More doctors need to join the brave few

July 26, 2003

Hilary McQuie, San Francisco Chronicle (CA)

Hilary McQuie

Every day people call me asking how to get legal. They suffer from many different ailments -- cancer, AIDS, arthritis, glaucoma, MS, chronic pain and others -- but the commonality is that they have all talked to their doctors about using marijuana to treat either their condition or its symptoms. And while their physicians have agreed that using marijuana might help, each of the doctors has declined to sign the recommendation necessary to getting access to a medical marijuana dispensary.

So I refer them to one of the doctors courageous enough to stand behind patients.

Unfortunately, there are only a few.

It's true that since the passage of California's Compassionate Use Act of 1996, more than 1,500 physicians statewide have recommended medical cannabis to their patients. But over 80 percent of medical cannabis recommendations have come from 10 doctors. Many of the others that have made recommendations will only agree to do so if the patient has a terminal illness, despite the widespread understanding that marijuana is also effective in treating many nonterminal illnesses. Sadly, rather than recognize either the fear that inhibits many physicians or the courage of these brave few, the California Medical Board has looked at these statistics and brought nine of the 10 under investigation.

But these are not simple 'scrip docs' who are cashing in on Californians seeking prescriptions for recreational use. In fact, though over 30,000 Californians have obtained recommendations, doctors believe many more would benefit from the anti-nausea, anti-spasmodic, analgesic and appetite- increasing properties of marijuana. Over 110,000 Californians live with HIV/AIDS, over 125,000 will be diagnosed this year with cancer and over 10,000 have multiple sclerosis. Marijuana may well be part of the constellation of helpful treatments for all of them, but too many will never know, because -- eight years later -- they still do not have the safe and legal access the law guarantees them.

One of the physicians working to implement the law is Dr. Tod Mikuriya, a leading authority on the medical use of cannabis. Since California's medical marijuana law was enacted in 1996, Dr. Mikuriya has approved the use of marijuana for 7,500 patients. And gotten himself investigated. The state medical board does not seem to understand that Dr. Mikuriya has been busy putting into practice the American Medical Association's third principle of medical ethics, 'A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.'

Nor do they seem to understand that California's Compassionate Use Act stipulates that, 'no physician in this state shall be punished, or denied any right or privilege, for having recommended marijuana to a patient for medical purposes.' Last year's ruling from the U.S. Court of Appeals in San Francisco further affirmed doctors' First Amendment right to recommend medical cannabis, and prohibited the federal government from investigating or punishing physicians for talking to their patients about how marijuana might help them.

Dr. Mikuriya and Dr. Marcus Conant have been busy putting into practice the American Medical Association's third principle of medical ethics, 'A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.'

Certainly, these are fearful times for doctors fully exercising their ethics. This month, the U.S. solicitor general filed papers with the U.S. Supreme Court requesting that the court overturn the unanimous decision in Conant, seeking to allow the Justice Department to investigate any physician who mentions the word 'marijuana' to patients and to sanction those who approve it for patient use.

Doctors everywhere need to find the courage that Dr. Mikuriya and too few others have exhibited on this issue. They will join a growing chorus of resistance to the federal campaign against patients and doctors who decide on a medical marijuana treatment. For example, members of the House of Representatives voted last week on an amendment that would put a stop to the federal government's attack on state medical marijuana laws. Although the bipartisan amendment failed 152 to 273, the level of congressional support for medical marijuana was the highest ever and indicates that federal law is moving rapidly toward reform. Fear of sanctions should not prevent any physician from offering honest, well-informed medical advice. State law requires it, federal court rulings still protect it and the Hippocratic oath demands it.

Hilary McQuie is the political director of Americans for Safe Access (www.safeaccessnow.org), a medical marijuana patients' advocacy organization.



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