MEDICAL ESTABLISHMENT ABANDONS PATIENTS AND ETHICS

Is There A Doctor (Or Nurse) In The House?

Nursing is caring

Twenty years ago I began to learn what real suffering looks and feels like.
I watched helplessly while beautiful young men would, in three months time,
age 50 years, dying from a disease no one knew anything about at the time.

I have watched tobacco-cancer eat the lungs, livers and hearts out of
people. They had no idea, when they began using this legal herb, the
consequences in store for them.

I've cared for all of these people because they were suffering, and because
I am a nurse.

Today I sadly witness another widespread--and preventable--tragedy of human
suffering. It is the pain of ill and dying people, legally persecuted for
using an illegal herb, and simultaneously denied their appropriate medicine
by the medical establishment. This is the everyday experience of cannabis
patients, the "untouchables" of American medicine.

I've listened countless times as patients beg me to give them something I
can't--permission to use, grow, smoke, eat, and possess one simple herb.
They ask me to tell a narcotics "task-force" that they couldn't find their
registry card, or explain to a doctor that the drug keeps them from
vomiting up their protease inhibitors.

I've been watching this nightmare unfold in slow motion, while the medical
system that I thought supported patients consigns them to unnecessary
suffering and death.

My nursing education, which taught me all about mitering the corners of bed
sheets and the anatomy of disease, never prepared me for this.

Nursing school taught that the essence of nursing is compassion. Yet today,
I watch as Oregon's nursing and physician leaders cause pain and suffering
to the very people they are ethically committed to care for. Who forbids a
dying cancer patient a safe and natural herb that mitigates some of the
worst symptoms of their disease? What kind of society allows legalisms to
envelop and destroy an entire class of people, namely cannabis patients?
What can I say to these patients, other than "I'm sorry".

Oregonians to Medical Establishment: "Take Care of 'em" Scientific,
historical, and experiential research has described numerous clinical
indications for cannabis. The biochemical mechanisms underlying its
efficacy are only now being uncovered. Although its primary medical
indication is for pain, it is also indicated as an anti-emetic
(anti-nausea), anti-spasmotic, intraocular (eye) pressure reducer,
anti-anxiety agent, and appetite stimulant--among others. For many sick and
suffering people, Cannabis is a good medicine.

On November 3rd 1998, voters approved Ballot Measure 67, The Oregon Medical
Marijuana Act, 54% to 45%. Voters' intention was clear: cannabis patients
belong in the medical, not the criminal justice system.

The Oregon Medical Marijuana Act represented a watershed event in Oregon,
and nationally, by exempting patients from state criminal sanctions for
using cannabis, and by mandating the Department of Human Services (DHS),
Health Services (formerly the Oregon Health Division) to establish a
registration system on their behalf.

Upon passage, and with such unequivocal voter mandate, the legal protection
envisioned by OMMA'S framer's was finally realized. We thought.

First results were encouraging. Through 1999 and 2000 the Medical Marijuana
Program grew rapidly under the leadership of Ms. Kelly Paige, an employee
of the Department. By May of 2001 it had grown to include 2800 registrants,
with some 550 physicians having registered one or more patients in the
Program. This remarkable number represents the highest physician compliance
rate in the US. It also reflects the large number of patients in Oregon who
use cannabis. And, in the three years that the Medical Marijuana Program
has existed, it has afforded some substantial protection to thousands of
Oregonians from unwanted contact with police.

But all is not well in this system. Structural flaws and interpretations
have left thousands more vulnerable to legal harassment. And,
unfortunately, even registrants in the Medical Marijuana Program face
frequent police searches because of inadequate possession limits and
confusion in the law. At the end of the day, thousands of ill Oregonians
still suffer from double exclusion (from both the Medical Marijuana
Program, and the medical system), and double inclusion (into the legal and
criminal system). This is not what Oregonian voters voted for.

The passage of the OMMA should have ended forever the abuse of cannabis
patients at the hands of police and District Attorneys. Unfortunately, it
didn't. In the intervening years, multiple unforseen problems have
developed. These include 1. Patient inability to pay the application fee;
2. Inadequate cannabis possession limits; 3. Uncooperative physicians, 4.
Obstruction of physicians by the Board of Medical Examiners, and 5. The
Oregon DHS's prohibitive new Administrative Rules. Each of these hurdles
effectively pushes patients back into the waiting arms of police and the
criminal justice system.

Prohibitive program registration fees have prevented many patients from
accessing the program. Chronically ill patients, bankrupted by America's
for-profit medical system, are forced to choose between sending $150 to the
Medical Marijuana Program, or paying rent. Some patients resort to selling
pharmaceuticals on the black market to raise the funds. As one patient
stated at recent Administrative Rules hearings: [The] "Oregon Health
Divisions Medical Marijuana Program is a Mafia Protection Racket."

Yet the Department is currently taking in excess of $350,000 per year in
patient money. This income should have allowed for a reduction in the
registry fee. It didn't.

Instead of a reduction in the registry fee, vast sums of patient moneys are
being spent by the bureaucrats of the Medical Marijuana Program on Attorney
General consultations, and Administrative Rules revisions. These activities
have prevented timely processing of applications. Legally, the OMMA
requires processing of applications within 30 days. The Department is
chronically out of compliance. This great waste of energy has come at the
expense--physically, and financially--of the patients whose wellbeing the
program is supposed to support.

Impossible plant and medicine possession limits also obstruct patients. The
OMMA allows only seven plants, up to three of which can be mature at any
time. "Usable" cannabis amounts are tied to the number of flowering plants.
Patients are often unable to maintain compliance with these small
allowances. If they harvest one plant then the allowable possession limit
of cannabis is reduced by one ounce! If they harvest all plants together,
or make cuttings, they exceed the limit again. If they grow their seven
plants outside, a sensible approach, they end up with seven large flowering
plants, and a pound or more of medicine. Most often the problem is simply
an inability to grow a quantity of medicine sufficient to meet the
patient's medical needs.

Unfortunately, Administrative Rules don't address these issues.

Doctors to Patients: "Don't bug me" An even greater obstacle to patients
became apparent in 1999, as large numbers of physicians quietly decided not
to participate in the Registry Program. This left chronically ill people
all over Oregon searching for a physician who'd sign their form, allowing
entry into the Medical Marijuana Program.

Often, the doctor will privately admit to the patient that cannabis appears
to be an effective treatment. Still, many physicians refuse to sign the
form, citing fear of Drug Enforcement Administration (DEA), or disagreement
with cannabis therapy on ideological or medical grounds.

The Health Services's Mission Statement says it exists "To protect,
preserve and promote the health of all the people of Oregon. To prevent
unnecessary death and disability, improve the health status, and reduce the
per-capita cost of illness care for all Oregonians." The ethics of medicine
and nursing describe a philosophy of compassion that is at the "root" of
medical practice. Caring for others is a fundamental quality of civilized
society.

Oregon voters clearly expressed themselves in November 1998. Their wishes
have only partly materialized.

Edward Glick, RN has been practicing nursing since 1983 in a variety of
clinical settings including AIDS, medical, cardiac, ayurvedic, and
currently, psychiatric at Good Samaritan Hospital in Corvallis, Oregon. He
participated in writing and campaigning for The Oregon Medical Marijuana
Act, (1998) and is a member of the DHS's Debilitating Medical Conditions
Advisory Panel (2000).

Ed is founder of "Contigo-Conmigo", an Oregon educational non-profit
corporation (1999), and a co-Chief Petitioner on OMMA-2.

Ed Glick is author of The Oregon Medical Marijuana Guide- A Resource for
Patients and Health Care Providers, (2001). Ed can be reached at
gina@proaxis.com