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.

Pamela Lichty, President of the ACLU of Hawaii, Vice President of the
Drug Policy Forum of Hawaii