Pot-prescribing doctors warned

October 18, 2005

Andre Picard, Globe and Mail (Canada)

The organization that provides malpractice insurance to Canadian physicians is telling doctors they should not prescribe medical marijuana unless patients sign a release-of-liability waiver.

In a letter to its 60,000 members, the Canadian Medical Protective Association cautioned physicians that they could face lawsuits for prescribing marijuana because it is an unproven drug so they should be careful to protect themselves, according an article published on the web site of the Canadian Medical Association Journal.

Both the CMPA and the Canadian Medical Association have opposed the medical-marijuana program since its inception in 2001.

The physicians' group and its insurers have argued that marijuana has not been subject to the same testing as other prescription drugs and that doctors have been unduly burdened with the role of "gatekeepers" of a program that they do not support and that leaves them vulnerable to lawsuits.

In June, the federal government adopted new regulations that were designed to address the concerns of physicians, but the CMPA said in its letter to doctors that the amendments were insufficient.

"The revised regulations are certainly an improvement but underlying concerns remain," said Dr. John Gray, chief executive officer of the CMPA. "Prescribing medical marijuana cannot be compared to prescribing prescription drugs."

Canada's Marihuana Medical Access Regulations were amended so doctors no longer have to recommend the daily dosage of marijuana or the manner in which the patient intends to take the drug, nor do they have to attest to the benefits of marijuana use.

Many physicians found it absurd and unethical to give their patients a prescription to smoke, and many had concerns about the lack of research showing the benefits of pot for treatment of specific symptoms.

Under the new regulations, the onus shifted from the prescribing physician to the patient. People who apply for the right to use medical marijuana must now attest that they "discussed the risks of using medical marijuana with a medical practitioner . . . and consent to using it for the recommended medical purpose."

Currently, 1,042 people in Canada are legally authorized to possess marijuana for medical purposes, according to Health Canada. About 250 of the program participants buy dried marijuana from Health Canada while the balance are authorized to grow their own pot.

Most of them smoke pot to treat chronic pain or to alleviate symptoms of chronic illnesses such as HIV and AIDS and multiple sclerosis.

The CMPA recommends that physicians present their patients with a release form, but patients are not obliged to sign it. And even a patient who has signed the waiver is not prevented from suing.

In Quebec, physicians are specifically prohibited by law from requesting that a patient sign a release from professional liability.

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