AMA TO WEIGH MEDICAL USE OF MARIJUANA

The historically cautious group is being asked to change policy to assist
seriously ill patients.

CHICAGO - One month after the U.S. Supreme Court ruled against the medical
use of marijuana, the American Medical Association is being urged to
endorse the illegal drug as last-resort pain relief for seriously ill patients.

At its policy-setting annual meeting starting here yesterday, the AMA also
is being asked to support a moratorium on executions nationwide, although
it rejected a similar proposal last year. The measures are among more than
250 reports, resolutions, and proposals that conference delegates are
asking the nation's largest group of doctors to approve.

Whether the historically cautious group will take a more activist role at
its five-day meeting remains to be seen as the AMA struggles for
effectiveness amid a worrisome slide in membership. The challenge is to
appeal to physicians with divergent political views while at the same time
tackling issues relevant to patients.

"They don't want to take positions that they're concerned the public would
consider not necessarily appropriate for physicians to take," said Dr.
Jimmy Hara, a sometime AMA member and copresident of the Los Angeles
chapter of the activist group Physicians for Social Responsibility.

Desperately seeking to attract new members, the AMA is more likely than
ever to stick to the middle ground, Hara said.

The marijuana question is an example. The Supreme Court's May 14 ruling
that it is illegal to sell or possess marijuana for medical use appears to
be having little effect in the eight states with medical- marijuana laws,
and some have even moved to expand marijuana laws despite the ruling.

The AMA's current policy opposes the use of medical marijuana but says
there should be more research on the issue. But a report by an AMA council
says the group should support the "compassionate use" of marijuana while
also urging further research.

Like all proposals at the meeting, the marijuana report could be altered or
withdrawn before being sent to the House of Delegates for a vote on whether
to make it policy during the meeting's final three days.

The AMA enters this year's meeting leaner, in better fiscal health, and -
its leaders maintain - better equipped to tackle ongoing challenges such as
membership and managed-care reform.

In its 2000 financial report, the AMA reported earning $2.7 million on
operations, compared with a $15 million loss in 1999. The turnaround was
achieved by reducing or eliminating programs and cutting staff by 14
percent, or 188 jobs.

But the AMA lost more than 3,000 members and $4.2 million in revenue from
membership dues last year, continuing a slide that began several years ago.
That puts membership at 290,357, or only about one-third of the nation's
800,000-plus doctors, residents and medical students.

Ten years ago, the AMA had nearly 300,000 members, or about 40 percent of
the nation's doctors.

"Membership is the most crucial area for the AMA," the financial report
said, acknowledging that the group's effectiveness and success depended on
rebuilding its ranks.

The AMA formed an advisory committee after last year's annual meeting to
address the problem, and gained insight into possible remedies from a
doctors' survey the committee conducted at the AMA's winter meeting in
Orlando, Fla.

Comments included complaints about high dues - ranging from $420 annually
for regular members to $20 for medical students. But one respondent told
the group the "biggest issue in AMA membership deterioration is public
perception that AMA has become a trade union interested primarily in MD
income. Many physicians would return to membership if widespread
perceptions become that AMA is really 'physicians dedicated to the health
of America.' "

Alternative dues packages for residents and fellows and outreach programs
targeting young doctors, residents, and even premed students are among the
solutions the AMA has implemented or is considering, the committee said in
a report to be presented at the meeting.

Other proposals at the meeting include:

Urging the AMA to officially recommend a low-salt diet to all Americans,
even those without high blood pressure, "as an effective means of
preventing the development of hypertension."

Calling for a ban on prescription-drug ads to the public to decrease drug
costs and improve doctor-patient relationships.

Calling for the AMA to lobby for mandatory alcoholism screening for all
drunken-driving offenders.