UNDER ASHCROFT'S PLAN, MORE PAIN AND NO GAIN

Special To The Examiner

THE U.S. CONGRESS has declared 2001-2010 the Decade of Pain Control and
Research. It is a worthy and overdue focus, as pain control has been a
neglected part of health care for many years.

Unfortunately and paradoxically, however, another arm of our federal
government is proposing to make pain relief harder to obtain. And some
major medical organizations are feeling forced into taking legal action
against our own attorney general.

In 1997, voters in the state of Oregon legalized "physician-assisted
dying." Each year since then, a couple dozen patients per year have opted
to exercise this last resort.

But ever since Oregon's vote, federal politicians and officials vehemently
opposed to the practice have attempted to overturn that vote.

First they insisted on a revote, which resulted in an even larger majority
of the voters supporting assisted dying. Then, last year, they proposed the
deceptively-named "Pain Relief Promotion Act" (PRPA), which would have
moved the regulation of pain medications from medical boards into the
purview of the Drug Enforcement Agency, an organization which admits to no
medical expertise and specializes in breaking down doors and intercepting
drug shipments on ships and airplanes.

The act also proposed a mandatory 20-year minimum sentence for any
physician who provided any patient with a lethal dose.

THE PRPA was opposed by a broad coalition of medical and legal
organizations and was defeated. But now the opponents of Oregon's singular
law are back with similar Draconian proposals in the form of a new
"directive" by Attorney General John Ashcroft.

Once again, federal officials seek to usurp state control of medical
practice and turn it over to the DEA, with heightened monitoring of
prescriptions and severe penalties, including the revoking of the doctor's
license to prescribe, for those who tread into -- or close to -- the murky
waters of real or suspected "assisted dying."

IT HAS BEEN SHOWN that pain is far too commonly under-treated in this
nation, and that one of the reasons for this is the over-scrutiny of
prescribing. The kind of regulations proposed have never been demonstrated
to reduce the illegal "recreational" use of prescription medications.
Recognition of these problems has finally begun to result in a trend
towards trusting physicians to do the right thing when prescribing pain and
other "scheduled" medications, with only five states -- including
California, alas -- still retaining the archaic "triplicate" system for
such medications.

It may be true that the best way to truly prevent requests for "assisted
dying" is to make pain medications as freely available as appropriate and
possible.

The directive by Ashcroft would change the entire nation's approach in this
complex arena to a system that would likely do little to attain the stated
goal of preventing and prosecuting "assisted dying" -- but likely would
result in many thousands of patients being denied appropriate pain relief.

Two well-known experts on care of the dying have recently called the
Ashcroft directive "a new and dangerous precedent for all health care
professionals."

THAT IS WHY the hundreds of doctors who make up the governing body of the
California Medical Association -- which, it should be noted, opposes
legalization of assisted suicide -- have just voted to take the drastic
step of suing our own Attorney General to block his new proposal.

It is not a step taken lightly. But, as Oregon governor -- and physician --
John Kitzhaber, lamented, "Given everything the country is going through
now, why Ashcroft picked this moment to inject this divisive issue into the
public debate is just beyond me."

Even those who oppose assisted suicide seem to agree: We don't need to
impede pain control for uncounted numbers of suffering patients because of
the ideological blinders of a powerful but shortsighted few.