MARIJUANA BILL MISUNDERSTOOD

The Hawaii Medical Association's continuing opposition to the medicinal use
of marijuana (Letters, May 1) rests in large part on its failure to read and
understand the language of the recently approved legislation.

While it's true that the federal Drug Enforcement Administration controls a
physician's ability to write prescriptions, that process is not affected by
Hawaii's bill. Rather SB 862 calls for only a "written certification" from
the physician that in his or her professional opinion "the qualifying
patient has a debilitating medical condition, and the potential benefits of
the medical use of marijuana would likely outweigh the health risks for the
qualifying patient."

While the legislation would protect patients and physicians who wish to
discuss the issue, of course no physician would be obligated to recommend or
even discuss marijuana with a patient.

The bill's language is similar to that used in most of the six states where
voter initiatives have approved permitting the medical use of marijuana.

Realizing it would be politically untenable to go after seriously ill
patients, the feds are trying to frighten physicians instead. The government
has not filed any suits against physicians, however, because they know that
states have the legal right to enact drug laws that are different from
federal ones.

In 1996, California (along with Arizona) became the first state to pass a
voter initiative allowing medical use of marijuana. The federal government
response was to threaten physicians who discuss the option of medical
marijuana with their patients, thus chilling the doctor-patient
relationship. In response to this threat, a group of California physicians,
patients and nonprofit organizations sued Barry McCaffrey, director of the
Office of National Drug Control Policy, in Conant v. McCaffrey.

On April 30, 1997, federal Judge Fern Smith (a Bush appointee) ruled against
the government, writing in her strongly worded decision that "The plaintiffs
have raised serious questions as to whether the government's medical
marijuana policy is impermissibly vague. Further, because the policy may
infringe on plaintiffs' First Amendment rights and is affecting physicians'
treatment of patients suffering from life-threatening diseases, the balance
of hardships tips in plaintiffs' favor. For these reasons," the ruling
continues, "the court issues a preliminary injunction limiting the
government's ability to prosecute physicians, revoke their prescription
licenses, or bar their participation in Medicare and Medicaid because they
recommend medical use of marijuana."

Experts believe this ruling is likely to stand.

As the Hawaii Medical Association maintains its ardent opposition to
medicinal use of marijuana in Hawaii, it is important to know that around
the nation, scores of health organizations have supported the use of medical
marijuana, including the American Academy of Family Physicians, the AIDS
Action Council, the National Nurses Society on Addictions, the American
Public Health Association, The New England Journal of Medicine, numerous
state nurses' associations, including the Hawaii Nurses' Association, and
the Florida and California medical associations.

In fact, in January, the California Medical Association in a legal brief
wrote: "A patient and his or her physician must sometimes embark together on
a difficult and frustrating process of exploration and discovery. The
patient and physician must explore all therapeutic options, and the
physician must be able to offer the patient his or her opinion and advice on
any and all potential courses of treatment. Neither the courts, nor any
other government entity, should punish or otherwise impede a desperate
patient, acting with the advice and approval of his or her physician, who 1)
seeks to relieve his or her serious suffering by using an unconventional
treatment that has been shown to be effective in his or her case and 2) has
tried other standard, lawful treatments without success. Furthermore, those
who attempt to aid the patient in that effort would be similarly free from
sanction."

It is a pity that HMA, representing less than half of Hawaii's physicians,
does not hold such an enlightened and compassionate view while advocating
for its patients.