Friday, Oct. 6, 2000 | 12:02 p.m.
Mike O'Callaghan is the Las Vegas Sun executive editor.
Several months ago this column supported the Pain Relief Promotion Act introduced by Sen. Don Nickles, R-Okla. The proposed act contains some of the first positive steps toward proper pain mitigation.
As in the past, allow me the opportunity to quote a 1998 editorial from the Journal of the American Medical Association:
"Undertreatment of pain is a persistent clinical problem. A leading indicator of inadequate pain management is the poor control of cancer pain, a condition for which every effort should be made to assure patient comfort. Cancer pain is feared by patients, their families, and the general public and this fear has helped to fuel the debate concerning assisted suicide."
The same editorial concluded: "Treatment of pain should be a top priority in cancer care. However, excellence in pain control and symptom management has not been adopted as a 'mission' of cancer practitioners, probably for several reasons. First, patients do not die of pain, although some evidence suggests that untreated pain begets worse pain."
Certainly the legalization of physician-assisted suicide, as practiced in Holland and the state of Oregon, is taking pain relief too far. Relieving pain shouldn't end in death as the final solution for any person wanting to live with less or no pain. This is the only answer physician-assisted suicide provides. The act proposed by Nickles flies in the face of the Oregon death act and therefore has received strong opposition from Sen. Ron Wyden, D-Ore., who calls it the Pain Promotion Act.
Wyden and other opponents of the Pain Relief Promotion Act have found a couple of weaknesses in the proposed legislation. Probably their most legitimate complaint is the use of the federal Drug Enforcement Administration to prevent abuse of drugs given to suffering patients. I find it difficult to disagree with this argument and believe the enforcement powers should be with state medical examiners boards and other doctor-run state agencies.
The DEA has a reputation of being more enforcement than medically oriented. There's no doubt that some doctors may be intimidated by having DEA agents peering over their shoulders or seeking any possible wrongdoing. This, in some cases, could result in doctors being reluctant to aggressively treat the pain of their patients.
In recognizing this problem the proposed act promotes "the dispensing or distribution of certain controlled substances for the purpose of relieving pain and discomfort even if it increases the risk of death is a legitimate medical purpose and is permissible under the Controlled Substances Act."
In addition, the act also provides an additional $5 million for research and education improving the use of drugs designed to relieve pain. About the only suggestion I could make is the addition of another $20 million to this program because we are so far behind in pain relief.
If the present bill fails, it should be brought up again next session with the oversight remaining with doctor enforcers in the several states and not with a federal police agency. The proposed act is both valuable and needed and shouldn't be cast aside and forgotten if it fails to get enough votes.
Sen. Orrin Hatch, R-Utah, said it best when telling a committee:
"In my judgment, terminally ill patients deserve better pain control management because their lives have the same worth and dignity as all other human beings."
This is exactly what the Pain Relief Promotion Act will provide for suffering American patients.
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