PAIN RELIEF ACT MISNAMED

It Would Be The Utmost Of Cynicism To Turn Patients Into Political Pawns By
Wrapping Their Medical Care Into The Debate On Physician-Assisted Suicide.

The U.S. Senate is expected to vote soon on a misleadingly named bill, the
Pain Relief Promotion Act, that would actually cause great harm to people
who suffer from serious pain.

Proponents of the bill want to make it a federal crime for a doctor to
prescribe morphine or similar medicines for physician-assisted suicide. But
this bill is so flawed that it would end up deterring doctors from
legitimately using powerful drugs to treat patients in severe pain. Cancer
patients and older Americans with advanced medical conditions or near the
end of life would be hurt the most.

The American Pain Foundation--along with nearly 50 major organizations of
physicians, nurses, pharmacists, patients and hospices--strongly opposes
this bill. According to the New England Journal of Medicine, "If the bill
becomes law, it will almost certainly discourage doctors from prescribing or
administering adequate doses of drugs to relieve the symptoms of dying
patients."

In the words of the American Cancer Society, "This Act would heighten
physicians' fear of investigation concerning the prescription of controlled
substances for pain and symptom management likely leading to greater
undertreatment of pain."

Pain is already vastly undertreated in America. A nationwide survey found
that 50 percent of those who died in hospitals from chronic illness
experienced moderate to severe pain in the last three days before death.
Other studies show that more than 40 percent of cancer patients and 80
percent of AIDS patients with chronic pain receive a lower level of
painkillers than called for by national guidelines.

This controversial bill authorizes the U.S. Drug Enforcement Administration
to second-guess the medical judgment of any health-care professional who
provides or administers a powerful pain drug like morphine if the patient
dies shortly thereafter. DEA agents, the federal crime-busters whose job is
to fight illegal trafficking in narcotics, would now become medical
overseers.

The proposed legislation would give the DEA explicit authority to
investigate the "intent" of any health-care professional prescribing strong
pain medications and decide whether he or she intended to relieve pain or
hasten death. Doctors could face criminal penalties including a minimum
20-year jail sentence if DEA agents misconstrue the doctor's intent.

With the threat of DEA investigation and possible conviction, physicians,
nurses and other health-care providers will be far more hesitant than they
already are to treat patients in pain with medically appropriate, aggressive
measures. The result: needless suffering.

Current regulation of pain medications is so restrictive that it already
chills their proper use. A recent study of 1,300 doctors in New York found
that 59 percent of them sometimes prescribe lower doses of morphine and
similar drugs than medically appropriate because of concern about possible
investigation by a regulatory agency. Even for cancer patients, one in three
said they sometimes underprescribe out of regulatory fear. Many also
prescribe less powerful, less effective pain drugs at times because of the
chilling effect of state and federal regulators. The Senate bill would only
make the situation worse.

What we really need from Congress is legislation that promotes comprehensive
education and training for health-care professionals in pain medicine,
raises public awareness and understanding of pain management and expands
research on pain. Meanwhile, it would be the utmost of cynicism to turn
patients with pain into political pawns by wrapping their medical care into
the debate on physician-assisted suicide.

Congress should not turn the War on Drugs into a War on Patients. The
doctors, nurses, pharmacists, hospice workers, patients and others who
desperately want to provide better pain relief urge Congress to vote "no" on
the misguided Pain Relief Promotion Act and begin work on legislation that
is truly worthy of the name.