AMA DISCUSSES MARIJUANA MEDICAL USE

CHICAGO (AP) - 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 Sunday, the AMA
also is being asked to endorse a moratorium on executions nationwide,
although it rejected a similar proposal last year. The measures are
among more than 250 reports, resolutions and proposals 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 group 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 sometimes AMA member and co-president 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 middle ground, Hara said.

The marijuana question is an example. The Supreme Court's May 14
ruling that it's 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 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altered or withdrawn before being sent to the House of Delegates for a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 year 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
depends 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.

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 pre-med students
are among 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.

The health of the AMA-sponsored union, Physicians for Responsible
Negotiation, also will be discussed in light of a recent Supreme Court
decision preventing private-hospital doctors from organizing if they
have supervisory duties.