PAIN CONTROL: Lawmakers Struggle to Find a Balance
As the debate over controlling pain for terminally ill patients and guarding against assisted suicide continues, Congress attempts to strike a balance with the Pain Relief Promotion Act. Building upon legislation recently passed by 15 states that ensures "doctor's licenses won't be revoked for prescribing powerful controlled substances ... for severe pain," the bill, written by Sen. Don Nickles (R-OK), legitimizes prescribing controlled substances for pain reduction at the end of life, despite the increased risk of death. While encouraging pain management using controlled substances, the Act bans the use of these same drugs for physician-assisted suicide. This legislation therefore sends what many consider to be a mixed message: control pain, but don't hasten death. If passed, this legislation would overturn assisted suicide in Oregon, the only state where such action is legal. The greater concern expressed by physicians is the intensity in which this act would be enforced. The question of whether doctors would be liable if patients overdosed on their medication is only one of many issues. James Rathmell, a pain expert at the University of Vermont, argues that "proper training and oversight of the federal officials who would enforce the law" are essential. While a House committee has passed one version of the bill, it is unlikely to be voted on by the Senate Health Committee this year (Neergaard, AP/Philadelphia Inquirer, 10/18).
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