ALLOW DOCTORS TO EASE THE PAIN

Your July 27 editorial "Treat the Pain" on the medical profession's
woefully inadequate treatment of pain among the terminally ill struck a
chord with anyone who has lost a loved one to a long, debilitating illness.

Since last year, when the U.S. Supreme Court unanimously upheld New York's
ban on physician-assisted suicide, I have enlisted some of the leading
experts in the field of palliative care to propose workable solutions to
ease the suffering of the terminally ill among our aging population.

The Commission on Quality Care at the End of Life is charged with finding
ways to improve standards of medical care for the dying, to surmount
statutory and regulatory barriers to compassionate end-of-life care, to
train professionals who serve the terminally ill and to set forth the
rights of terminally and chronically ill patients to receive appropriate
care in their final days.

The commission's report, due for release this fall, is an important first
step in identifying the roadblocks to proper palliative care for the dying.
The report recommends changes in the laws and regulations that constrain
the way physicians and other health professionals treat pain at the end of
life. The commission also recommends methods to teach care-givers to
identify and alleviate pain and related symptoms.

The end of life is a profound experience for both the dying and their
families and friends. We must not allow this most intimate time of closure
in a person's life to be one of unnecessary suffering.

Dennis C. Vacco Attorney General New York

Your editorial addresses the problems many doctors face. One of my
colleagues was dying of cancer of the lung in 1954. He was in severe pain
and while his wife, a registered nurse, would not give him shots of
morphine, I and other doctors would come in every four hours to give him a
shot that to a normal person would be a lethal dose of morphine. It never
bothered him, but it did allay the pain.

While I was in practice, I was told by a pharmacist that the state agents
checking on illegal drugs did not approve of my prescriptions for two
nembutals a night for two sisters. They had been on this for years and if I
cut them off, they might convulse. To give them the medicine they needed, I
had to order them only one pill each night and they had to go to another
doctor to get a duplicate prescription.

These ill-educated agents have tremendous power over doctors, but it is the
doctors who know what they are doing is medically sound. None of us can
resist. We cannot afford to because it would be a loss of time and money to
defend ourselves.

John S. Hooley M.D. Merritt Island, Fla.

Checked-by: Mike Gogulski