LET DOCTORS DECIDE

Proper drug dosages for dying patients is no business of federal narcotics
agents

The doctor will see you now. He's fighting the drug war, you see, and, well,
you're the target.

If enough votes go the wrong way in the U.S. Senate, that scenario will be a
fair but obviously chilling description of the plight facing the 50 million
Americans who suffer chronic pain from injury or terminal illness. Often
their agony is so chronic that routine medication can't treat it. Instead
they must rely on prescribed narcotics.

Such a regimen must be closely monitored, obviously. But by whom?

Under the Pain Relief Promotion Act, sponsored by Sen. Don Nickles, R-Okla.,
and Sen. Joseph Lieberman, D-Conn., the Democratic vice presidential
nominee, it would be up to the Drug Enforcement Administration to assess
whether a doctor was prescribing too many narcotics for a patient.

Upon what evidence, one wonders? Since when are DEA agents medical
professionals? Their job is to combat drug smuggling and drug crime. It
should not be to interfere with the medical judgments in prescribing use of
legally prescribed drugs. There are other, more appropriate ways to assess
those judgments and set standards for practices.

The argument behind this legislation may be sincere, but it's flimsy
nonetheless. Proponents fear that doctors might use excessive doses of
narcotics to help terminally ill patients take their own lives. With such
drugs as morphine and methadone, that's easy enough to do.

But how much hard evidence is there that doctors are acting so
irresponsibly? The American Cancer Society, for instance, finds doctors
already are quite hesitant to prescribe narcotics. If anything, it says, the
fear of criminal penalties applied by the DEA could have doctors even more
reluctant to dispense the proper medication to their patients. The result
would be the inadequate treatment of the worst physical pain imaginable. But
someone else's death may well appear preferable to a doctor's own loss of a
license.

Other arguments for this bill can be similarly deflected. The American
Medical Association makes the point that such a law would provide a
guideline for doctors for just what constitutes the proper use of controlled
substances in treating pain. It could do that, in fact. But couldn't that
goal be obtained without the unwarranted role of the DEA in medical care?

Always, the issue comes back not to scrutiny of the medical profession, but
to the DEA. And always the agency would seem to be better concerned with the
menace of a cocoa farmer in a foreign jungle than with the plight of an
unenviably sick person in his or her last days.