lth in ­
te r n a tio n a lly
High blood pressure, or hyperten­
sion, affects about 50 million Ameri­
cans— one in four adults. It is the
leading cause o f stroke and contrib­
utes to heart attack, heart failure, and
kidney failure. Some
Americans, such as older Ameri­
cans and African Americans, are at a
particularly high risk from high blood
pressure. The National Heart, Lung,
and Blood Institute (NHLBI) sup­
ports a range o f research, including
epidemiological and clinical studies,
to help Americans and their health
care professionals better prevent and
control high blood pressure.
As part o f this public health effort,
the NHLBI works with other public
and private sector organizations to
develop clinical practice guidelines
based on reviews o f the scientific
literature. The latest hypertension
guidelines were released in Novem­
ber 1997. The NHLBI also conducts
periodic reviews on topics such as
dietary sodium as new findings are
published.
One important aspect o f hyper­
tension prevention and management
that has raised questions among sci­
entists and in the media is the effect
o f sodium consumption on blood
pressure. Sodium chloride, or table
salt, increases average levels ofblood
pressure. Some individuals have
greater blood pressure responses to
salt than others.
Various controlled intervention
trials and observational studies have
provided strong evidence that con­
suming a moderately reduced intake
of sodium contributes to lowering
blood pressure. As yet, science can­
not distinguish between those whose
blood pressures are and are not more
responsive to sodium. Available evi­
dence shows that a moderately re­
duced intake o f dietary sodium causes
no harm. Thus, a moderate salt intake
is recommended forali Americans to
help prevent and treat hypertension,
especially in those who are respon­
sive to sodium.
Recently, more research findings
have become available about the ef­
fects o f dietary sodium and salt in
those with and without high blood
pressure. For instance, the Trials of
Hypertension Prevention, Phase II
(TOHP II), published in 1997, found
that short-term sodium reduction and
weight loss each lowered blood pres­
sure in those who were overweight
and had slightly elevated blood pres­
sures. However, the interventions did
not fully maintain weight loss and
sodium reduction over 3 to 4 years
and the effects on blood pressure
reduction were lessened. In 1998, the
Trial ofNonpharmacologic Interven­
tions in the Elderly (TONE), a multi­
center clinical trial, reported that
lifestyle changes—dietary salt reduc­
tion, weight loss, or both to g e th e r -
reduced blood pressures in older
patients with hypertension, decreas­
ing their need for medication. In a
1997 article, the trial o f Dietary Ap­
proaches to Stop H ypertension
(DASH) described the effects on
blood pressure o f entire eating plans.
DASH found that, without testing
the effect o f salt reduction, a diet
lower in fat and higher in vegetables,
fruits, and low fat dairy foods signifi­
cantly reduced blood pressure in
those with normal to slightly elevated
pressures.
WydenCalls forMinority Concerns to be
Included In New Tobacco Settlement
W ashington, DC
U .S. S en ato r Ron W yden (D-
O re.) today called on state atto r­
neys general negotiating a settle­
ment w ith the seven m ajor tobacco
com panies to include provisions
benefiting m inority citizens in any
se ttle m e n t th a t they agree to.
W hen C ongress considered to­
bacco legislation earlier this year,
W yden w orked w ith m em bers o f
the C ongressional B lack and H is­
panic C aucuses to include provi­
sions in that bill ensuring that a
portion o f anti-sm oking research
and education w ould be targeted
tow ards m inority com m unities.
In a letter W ashington State
A tto r n e y G e n e r a l C h r is tin e
G regoire, the lead negotiation for
the A ttorneys G eneral, W yden
w rote, “ I u rg e you not to fo rg et
th e d e c a d e s of ta rg e tin g of m i­
norities by the tobacco com panies
w hich has re su lte d in sta g g e rin g
h e a lth and fin a n c ia l im p acts fo r
th e n a tio n ’s A fric a n -A m e ric a n ,
A sia n -A m e ric a n , H isp a n ic , and
N ative-A m erican com m unities.”
“ Before you agree to any settle­
m e n t,” W yden w rote G regoire, “ I
hope you will m ak e c e rta in th a t
m in o rity c o m m u n itie s have a c ­
cess to effective sm o k in g c e ssa ­
tion p ro g ram s, an d to en sure th a t
no m in o rity c h ild re n a re s a c r i­
ficed to tobacco com pany profits.
J u s t as th e o p p o r tu n ity , an d r e ­
sp o n sib ility , to e n su re th a t these
c o m m u n itie s have th e fin a n c ia l
re s o u rc e to begin re p a ir in g th e
dam age.”
In his letter, W yden cited data
from the C enters for D isease con-
trol show ing that sm oking rates
am ong A frican A m erican high
school stu dents rose 80% in re ­
cent years, w ith d ram atic rises
also occu rrin g am ong H ispanic,
A sian A m erican and A m erican
Indian teenagers.
T h e p r e v io u s s e ttle m e n t
agreed to by the attorney general
and the tobacco com panies failed
to re c e iv e C o n g re s s io n a l a p ­
proval. T hey are now attem pting
to reach a second se ttle m e n t,
new s re p o rts, an agreem ent is
expected shortly.
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