Medical Leaders Seek Truce in Battle Over Marijuana

Health: Letter says fight over Prop. 215 could hurt efforts
to promote research into pot's effectiveness.

By ERIC BAILEY, Times Staff Writer

SACRAMENTOTop leaders of the medical
establishment are asking a group of physicians and the federal
government to stop their bitter legal battle over California's
new medical marijuana law. In a March 14 letter to the warring
doctors and government officials, the presidents of the
American Medical Assn. and the California Medical Assn. said
a prolonged court fight may only create "an intolerable period
of uncertainty" for physicians and the public.
The letter from Dr. Jack E. McCleary, the CMA's leader,
and AMA President Dr. Daniel H. Johnson Jr. also said that
continued disputes over the interpretation of Proposition 215,
the medicinal marijuana law approved by state voters in
November, could hurt cooperative efforts to promote more
research into pot's medical effectiveness.
Although it is now legal under state law for doctors to
recommend marijuana for patients who need it, the drug
remains illegal under federal law.
Faced with federal threats of a crackdown, a group of
doctors filed a lawsuit in January to block U.S. officials from
punishing physicians who recommend marijuana for sick
people in their care. Meanwhile, many physicians around the
state have refrained from even discussing pot with patients.
The federal government has recently stated that it has laid
down no such gag order, and McCleary and Johnson said that
should ease "any reasonable fears" physicians might have. As a
result, they said, "We believe that further litigation will serve no
productive purpose."
But several other medical officials said it was too early to
call for a truce because the federal government hasn't backed
off threats to punish physicians who recommend pot to
patients.
"As a practical issue, if you are a doctor who wants to
recommend marijuana to a patient, you are left up in the air,"
said Steve Heilig, director of the San Francisco Medical
Society. "There may be a place for this lawsuit still."
Heilig said breaking off the fight now would also leave
needy patients frustrated.
"You've heard pot helps you, then you're faced with the
choice of do you go out in the street and break the law to
acquire some marijuana," he said. "Until there is a formal
statement from the federal level clarifying what they think is
allowable, we're all just groping for an interpretation. I don't
think they even know yet."
Along with its joint letter with the American Medical Assn.,
the CMA issued a list of guidelines for physicians to interpret
the law.
It advises that a doctor can discuss the risks and benefits of
pot as medicine, but should not make a recommendation on
whether to use it and should remind a patient that marijuana
remains illegal under federal law. The guidelines also tell
doctors to avoid cooperating in any way to help a patient get
pot from a buyer's club or provide a recommendation that
could, under the terms of Proposition 215, be used by the
patient as a defense in court.
The guidelines recommend that physicians document
discussions about pot with patients, but suggest such records
cannot be used against a doctor if a patient attempts to use
them as a defense in court against a possession or cultivation
charge.
In their letter, McCleary and Johnson asked that federal
officials embrace the guidelines.
An attorney for the physicians suing the government said the
guidelines provide a good springboard for a possible
settlementif U.S. officials embrace them.
Graham Boyd, a San Francisco attorney handling the case
against the federal government, said the guidelines don't give
doctors carte blanche, but are a significant step. He suggested
that the guidelines give a physician leeway to advise patients
"that medical marijuana is appropriate and then testify in court
about that fact" without facing sanctions.
A spokesman for the Office of National Drug Control
Policy said that Boyd was "entitled to his interpretation," but
that a more careful reading of the guidelines indicated that it
remains illegal under federal law for doctors to recommend
pot.
Advocates of medical marijuana said the guidelines are an
important step for the California Medical Assn. because it
marks the first time the group has told doctors to do anything
except avoid pot as a topic.
"Now we're beginning to see guidelines for physician
behavior that dance on the edges of federal law," said Dave
Fratello of Americans for Medical Rights.