The MacNeil/Lehrer NewsHour

MR. MacNeil: Good evening. Leading the news this Thursday, President Bush called the Alaska oil spill a major tragedy but ruled out a federal cleanup. The U.S. asked Soviet Leader Gorbachev to help peace efforts in Central America. We'll have details in our News Summary in a moment. Judy Woodruff is in Washington tonight. Judy.

MS. WOODRUFF: After the News Summary, the Alaska oil spill is first. We look at the slow cleanup efforts in News Maker interviews with Lawrence Rawl, the Chairman of Exxon, the company that owns the super tanker that went aground, and Alaska Governor Steve Cowper [Focus - Troubled Waters]. Then when is it all all right for a doctor to help a sick person die? [Focus - Decision To Die] We have a report from Kwame Holman. Then we hear from two specialists on opposite sides of the debate, Dr. Jan Van Eys and Dr. Ronald Cranford. Finally, essayist and now Pulitzer Prize winner Clarence Page on the price we pay for expressing our opinions [Essay - Express Yourself].NEWS SUMMARY

MR. MacNeil: The question of whether the captain of the oil tanker Exxon Valdez was legally drunk when his ship ran aground was answered today. Federal investigators announced that Capt. Joseph Hazelwood was drunk when his ship hit a reef and spilled millions of gallons of oil. They said his blood alcohol was .061 when it was measured nine hours after the accident. That's above the level allowed by the Coast Guard for operating a commercial ship at sea. Meanwhile, the Bush administration today called the Alaska oil spill a great tragedy but decided it would be counter productive for the federal government to take over the cleanup. Three federal officials reported to President Bush after inspecting the spill that the cleanup was moving ahead after a slow start. Transportation Secretary Samuel Skinner gave an assessment at a White House news conference.

SAMUEL SKINNER, Secretary of Transportation: The effort is now going forward at the correct pace that Exxon, the state and the federal government are working well together, and that at this point there is not a need to federalize this effort. That will be held in abeyance and, in fact, such a decision might be counter productive because of the coordination that is ongoing.

MR. MacNeil: At the same news conference, Coast Guard Commandant Admiral Paul Youst said he was surprised that the tanker Exxon Valdez could have strayed so far from the safe channel.

ADM. PAUL YOUST: Remember, we've got 10 miles of open water there, and that vessel to have come over and hit a reef is almost unbelievable. It is not something that the vessel traffic system was designed to keep vessels from doing. We would need vessel traffic systems up and down the coasts of the United States if we're going to try to keep every vessel from hitting the beach; you can't do that. This was not a treacherous area, as you people in the press have called it. It's not treacherous in the area they went aground; it's 10 miles wide. Your children could drive a tanker up through it.

MR. MacNeil: The Chairman of Exxon Corporation said today that the Coast Guard and Alaskan officials were responsible for the delay in starting the cleanup. Lawrence Rawl told Reuters News Agency that Exxon was prepared to begin on Saturday, a day after the spill, but could not get official authorization until Sunday evening. We'll have interviews with Mr. Rawl and the Governor of Alaska after the News Summary. Judy.

MS. WOODRUFF: President Bush has sent a leader to Soviet Leader Mikhail Gorbachev urging him to get involved in finding a peaceful settlement of the situation in Nicaragua. A White House spokesman said the U.S. would like to see the Soviet Union withdraw its resources and support for the ruling Sandinista Government. The message to Gorbachev comes just before the Soviet leader travels to Cuba this Sunday for meetings with Fidele Castro. Secretary of State James Baker meanwhile today said the Soviets have an opportunity to demonstrate new thinking on Central America. Speaking in Atlanta, Baker said the Americas were not a dumping ground for failed ideologies or foreign arms.

MR. MacNeil: There was more violence in the Israeli-occupied West Bank and Gaza Strip today as Palestinians marked the anniversary of what they call Land Day. That was a violent clash 13 years ago over Israeli confiscation of Arab land. Three Palestinians were killed in today's clashes with Israeli soldiers in the occupied territories. Arabs in Israel proper protested peacefully without incident. An inmate rebellion at Guatemala's largest prison ended today. Inmates took control of the prison Sunday after some of them tried to escape but failed. Three inmates and four guards were killed during the uprising. The inmates surrendered after the government agreed to improve conditions at the prison and replace all the guards.

MS. WOODRUFF: In Washington, the Federal Environmental Protection Agency today added another 101 sites in 33 different states to its lists of hazardous waste dumps that pose the greatest long-term threat to public health in the environment. The sites are eligible for the government's superfund cleanup program. The list includes garbage dumps, refineries, dry cleaners, chemical dumps and a variety of manufacturing plants.

MR. MacNeil: The Pulitzer Prize winners for 1989 were announced today. Among the winners, the prize for non-fiction went to journalist Neil Sheehan for his history of the Vietnam War era called "A Bright Shining Lie, John Paul Van and America in Vietnam." In the arts, awards went to a play about baby boomers by Wendy Wasserstein called "The Heidi Chronicles" and the award for best fiction went to Anne Tyler for her latest novel, "Breathing Lessons". In journalism, the public service award went to the Anchorage Daily News for its series on alcoholism and suicide among native Alaskans, and the Pulitzer for best commentary went to the Chicago Tribune's Clarence Page, who is also a regular essayist for the Newshour.

MS. WOODRUFF: That ends our summary of the day's top stories. Ahead on the Newshour, the Alaska oil spill, doctors and dying, is suicide a rational option, and an essay from Pulitzer Prize winner Clarence Page. NEWS MAKER - TROUBLED WATERS

MR. MacNeil: First up tonight, a News Maker Interview with Lawrence Rawl, Chairman of the Board of Exxon Corporation, the company whose super tanker, the Exxon Valdez, ran aground in Alaska six days ago. Since then, 10 million gallons of oil from the ship have spread over the waters of Prince William Sound in an oil slick of more than 500 square miles. As we reported, the Secretary of Transportation today decided to leave the cleanup in Exxon's hands, saying that it is now proceeding at full speed. Exxon Chairman Lawrence Rawl is with us now in New York. Thank you for joining us, Mr. Rawl. President Bush called this a tragedy today; the EPA called it a disaster. How do you characterize it and how does Exxon feel about it?

LAWRENCE B. RAWL, Chairman, Exxon Corporation: Well, I agree with both characterizations. It is a tragedy and there is a disaster and at the start I'd like to apologize to the people of the U.S., particularly the people in Alaska. We feel very badly about this, and it's not just in economic terms. We feel badly about the environment up there, and our employees are very stressed, and particularly the people in our shipping company and it was a very unfortunate happening and we just appreciate the opportunity to talk about this.

MR. MacNeil: Earlier today in an interview, you blamed state officials and the Coast Guard for delay in dealing with this spill. Why are they to blame in your view?

MR. RAWL: Well, I didn't exactly use the word blamed. I said that we had the material on the ground in Valdez on Saturday morning, which was the dispersant. We had the aircraft to disperse it at the spill. At that time we were very fortunate in terms of weather. All day Friday, Saturday, and a good part of Sunday, it was very calm there. The winds were low and the slick, itself, the spill, although very long, was sitting in deep water in the channel right near the ships. We felt like that we could, in fact, disperse this material, break this oil slick up into small globules which would permit bacterial action and so forth and basically improve the situation or mitigate the deleterious effects of such a spill. The basic problem we had, we asked for authority and I guess the implication is that I blamed the authorities because the question came back to me, well, who could give you the authority and I said, well I understood the representatives of the federal government was the Coast Guard, the representatives of the state government were the environmental people up there. But I also understand that the difficult situation that an environmental agency person in Alaska or anywhere else is under when there undoubtedly were a number of environmentalists telling them that this material corexit was toxic. The facts are it isn't toxic to wildlife and to fish. Certainly toxicity would be nothing like the ingestion of crude oil. It's licensed for use in California in spills, eight or nine countries around the world, the EPA has licensed it in Washington. Now there was a lot of confusion up there. This was a very very large spill and we can understand that. Now the implication was that I blamed the -- I really didn't blame them -- what I'm trying to do is defect the fact -- we've been under a lot of pressure, our employees who have been working very hard on this thing feel very badly about these delays and they just wanted to say that they felt like we were ready to mitigate this disaster. We take full blame for this disaster, but the concern about what took us so long to get started, we have people putting one ship up against another, which is a very delicate situation. We've gotten that ship out, another one in, we feel like they're doing well and I was delighted to hear that Sec. Skinner felt that we were doing well, and the state and the Coast Guard have been working very closely with us on this.

MR. MacNeil: Well, the Governor of Alaska is going to be on after you and he can talk about any delay in giving the permission. On Monday night, he told us after a test on Saturday, they had given you permission to use the dispersant on Monday in a deep water area where any toxic effects would be lessened, but he can elaborate on that after this.

MR. RAWL: Well, Monday, obviously, was a couple of days too late in terms of the weather window that we have.

MR. MacNeil: But we talked to the Department of Transportation today and they say that there were no restrictions or delays imposed by any officials on using booms or on any effort to scoop up the oil.

MR. RAWL: That's correct.

MR. MacNeil: And the first line of defense, one assumes in things like this, would have been to boom around the vessel to prevent the slick from dispersing, but isn't it the case that you didn't have the boom materials on hand there and the barge that would have carried them turned out to be in the dry dock?

MR. RAWL: Yes. There's plan, Robin, that has been established for a number of years, is approved from time to time by the state and other officials, I presume the Coast Guard, but basically the design has been in the Aliaska organization --

MR. MacNeil: The consortium of oil companies that run the pipeline.

MR. RAWL: Which we are a member of, we are part owner -- they have the responsibility in Phase 1, but the anticipated spill that that sort of an arrangement with booms could take care of would be anticipated where you'd have littering from one vessel to another, or you might have a spill at the peer with a tanker up close to it, and you can boom it and pick it up with a relatively small skimmer that they have available, I forget the number, but it might be three or four hundred barrelsan hour or something. We're talking about a catastrophic spill, as Admiral Youst or Sec. Skinner talked about, where within a matter of an hour or two, this material was on the water. This vessel was hold in five cargo tanks in the center, five out six on the starboard side and fortunately it was not hold on the port side. Now with that kind of effluent hitting the water that rapidly, and there was a delay because of the dry dock of the barge, took instead of -- they might gotten there in five hours -- took ten hours -- I read the Secretary and the press account of their news conference in Washington, they said and I had said this morning in this Reuters interview, that had they gotten there five hours or even earlier, the equipment was inadequate for this kind of a spill. The plan stipulates that in such a situation you use dispersants or you use burning. Now on Saturday we were able to test the dispersants, they worked, and we tested the burning and it worked. Now if you wait long enough and you weather this crude oil, burning becomes very difficult, because you get emulsion of crude in the water.

MR. MacNeil: The people of Valdez, as I don't have to tell you, are very angry. They sued to prevent this pipeline outline being located there, the suit was finally settled after a long legal battle when this contingency plan was imposed. Now disaster strikes and the plan doesn't work. What is your reaction to that, to their anger based on that sequence of events?

MR. RAWL: If I lived in Valdez, I would be very angry myself. By the way, I'm very angry anyway, you can imagine, the kind of situation we find ourselves in, but I think what we can do and we intend to do is clean this up as rapidly as we can, mitigate to the extent possible no, you know, pulling out all the stops on the environment, on the birds, on the fish, on the marine mammals, and settle all the claims as rapidly as we can in terms of the people who have been damaged by this. We've set up a claims office in Valdez and we've set up another claims office.

MR. MacNeil: But they're feeling misled, Mr. Rawl, they're feeling that this contingency plan which was always used to reassure them apparently was never designed to cope with a spill of this dimension, is that correct?

MR. RAWL: Well, I think the contingency plan includes catastrophic spills possibly not of this dimension but something in the tens of thousands of barrels probably to where had we moved as promptly as we might have, without trying to point a finger at who --

MR. MacNeil: With dispersants?

MR. RAWL: With dispersants -- we would mitigate that. We would still have a problem and I'm not sure how this communication with the people of Valdez, or I'm not quite sure how the settlement went, I wasn't there at the time.

MR. MacNeil: It is also widely believed there in Valdez and also by people familiar with the sort of pollution control side of the oil industry that the Aliaska consortium to save money has so scaled down its staffing and equipment in recent years that any contingency plan was really bogus now, that it was just on paper and not backed up by the proper equipment.

MR. RAWL: Well, I don't think that's true in terms of equipment. I really don't know the staffing situation, but the basic problem we had when you have this type of a spill is in terms of immediate reaction it's more a question of equipment and a minimum question of how many people are available. You have to have trained people and I know there are trained people. Now the problem we have around the world, there is in the free world, ex the Communist countries, there's 50 million barrels a day consumed and a lot of it's transported in ships. As a consequence, not knowing precisely where a spill might occur or an accident might occur, there is material, booms, skimmers and things like that, placed in relatively strategic areas. As the Secretary said today, or it might have been Mr. Reilly, there have been 6 billion barrels come down that pipeline, transported through this facility, which is a heck of a lot of oil. Right now, it's probably 20 to 25 percent of the oil consumed in this country that's produced in this country and unfortunately we've had this very bad spill and I feel very badly about that, but the facts are it's a fairly small percentage but it's way too much.

MR. MacNeil: You can't have enough anti-spill equipment everywhere, that's what you're saying?

MR. RAWL: That's right.

MR. MacNeil: It's also said by people in the industry that people in your own company in order to economize in recent years has drastically scaled back on your own sort of pollution control experts, a group of nine people in a section of the company that isn't very large anyway left all in one go, and that has hampered you in dealing with this spill.

MR. RAWL: That is totally untrue and the facts are we don't just have nine people who are trained to deal with spills.

MR. MacNeil: No, but a group of nine people, it is said, left in one --

MR. RAWL: We have a thousand people worldwide that are trained to deal with these problems. We as a company have 8 million tons of shipping worldwide. We have 71 ships; we have a very large shipping fleet. We have what I consider the greatest training for captains. We unfortunately didn't catch the kind of problem that has been apparently proven today, and that was untrue. The facts are of course whenever you down size or whenever you have people retire, you replace them. And all that nine, a group of nine moved out of New York, but we have, our international fleet is run out of an office in New Jersey, and a lot of those people, by the way, are in Alaska, although they work in other places, so we've got two to three hundred of our own people in Alaska. A larger number of them are expert in one phase of this or another, so that's just absolutely false.

MR. MacNeil: How is it that Exxon, which trains its captains as you just said, didn't pick up Capt. Hazelwood's drinking problem? His mother says it was known, these various, unusual drunk driving convictions, license revocations or suspensions as recently as last September. He'd gone through a rehabilitation program and his mother says Exxon knew about that.

MR. RAWL: I of course, after the fact, but Exxon did know about the rehabilitation and I think we made a gross error which I guarantee you won't be repeated with that kind of rehabilitation. We've got a program which says we'll give people a job. It doesn't say we'd put them back to flying airplanes or piloting tankers or whatever other kinds of very risky kinds of activities we have and there are a lot of them in any large business, but I frankly wish I had known or I wish some of the senior management in Exxon USA had known.

MR. MacNeil: Finally, it's being predicted in the industry that this spill is going to affect the entire future of oil drilling, the location of oil ports, terminals, refineries. Do you have an observation on that? Are you going to have a long way to claw back as an industry against the public relations and other effects of this?

MR. RAWL: There's no question that it's a setback in terms of a number of things, such as drilling in the North slope and things of that nature, but I just don't think it's practical in terms of the worldwide industry, in terms of when you start talking about moving refineries or moving oil ports or something, you know, and then people start saying put it in somebody else's backyard, and it's just not even realistic to think in those terms. I think it's incumbent on us as a company and our employees, however, to make darn sure that we do the best possible job. I'm absolutely convinced that we'll clean this thing up quicker than people think. The effects will not be as long lasting as people think and this is a very large spill in terms of U.S. situations. If you leave out World War II when we had a large number of tankers in the Gulf of Mexico and along the East Coast here, around the Coast of Florida, which were smaller, but carried maybe a hundred thousand barrels of oil that were going down a great deal of the time. We've seen -- and this is not meant as an excuse or trying to say this isn't a bad thing to have happen, it's a terrible thing to have happen -- but the facts are I don't really think that the impact will really be as catastrophic in terms of industry relations and changing the sites of ports and so forth unless people want to stop using oil or they just give up on energy totally and I don't think any of us think that that's a very practical way to do things.

MR. MacNeil: Okay, Mr. Rawl, thank you very much for joining us.

MR. RAWL: Thank you for giving me the opportunity.

MR. MacNeil: Judy.

MS. WOODRUFF: Next we hear from Gov. Steve Cowper of Alaska. He joins us from public station KTOO in Juneau. Governor, thank you for being with us. You just heard Mr. Rawl of Exxon say that while he didn't want to place blame that it was the state that delayed the beginning of the cleanup, that did not give Exxon permission to start the cleanup as quickly as it was ready. Do you acknowledge that that's what happened?

GOV. STEVE COWPER, Alaska: No, that wasn't what happened, Judy. It turns out that I was there on Friday when they made the first test run of chemical dispersant. I saw it. It was from a Coast Guard helicopter and the test was regarded as a failure. The reason was that the chemical dispersant way of dealing with a spill only works when there's relatively rough water. It's kind of like a detergent; you need to stir up the water a bit before it works. The water was calm. It was perfect for the use of boom and skimmer technology, but it was not a very good time to use chemical dispersant, however, the state had preauthorized the use of chemical dispersant in the so-called "Zone 1" areas, those are the areas that are not so environmentally sensitive, and that included the area where the oil was over the weekend. It appears that the U.S. Coast Guard did not want to drop the dispersants without a test. There were two tests on Saturday and there were two tests on Sunday. The use of the dispersant was finally okayed by the Coast Guard in the early afternoon of Sunday. We called back to Anchorage, and I'm told that the C-130s which were to transport the dispersant to the area were not loaded and that it would take three to four hours to load the airplanes with the dispersant, and that's why they didn't have a drop. It was not the state telling Exxon they couldn't do it.

MS. WOODRUFF: So you're saying if there was a responsibility there for a delay, that responsibility lies with the U.S. Coast Guard and not with the State of Alaska?

GOV. COWPER: Well, I think frankly, Judy, that it was pretty doubtful as to whether the dispersant would have broken up the oil in that calm water. It's pretty well known that dispersants need to have a little rough water in order for it to work.

MS. WOODRUFF: Governor, was there anything that could have been done at that point do you believe?

GOV. COWPER: Sure, absolutely. If the industry had had the equipment there on time or had known how to get it there within a reasonable length of time, then we could have used boom and skimmer type operations to start mopping up some of the oil as it moved on, and as it began to, as the weather began to get rougher, then we could have used the chemical dispersants. As it was, the weather got rougher all right on Monday, but it was so rough that the airplanes couldn't even high and the helicopters, neither one. And let me say this, I don't usually do this, but the Chairman of the Board of Exxon I think has been too heavy on his own company. I think that this was not Exxon's situation. It was the Aliaska Pipeline Corporation, and they were the ones that didn't respond.

MS. WOODRUFF: Can you explain what you mean by that? What do you mean they didn't respond? And also when you say the Aliaska Pipeline, you're talking about a consortium of oil companies, of which Exxon is one company.

GOV. COWPER: That's right. Exxon is a participant, but the pipeline company is the one that was supposed to have the spill response ready to go and they didn't. They did not respond in the way that they said they could through their contingency plan. As a matter of fact, there is some evidence that the people that were at the ready were not even contacted after Aliaska had notice of the spill. But leaving that aside, I think that what we had is an unfortunate set of circumstances that is a little ironic looking at it in retrospect, and that is that when we had the calm weather, we didn't have the booms and skimmers to remove the oil and the chemical dispersants really don't work very well when you have calm water.

MS. WOODRUFF: Let's go back in time to the point when this contingency plan that would have provided cleanup equipment being there was approved. This was what, about 10 years ago. This was something that the oil companies came together to the citizens of Alaska and others and said this is what we want to do. Now the State of Alaska at that time played a role in approving this plan, did it not?

GOV. COWPER: Oh, we sure did, yeah.

MS. WOODRUFF: In retrospect, was that a mistake, Governor?

GOV. COWPER: I think that there were two problems here. First off, as Chairman Rawl said, it's very very difficult to predict a spill of this magnitude. It's difficult to predict that a drunken captain is going to run a super tanker out of the shipping lanes and onto a reef that's on every marine chart in town.

MS. WOODRUFF: Are you convinced that's what happened?

GOV. COWPER: Yes. And, No. 2, it was very difficult for us to check and see if Aliaska was actually doing what they said they were going to do. We were actually in a process of trying to check up on what materials and equipment that they had just before this disaster took place. And we were being stonewalled.

MS. WOODRUFF: That's what I wanted to ask you. Didn't the state have a responsibility to make sure that those, protect that those procedures were in place in the event of a major spill?

GOV. COWPER: Well, sure we do, but people have to show us the equipment and we weren't getting that kind of cooperation. That was going on just before, immediately before this took place.

MS. WOODRUFF: Who wasn't cooperating with the state?

GOV. COWPER: Well, according to our Department of Environmental Conservation, the Aliaska Pipeline Corporation was not cooperating in showing us the kind of equipment that they should have had under this plan. The other part of this is that the barge that was necessary for the pick up had been damaged by a windstorm in January. It had been weeks and weeks in a condition in which it could not be used, and so that was a problem as well.

MS. WOODRUFF: At this point, do you feel, are you comfortable with the reaction of the state government in handling this once it took place?

GOV. COWPER: Well, sure, I think that the state government, that Department of Environmental Conservation has done a monumental job here and that they bear absolutely no part of the blame for this. And in fairness, that was not what Chairman Rawl was saying. He was preferring to a specific incident. He got one version and I got the other.

MS. WOODRUFF: You've pinned a fair amount of the blame -- you said some goes on the shoulders of Exxon, but I understood you to say more goes on the shoulders of the pipeline consortium, Aliaska.

GOV. COWPER: I don't want to sort out the relative percentage of blame here. We've got too much work to do together. Obviously, Exxon's skipper caused this accident, but after it took place, I think that Exxon did a good job under the circumstances, I really do.

MS. WOODRUFF: And to resolve it, you look to all of you to work together.

GOV. COWPER: That's more important than anything else. The No. 1 thing that we have to do here is get this oil cleaned up and then we can fight over who's supposed to pay and who was at fault, and I'm sure that'll go on in the courts for many many years.

MS. WOODRUFF: Gov. Cowper, thank you for being with us again.

GOV. COWPER: Thank you.

MS. WOODRUFF: Robin.

MR. MacNeil: Still ahead on the Newshour, the role for doctors in taking the life of the very sick and Pulitzer Prize winner Clarence Page with an essay on censorship. FOCUS - DECISION TO DIE

MS. WOODRUFF: Next, doctors and the dying. "It is not immoral for a physician to assist in the rational suicide of a terminally ill patient." That's the controversial statement made in a special article in today's New England Journal of Medicine. In a moment we will talk to two doctors who helped write the article, but first Kwame Holman has a report on the ongoing debate about the rights of hopelessly ill patients and the responsibilities of their doctors.

KWAME HOLMAN: Cliff Culham was dying of amyotrophic lateral sclerosis, Lou Gehrig's Disease, when this videotape was made in 1985. His condition worsened and in 1986 he asked his wife, Joan, to turn off the respirator that kept him alive.

JOAN CULHAM: Never a day in my life after December the 30th of '86, did my husband not look at me and say, if you love me, turn off the respirator and go shopping, go anywhere, if you have to go to the bar, go to the bar, but turn off the goddamned machine.

MR. HOLMAN: Culham's disease was terminal, and his wife and doctors supported his decision to be allowed to die in a Detroit hospital.

JOAN CULHAM: He was told by his medical team that when he wanted off the respirator, this could be done without any problem at all.

MR. HOLMAN: But officials at Henry Ford Hospital in Detroit overruled Culham's doctors and refused his request to die. They said Michigan, like 10 other states, has no law empowering families or doctors to make such decisions. Hospital officials feared they and their doctors might face legal liability. Culham's doctor, Mark Glasberg.

DR. MARK GLASBERG, Cliff Culham's Physician: One of the issues was for my protection, because, for example, let's say the physician who removes someone from the ventilator could well be liable to manslaughter or even homicide charges. The other other was in regards to the fact that there has not been a legal precedent or a law in the State of Michigan. Actually, 39 states do have some sort of law in regards to that, but not Michigan.

MR. HOLMAN: Cliff Culham and his wife were told they would have to fight in court for his right to die. Since Culham was too disabled to be moved, a Michigan judge held this rare bed side hearing to prove to himself that death was what Culham really wanted. [HEARING IN HOSPITAL ROOM]

MR. HOLMAN: The judge was convinced and on December 16, 1987, Culham's respirator was withdrawn. He died 40 minutes later.

JOAN CULHAM: We shouldn't have to go to court and beg for things like this. God, we're better to our animals. We would take our dog to the vet to end its life if they were suffering like that, yet, we hook people up to these things and say have a good day.

MR. HOLMAN: Like the Culhams, Jackie Rosebush and her former husband, Fran, had to go before a Michigan judge to fight for the right to end their 12 year old daughter's life support.

JACKIE ROSEBUSH: She was crossing the road and she got hit by a car off an expressway that has a speed limit of 55 miles an hour and she was hit and thrown about 100 feet. She lost oxygen to the brain and she had died. They revived her, I don't know how many times they revived her but she finally went on a vent.

FRAN ROSEBUSH: The machine was Joelle. Joelle has no breath. If you remove Joelle off the machine, Joelle will not breathe, and to me, that is the Lord took Joelle and man's keeping her alive.

RICHARD THOMPSON: They are making the decision that her quality of life is not good, and, therefore, we're going to kill her. Under Michigan law, as a it presently exists, that would be murder.

MR. HOLMAN: Michigan Prosecutor Richard Thompson sought the court order that prevented the Rosebushes from having their daughter's respirator removed. He wanted a judge to review the decision first.

RICHARD THOMPSON, Michigan Prosecutor: We have the attending nurses who sit by Joelle hour after hour, day by day and who have been able to observe her, and they do say, and there are reports in the files that indicate that she has improved and that she has attempted to speak, they think that she has mouthed words.

ANDREW BRODER: Joelle is in a condition that the physicians refer to as a persistent vegetative state.

MR. HOLMAN: Andrew Broder is the Rosebushes' attorney.

ANDREW BRODER, Attorney: She cannot experience any conscious thought, we are told by the physicians. She has no emotions; she has no sensitivity to deep pain. She cannot speak.

MR. HOLMAN: Last summer the judge ruled the Rosebushes did have the right to have their daughter's respirator removed. On August 13th, it was. Joelle Rosebush died a few minutes later. But the prosecutor in Michigan appealed the court's decision in the Rosebush case. He said a review of the case by the court would help to establish guidelines for the right to die in Michigan.

DR. GRANT STEFFEN, Swedish Medical Center, Denver: It is agreed among most ethicists and surely in many courts in this country that if a competent patient wishes to have all therapy withdrawn, that request should be granted.

MR. HOLMAN: In other states like Colorado, medical decisions of life and death are not decided in courtrooms but by doctors, lawyers and others who sit on bioethics committees like this one in Denver. Colorado and 38 other states have laws that establish a patient's right to have life sustaining measures stopped and protect doctors from legal liability when they do end life support. A year ago this committee agreed that Walker Van Antwerp dying of Lou Gehrig's Disease should be allowed to have his respirator remove. Van Antwerp's wife, Barbara.

BARBARA VAN ANTWERP: When I described to him the process the doctors would give him, a sleeping medication or morphine, so that he wouldn't feel any pain or, you know, he would be more relaxed, it's like the expression on his face was just about, he was very relaxed with it. It was a like a load, the agonizing that he had done for all these months had been lifted off his shoulders.

MR. HOLMAN: In recent years, leading medical organizations, including the American Medical Association, have affirmed that it is ethical and responsible for doctors to end life support of patients who request it, but even with favorable professional opinion and the majority of state laws on their side, doctors remain fearful of legal liability for granting a patient's wish to be allowed to die. Peter Peterson is a physician at Swedish Hospital in Denver. He takes part in decisions of the hospital's bioethics committee.

DR. PETER PETERSON, Swedish Medical Center, Denver: Frequently, we'll try to make sure that all of the family members attend our session so that all the questions can be answered. We want to protect ourselves from a dissatisfied brother from out of state that may come at us later with a lawsuit, so we want to include all these people in making the decision to stop.

MR. HOLMAN: According to some critics, doctors' inability to meet the needs of the dying can be blamed in part on medical education. Here at George Washington University in Washington, D.C., as at most medical schools, students spend lots of time in science classes like this one. But they spend little time in classes like this seminar on ethics. This class is not required for graduation. Only half of U.S. medical schools even offer courses on the ethical issues of dying. A medical students association says when the courses are available, only 4 percent of medical students volunteer to take them.

TOM BRESLEY, Medical Student: Oftentimes we'll rescucitate someone who is suffering terribly from a disease that's obviously going to take their life soon, but we get wrapped up in our technology and evolve our technology all of the time to bring back a life only for a few more hours of suffering and I would see that happen in a clinical setting and yet the only reason that it really didn't get addressed is because people are uncomfortable talking about death.

DR. JOANNE LYNN, George Washington University Hospital: Doctors have very little training in how to manage symptoms, in how to talk about dying, in how to even do things like make up the chart so that it reflects an intelligent plan of care.

MR. HOLMAN: Dr. Joanne Lynn teaches the ethics course at George Washington University and practices geriatric medicine. She says not only are doctors poorly trained in how to help patients move toward death, but the health care system often doesn't pay for the kind of services dying patients need.

DR. JOANNE LYNN: Services like effective pain relief or services to keep the skin intact, or to keep the person mobile or interactive with others, that sort of thing, and those in general are not insured and can be very hard to arrange. So it's really easy to ignore whole groups of supportive services because Medicare and Blue Cross and Medicaid and so forth simply do not pay for them, so there's almost a conspiracy of neglect of this group of needs, so the usual person faces a doctor who doesn't really know how to make things work and is in a system that makes it really hard to make the services available for the dying patient.

MR. HOLMAN: Some doctors say medicine should go further than providing better services to patients who are near death and allowing patients to refuse life sustaining treatment. Dr. Peter Peterson says it should be legal for doctors to take the lives of mentally competent patients who request death.

DR. PETER PETERSON: There's a difference between withdrawing treatment because the patient has made their wishes known about it and actually giving a lethal injection even if the patient requests it. That's not included in the law as of this time. In my personal opinion, I think it should be included in the law.

DR. JACK WILKE: The doctor who said that is an absolute disaster. I'm horrified. You don't start killing patients. You let them die, but you don't kill them.

MR. HOLMAN: Physician Jack Wilke is president of International Right to Life.

DR. JACK WILKE, International Right to Life: When you step across that line and say no longer will I only heal, but now I will kill, you have hung a price tag of certain utilitarian usefulness or whatever it is on that patient, and any merchandiser knows that price tags get marked down. We're on what we call the slippery slope. All you do is start and the next one is easier, easier, and easier.

MR. HOLMAN: For now, legal euthanasia or active killing seems a long way off, but all sides admit that even without laws that permit it, quietly across the country, doctors helped patients commit suicide and even take the lives of patients who request it.

MS. WOODRUFF: The article we mentioned earlier in the New England Journal of Medicine contains the strongest public endorsement of doctor-assisted suicide ever published in a major medical journal. It was authored by twelve doctors, two of whom took exception to the suicide concept. Joining us from Houston is one of those two, Dr. Jan Van Eys, Chairman of Pediatrics at the University of Texas School of Medicine in Houston. Also with us is Dr. Ronald Cranford, a neurologist who was in the majority. He is affiliated with the Hennepin County Medical Center in Minneapolis and the University of Minnesota. Dr. Cranford joins us from public station KTCA in Minneapolis-St. Paul. Dr. Cranford, under what circumstances is it all right for a doctor to help a patient die?

DR. RONALD CRANFORD, Neurologist: Well, I think we made it very clear in our article that it would only be an extreme situation where it would be wrong to assist a patient in a rational suicide, so it would be a situation like an AIDS patient where there were no other alternatives for treatment, where their pain is not responding to conventional treatment, so it would be an extreme situation where it would be permissible to actively assist the patient in suicide, as opposed to the vast majority of situations where we do allow patients to die.

MS. WOODRUFF: Dr. Van Eys, do you have a problem with that?

DR. JAN VAN EYS, Pediatrician: Well, first of all, I need to say that the article says much more than addressing suicide and I agree with the article as it is written. I personally cannot bring myself to assist in suicide for a rational person. I find the distinction between rational suicide and active euthanasia very problematical and not very distinct, in fact, in oral versus an intravenous euthanasia. My personal moral system would not allow me to do that.

MS. WOODRUFF: Dr. Cranford, what do you see as the distinction between euthanasia and helping a patient die who has requested this?

DR. CRANFORD: I think if we're saying helping a patient to die, we mean allowing them to die by stopping treatment, and all of us, including Jan, were very supportive of doing that. The critical issue was did we break new ground by saying that it was moral or not immoral for a physician to assist in an assisted suicide and is a physician assisted suicide more akin to active euthanasia, or is it more akin to allowing to die, and I personally think that physician assisted suicide is more akin to active euthanasia than it is to allowing to die, so we broke new ground, and at the time we did it, we were very aware that this was very controversial. What we're doing, I think all of us at a lot of extreme reservations about saying it, but we felt there were a lot of physicians out there that were doing it, that we felt we should be open about it. This was an opportunity for a group of physicians nationwide to make a statement about physician assisted suicide, which we believe we should make.

MS. WOODRUFF: Why isn't helping this patient to die, even if you know there's no other remedy for what illness the patient have, why isn't that the same as going one step further and killing the patient?

DR. CRANFORD: I don't think it is. I think that's one of the reasons, another reason why we did this, to spark a debate. We've said that physician assisted suicide may be done in some situations. We say it's dramatically different in allowing the patient to die in terms of stopping treatment, or the cause of death is their underlying disease; every day thousands and thousands physicians allow patients to die, but physician assisted suicide, as we said in the article, while it's not rare, is extremely uncommon. So I think there's a major difference between the two and I think Jan and myself agreed with 95 percent of what we said in terms of allowing to die, but it was only on the physician assisted suicide that we differed.

MS. WOODRUFF: Well, that is what we're trying to get at here and that is, you know, this disagreement over whether it's not immoral for a doctor to permit that. Dr. Van Eys, why do you have a hard time making the distinction that you mentioned a moment ago?

DR. VAN EYS: The distinction that I was having difficulty with is between assisted suicide and euthanasia, not in assisted suicide and allowing to die. I fully agree with Ron on that subject. I have to start somewhere in the decision making I do as a physician, and I think each physician is a moral agent who has to reason for him or herself what is it that makes you a physician and knowingly saying to somebody, okay, go ahead and commit suicide is outside that boundary for me.

MS. WOODRUFF: Dr. Cranford.

DR. CRANFORD: And I appreciate that and I think that there is no doubt there is no consensus on the propriety of a physician assisted suicide. Another reason why we took that position, knowing that it was very controversial and knowing that another group hadn't done that is we feel that there is a lot of hypocrisy going on out there because every day there are thousands and thousands of people dying with needless suffering and we were very clear in that article that we felt the public's perception that people were dying, that there was a lot of needless suffering, the public's perception of this was a justified concern, and so it was a very strong criticism of doctors not allowing people to die by treating their pain and suffering, and while some would say, including myself, that it may be beyond what a doctor would do when he kills a patient or assists in suicide, at the same time what we're doing today is a tragedy too in terms of allowing patients to die with needless suffering.

MS. WOODRUFF: But what about the point that Dr. Van Eys just made?

DR. CRANFORD: I think it's a very good point and we're all torn in where we should stand, but I think when you talk about physician assisted suicide and you talk about acts of euthanasia, you're talking about something that's outside normally the realm of what physicians do. But as I said before, physicians are causing a lot of needless suffering right now which is outside the realm of what physicians should be doing. I also think there was a concern about abuse of both physician assisted suicide and active euthanasia, but, nevertheless, we felt that this was an opportunity to spark a debate, to say a statement that was very controversial and to stand by it so that people would try to draw these things between allowing to die, physician assisted suicide, and act of euthanasia, and I'm glad that we have this debate.

MS. WOODRUFF: Finally, Dr. Van Eys, do you agree that this is something that will spark debate and do you welcome that?

DR. VAN EYS: It already has. Yes, I welcome it. I think that we sometimes slide over difficult problems and ignore them and thereby making the situation worse. Any time we honestly examine where we stand we're better off.

MS. WOODRUFF: Well, gentlemen, we thank you both very much. We know this is an issue we will be coming back to. Dr. Cranford, Dr. Van Eys, thank you both. ESSAY - EXPRESS YOURSELF

MR. MacNeil: Finally tonight, some thoughts about expressing opinions from a man who today won a Pulitzer Prize for the way he expresses his. Clarence Page was honored for the columns he writes about local and national issue for the Chicago Tribune. He does a similar job for the Newshour.

CLARENCE PAGE: What price are you, a citizen of the world, willing to pay for expressing your opinion? What price are you, the artist, willing to pay for your art? In some parts of the world, you can pay for your art with your life. Islamic fundamentalists took to the streets to protest Salman Rushdie's book, "The Satanic Verses". The Ayatollah Khomeini put a price on the author's head. In America, Christian fundamentalists and others railed against Madonna's video "Like a Prayer", and called for a boycott against her and the products she endorses. Some might think it's a long way from the art of Salman Rushdie to that of Madonna, but both share a common plea, artistic freedom, the freedom to say what you think. That plea is heard no less across this land than throughout the world, because at the same time we seek or demand the right to speak, inside each of us, a censor screams to get out. That censor's voice is heard right here at the Art Institute of Chicago, where a student artist has attacked our treasured national symbol, the flag. He put the flag on the floor as part of an exhibit and invited viewers to step on it. War veterans took to the streets to stage large demonstrations, to argue, and in some cases to fight. And the student artist who calls himself a revolutionary received death threats. It's a long way from the Ayatollah to the Art Institute, but not for the voices that cry for limits on artistic freedom. There are other flags that stir American souls, the battle flag of the Confederacy, for example, to some as a lasting symbol of past glory, to others, particularly black Americans, it is a symbol of historical racism, and there are protests against its display on public buildings. What do you do when the rights of one person to free expression rub up against the rights of others not to be offended? Should there be limits? Yes, no, not sure? The framers of the Constitution apparently weren't sure either. After much argument and debate, they wrote that Congress shall make no law respecting an establishment of religion or abridging the freedom of speech or of the press. It is the first amendment, the first of the Bill of Rights. But if the intent seems clear to some, it, along with the language, is ambiguous to others. Can the states make laws that Congress can't? What about this word "abridge" and in what context should we think of the word "freedom"? The founders seemed to understand one thing clearly, inside each of us there is a censor waiting to get out. It's easy to be tolerant of expression that blasphemes or is disrespectful of someone else's icon. It's less easy when the icon is one of your own, so the founders in their ambiguity established not just a right, but a dialogue, a series of questions and answers, discussions and debates that continue to this day and show no sign of letting up. In America, the best remedy for offensive speech is not death but more speech. Madonna's critics had the right to speak out against her, even boycott the products she advertises if they wish. Critics of the flag exhibit have the right to demonstrate and speak out against that too, as long as they do it peacefully. But all have a right to express themselves. In this we find the foundation of democracy, the freedom to make up your own mind about who is right. Freedom of expression is not a sign of weakness for our nation. It's a sign of our strength, especially when we extend it so freely -- to Madonna, to art students, to Christian fundamentalists, to abortion activists, on both sides, to gun advocates, to television producers, to me, and to you. RECAP

MS. WOODRUFF: Once again, the main story of this Thursday was the Alaska oil spill. Federal officials confirmed that the captain of the Exxon Valdez was legally drunk when his ship ran aground, and on the Newshour, the Chairman of Exxon said that the company made a gross error of judgment in allowing a captain with a history of alcohol abuse to command the ship. Good night, Robin.

MR. MacNeil: Good night, Judy. That's the Newshour tonight, and we'll be back tomorrow night. I'm Robert MacNeil. Good night.