A WAR THAT KEEPS HURTING SICK CIVILIANS

BOSTON -- And you thought the war on drugs was about keeping cocaine out of
the country and heroin out of the kids. Guess again.

If the bill that flew out of the House last week becomes law, those
intrepid folks at the Drug Enforcement Administration will be given
encouragement to go after doctors as if they were dealers.

The bill was titled, in the best Orwellian fashion, the Pain Relief
Promotion Act. In fact, it was a buffed and shined up version of last
year's loser, the Lethal Drug Abuse Prevention Act.

Both bills to prevent the use of federally controlled substances by doctors
assisting suicides were deliberately aimed at overthrowing the law approved
by the voters in Oregon. But this year, the sponsors added a few bucks for
pain management and changed the name. They convinced their colleagues that
this was an easy way to oppose doctor-assisted suicide while proving you
were sympathetic to dying patients, a k a "I feel your pain."

According to the sales and spin, the bill that passed wouldn't affect
doctors who prescribed substances like morphine for pain relief, even if
the drug unintentionally caused death. But it would punish the doctors who
prescribed these substances intentionally to cause death.

As Illinois' Henry Hyde declaimed, "We believe doctors should help people
cope with the pain and terror of death, not thrust death upon them." A
fellow sponsor, Charles Canady of Florida, added, "We draw a bright line here."

A bright line? The line between a dose that controls pain for the
terminally ill and a dose that ends up hastening death is one of the
murkiest in medicine. The bill doesn't say how doctors would walk this line
or how they would prove their intent.

If the companion law in the Senate passes, and the whole mess survives a
states' rights test, doctors could be sentenced to 20 years in prison.
Anybody could drop a dime and the DEA could be left to decide the doctors'
motives.

Joanne Lynn, the head of Americans for Better Care of the Dying, opposes
both assisted suicide and this law. But she can imagine signs posted around
hospitals saying: 1- 555-CALLDEA. To put it bluntly, she says, "Ordinary
record-keeping and conversations would be insufficient to protect us from
prosecution."

The House bill was described by the media and the sponsors as a litmus test
on assisted suicide. It gave Hyde et al. a chance to thumb their noses at
Oregon voters, not to mention the voters in California and Maine, where
doctor-assisted suicide is going on the ballot.

But ironically, the law wouldn't actually ban all assisted suicide; it
would just prohibit the use of certain barbiturates. Remember Jack
Kevorkian? He used carbon monoxide in his "practice." There are plenty of
uncontrolled substances that can end life.

The bill for "pain relief" could, however, increase pain. Says Oregon Sen.
Ron Wyden, another opponent of both assisted suicide and this bill, "The
undertreatment of pain is a documented crisis. If the DEA can second-guess
doctors who are already reluctant, we'll see pain relief programs set back."

Two months ago, for the first time, a pulmonary specialist was disciplined
for undermedicating patients. We know that in the last week of life, a
third of all people suffer moderate to severe pain. This pain is a cause
for the despair that underlies many requests for a merciful death.

In the past several years, with all the discussion about the end of life,
Oregon has actually pulled ahead of the country in both hospice care and
pain management. Only one in 10,000 Oregon deaths have been assisted
suicides. Indeed it's possible that the rate is lower in Oregon than in
states where it's still clandestine.

If our friends in Congress actually were interested in pain relief rather
than political grandstanding, there are two other bills -- the
Compassionate Care Act and the Conquering Pain Act -- that would build
family support networks, fund centers for pain management research and
require report cards on treatment for pain. Neither is given a chance of
passage.

In the past years, the war on drugs has done enormous collateral damage to
sick civilians. We keep marijuana from cancer patients, heroin from the
dying. Now the House of Representatives wants to encourage the DEA to sniff
around doctors' prescriptions of barbiturates. And the Senate may follow.

Whatever happened to that old slogan of the drug war? "Just Say No."