friday, november 5, 1999
drug-war folly not laughable
latest legislative assult on doctors increases pain for everyone
ellen goodman
boston globe
And you thought the war on drugs was about keeping cocaine out of the country and heroin out of the kids. Guess again.
If the bill that flew out of the House last week becomes law, those intrepid folks at the Drug Enforcement Administration will be given encouragement to go after doctors as if they were dealers.
The bill was titled, in the best Orwellian fashion, the Pain Relief Promotion Act. In fact, it was a buffed and shined up version of last year's loser, the Lethal Drug Abuse Prevention Act.
Both bills to prevent the use of federally controlled substances by doctors assisting suicides were deliberately aimed at overthrowing the law Approved by the voters in Oregon. But this year, the sponsors added a few bucks for pain management and changed the name. They convinced their colleagues that this was an easy way to oppose doctor-assisted suicide while proving you were sympathetic to dying patients, a k a "I feel your pain.
According to the sales and spin, the bill that passed wouldn't affect doctors who prescribed substances like morphine for pain relief, even if the drug unintentionally caused death. But it would punish the doctors who prescribed these substances intentionally to cause death.
As Illinois' Henry Hyde declaimed, "We believe doctors should help people cope with the pain and terror of death, not thrust death upon them." A fellow sponsor, Charles Canady of Florida, added, "We draw a bright line here."
A bright line? The line between a dose that controls pain for the terminally ill and a dose that ends up hastening death is one of the murkiest in medicine. The bill doesn't say how doc tors would line or bow
If the companion law in the Senate passes, and the whole mess survives a states' rights test, doctors could be sentenced to 20 years in prison. Anybody could drop a dime and the DEA could be left to decide the doctors motives.
Joanne Lynn, the head of Americans for Better Care of the Dying, opposes both assisted suicide and this law. But she can imagine signs posted around hospitals saying: 1-555-CALLDEA. To put it bluntly, she says, "Ordinary record-keeping and conversations would be insufficient to protect us from prosecution."
The House bill was described by the media and the sponsors as a litmus test on assisted suicide. It gave Hyde et al. a chance to thumb their noses at Oregon voters, not to mention the voters in California and Maine, where doctor-assisted suicide is going on the ballot.
But ironically, the law wouldn't actually ban all assisted suicide; it would just prohibit the. use of certain barbiturates. Remember Jack Kevorkian? He used carbon monoxide in his "practice." There are plenty of uncontrolled substances that can end life.
The bill for "pain relief" could, however, increase pain. Says Oregon Sen. Ron Wyden, another opponent of both assisted suicide and this bill, "The undertreatment of pain is a documented crisis. If the DEA can second-guess doctors who are already reluctant, we'll see pain relief programs set back."
Two months ago, for the first time, a pulmonary specialist was disciplined for under medicating patients. We knowthat in the last week of life, a third of all people suffer moderate to severe
This is a cause for underlies many requests or a merciful death.
In the past several years, with all the discussion about the end of life, Oregon has actually pulled ahead of the country in both hospice care and pain management. Only one in 10,000 Oregon deaths has been assisted suicide. Indeed, it's possible that the rate is lower in Oregon than in states where it's still clandestine.
If our friends in Congress actuarly were interested in pain relief rather than political grandstanding, there are two other bills - the Compassionate Care Act and the Conquering Pain Act that would build family support networks, fund centers for pain management research and require report, cards on treatment for pain. Neither is given a chance, of passage.
In the past years, the war on drugs has done enormous collateral damage to sick civilians.
Whatever happened to that old slogan the drug war? "Just Say No."
the webmaster notes: there is another area this nice lady didnt address. currently the goons at the DEA go after doctors who give large amounts of drugs to people with painfull terminally illnesses. the DEA's mentality is if a doctor makes a terminally ill person in pain feel good by giving out drugs the doctor is a dope dealer who should be jailed.