RESPECT PATIENT CONFIDENTIALITY

Oregon officials acted appropriately in tightening up rules on medical
marijuana, but the change goes too far.

Nobody, not even the most ardent campaigner for Oregon's medical
marijuana law, wants to open the way for a doctor mill churning out
pot-user cards by the hundreds.

That's why state officials have come up with a new rule physicians
must follow when authorizing patients' requests for medical marijuana.
One part of the rule makes perfectly good sense, but another part
makes you wonder what the state rule-makers are smoking.

Call it the Leveque Rule, for lack of a name. The change is entirely
the result of the recent discovery that one doctor, 77 year old
Molalla osteopath Phillip Leveque, had signed 40% of the approved
applications under the Oregon Medical Marijuana Act that voters passed
in 1988. An audit showed he had signed 890 of the approved
application, and now the board of medical examiners is investigating
an allegation that he signed one woman's request, "without first
examining her, diagnosing her condition, charting (her) care, or
conferring with any of her other providers," according to documents
obtained by The Oregonian.

The Leveque Rule's sensible part requires that a doctor who signs a
patients request for medical pot must actually do some doctoring. In
other words, there must be an "attending physician" relationship,
which means the doctor "has reviewed a patient's medical records at
the patient's request, has conducted a thorough physical
examination... and documented theses activities in a patient file."

Who could argue with that? Though worried that the change will create
hardships for some patients, some of the original sponsors of the
marijuana law say they have no fundamental objections to the new
requirements.

However, they feel quite the opposite, and rightly so, about a second
part of the Leveque Rule. It allows officials of the Oregon Department
of Human Services, which manages the medical marijuana program, to
examine a patients file if they question an applications validity.
Authors of the program say that's a blatant violation of medical
privacy, and we agree.

So does the Oregon Medical Association, the state's largest doctor
group.

"We certainly don't disagree with the intent of these changes, " says
Bob Dernedde, executive director of the medical association. "But our
position on the confidentiality of medical records is that it's not
acceptable for third parties to wander in and start plowing through
them. That's not only a violation of ethics, but its a violation of
law."

One solution that the doctors' group might support involves tweaking
the application process. The way Oregon's new law is structured,
physicians don't write prescriptions for the medical marijuana;
rather, they sign applications, permitting qualified patients to grow
and use marijuana for medical purposes. The applications could be
amended to require patients to OK, in advance, possible scrutiny of
their medical files.

Making the ill give up their privacy privileges is not a remedy we
would rush to embrace. Fortunately, though, the Leveque Rule is only
temporary pending a public hearing this fall. that will afford plenty
of opportunity for cautious debate of the confidentiality issue, which
seems loaded with potential trouble for the state officials who run
the new marijuana program.

Until then, the should resist rummaging through confidential records
of the patients of Dr. Phillip Leveque or any of the other 547 doctors
who have signed applications for medical marijuana in Oregon.