Pain is another one of those four-letter words, one that gets substantially too little attention - so states the American Pain Foundation. Unfortunately, the fact that so little note is paid to it is, in itself, painful. Proper and effective pain management is a Public Health crisis, and is a symptom often relegated to a position on the medical list well behind disease mitigation. Recent activity in congress brought the issue of pain out in the open, involving more than 50 health care professional and patient organizations.
Although not included in any special program or agenda, the 105th congress has heard much on the topic of pain management. The matter of pain and its management came to notice in a most unusual manner - incorporation in legislation curbing the use of controlled substances by physicians to assist in patient suicides. It was amazing to health care professionals, and the organizations to which they belonged, the level of activity and intensity the topic engendered. (The A.M.A. and the National Hospice Association officially oppose physician assisted suicides and other groups have no official position.)
The American Pharmaceutical Association's position is that it supports the right of the individual registrant to make his/her own judgement as to joining in the activity or physician assisted suicide. In its official statement, the association said it recognized the extreme diversity of opinion and would support any informed decision based on the professional judgement of the pharmacist. The organization did this rather than endorsing any particular moral stance.
The organizations were virtually unanimous in their opposition to the proposed legislation (The Lethal Drug Abuse Prevention Act).The closer the act and its provisions was examined, the stronger the opposition to it. Basically, the act was written to supervise the use of drug substances particularly concerning assisted suicides. The unfortunate point, and the one that rallied all the organizations to oppose the act sets a new role for the Drug Enforcement Agency (DEA), and that is reviewing the intended use of controlled substances prescribed and/or dispensed by physicians and pharmacists for terminally ill patients.
As the terminally ill patient draws ever nearer to the end of life, the strength and amount of pain relieving drugs would, of necessity, increase. It would then be the responsibility of the DEA inspector to determine if the drugs in question was prescribed to hasten the cessation of life; an entirely subjective decision, and one that could easily cause the institution of investigation. The fines and punishment for the alleged crimes are gross and unwarranted, but that has no bearing on the thought process of government workers.
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