Pubdate: Fri, 21 Mar 2003
Source: Alternatives for Cultural Creativity (Salem, OR)
Copyright: 2003 Get Real Inc.
Contact:  http://www.alternativesmagazine.com/
Details: http://www.mapinc.org/media/1149
Author: Ed Glick

MEDICAL ESTABLISHMENT ABANDONS PATIENTS AND ETHICS

Is There A Doctor (Or Nurse) In The House?

Nursing is caring

Twenty years ago I began to learn what real suffering looks and feels like. 
I watched helplessly while beautiful young men would, in three months time, 
age 50 years, dying from a disease no one knew anything about at the time.

I have watched tobacco-cancer eat the lungs, livers and hearts out of 
people. They had no idea, when they began using this legal herb, the 
consequences in store for them.

I've cared for all of these people because they were suffering, and because 
I am a nurse.

Today I sadly witness another widespread--and preventable--tragedy of human 
suffering. It is the pain of ill and dying people, legally persecuted for 
using an illegal herb, and simultaneously denied their appropriate medicine 
by the medical establishment. This is the everyday experience of cannabis 
patients, the "untouchables" of American medicine.

I've listened countless times as patients beg me to give them something I 
can't--permission to use, grow, smoke, eat, and possess one simple herb. 
They ask me to tell a narcotics "task-force" that they couldn't find their 
registry card, or explain to a doctor that the drug keeps them from 
vomiting up their protease inhibitors.

I've been watching this nightmare unfold in slow motion, while the medical 
system that I thought supported patients consigns them to unnecessary 
suffering and death.

My nursing education, which taught me all about mitering the corners of bed 
sheets and the anatomy of disease, never prepared me for this.

Nursing school taught that the essence of nursing is compassion. Yet today, 
I watch as Oregon's nursing and physician leaders cause pain and suffering 
to the very people they are ethically committed to care for. Who forbids a 
dying cancer patient a safe and natural herb that mitigates some of the 
worst symptoms of their disease? What kind of society allows legalisms to 
envelop and destroy an entire class of people, namely cannabis patients? 
What can I say to these patients, other than "I'm sorry".

Oregonians to Medical Establishment: "Take Care of 'em" Scientific, 
historical, and experiential research has described numerous clinical 
indications for cannabis. The biochemical mechanisms underlying its 
efficacy are only now being uncovered. Although its primary medical 
indication is for pain, it is also indicated as an anti-emetic 
(anti-nausea), anti-spasmotic, intraocular (eye) pressure reducer, 
anti-anxiety agent, and appetite stimulant--among others. For many sick and 
suffering people, Cannabis is a good medicine.

On November 3rd 1998, voters approved Ballot Measure 67, The Oregon Medical 
Marijuana Act, 54% to 45%. Voters' intention was clear: cannabis patients 
belong in the medical, not the criminal justice system.

The Oregon Medical Marijuana Act represented a watershed event in Oregon, 
and nationally, by exempting patients from state criminal sanctions for 
using cannabis, and by mandating the Department of Human Services (DHS), 
Health Services (formerly the Oregon Health Division) to establish a 
registration system on their behalf.

Upon passage, and with such unequivocal voter mandate, the legal protection 
envisioned by OMMA'S framer's was finally realized. We thought.

First results were encouraging. Through 1999 and 2000 the Medical Marijuana 
Program grew rapidly under the leadership of Ms. Kelly Paige, an employee 
of the Department. By May of 2001 it had grown to include 2800 registrants, 
with some 550 physicians having registered one or more patients in the 
Program. This remarkable number represents the highest physician compliance 
rate in the US. It also reflects the large number of patients in Oregon who 
use cannabis. And, in the three years that the Medical Marijuana Program 
has existed, it has afforded some substantial protection to thousands of 
Oregonians from unwanted contact with police.

But all is not well in this system. Structural flaws and interpretations 
have left thousands more vulnerable to legal harassment. And, 
unfortunately, even registrants in the Medical Marijuana Program face 
frequent police searches because of inadequate possession limits and 
confusion in the law. At the end of the day, thousands of ill Oregonians 
still suffer from double exclusion (from both the Medical Marijuana 
Program, and the medical system), and double inclusion (into the legal and 
criminal system). This is not what Oregonian voters voted for.

The passage of the OMMA should have ended forever the abuse of cannabis 
patients at the hands of police and District Attorneys. Unfortunately, it 
didn't. In the intervening years, multiple unforseen problems have 
developed. These include 1. Patient inability to pay the application fee; 
2. Inadequate cannabis possession limits; 3. Uncooperative physicians, 4. 
Obstruction of physicians by the Board of Medical Examiners, and 5. The 
Oregon DHS's prohibitive new Administrative Rules. Each of these hurdles 
effectively pushes patients back into the waiting arms of police and the 
criminal justice system.

Prohibitive program registration fees have prevented many patients from 
accessing the program. Chronically ill patients, bankrupted by America's 
for-profit medical system, are forced to choose between sending $150 to the 
Medical Marijuana Program, or paying rent. Some patients resort to selling 
pharmaceuticals on the black market to raise the funds. As one patient 
stated at recent Administrative Rules hearings: [The] "Oregon Health 
Divisions Medical Marijuana Program is a Mafia Protection Racket."

Yet the Department is currently taking in excess of $350,000 per year in 
patient money. This income should have allowed for a reduction in the 
registry fee. It didn't.

Instead of a reduction in the registry fee, vast sums of patient moneys are 
being spent by the bureaucrats of the Medical Marijuana Program on Attorney 
General consultations, and Administrative Rules revisions. These activities 
have prevented timely processing of applications. Legally, the OMMA 
requires processing of applications within 30 days. The Department is 
chronically out of compliance. This great waste of energy has come at the 
expense--physically, and financially--of the patients whose wellbeing the 
program is supposed to support.

Impossible plant and medicine possession limits also obstruct patients. The 
OMMA allows only seven plants, up to three of which can be mature at any 
time. "Usable" cannabis amounts are tied to the number of flowering plants. 
Patients are often unable to maintain compliance with these small 
allowances. If they harvest one plant then the allowable possession limit 
of cannabis is reduced by one ounce! If they harvest all plants together, 
or make cuttings, they exceed the limit again. If they grow their seven 
plants outside, a sensible approach, they end up with seven large flowering 
plants, and a pound or more of medicine. Most often the problem is simply 
an inability to grow a quantity of medicine sufficient to meet the 
patient's medical needs.

Unfortunately, Administrative Rules don't address these issues.

Doctors to Patients: "Don't bug me" An even greater obstacle to patients 
became apparent in 1999, as large numbers of physicians quietly decided not 
to participate in the Registry Program. This left chronically ill people 
all over Oregon searching for a physician who'd sign their form, allowing 
entry into the Medical Marijuana Program.

Often, the doctor will privately admit to the patient that cannabis appears 
to be an effective treatment. Still, many physicians refuse to sign the 
form, citing fear of Drug Enforcement Administration (DEA), or disagreement 
with cannabis therapy on ideological or medical grounds.

The Health Services's Mission Statement says it exists "To protect, 
preserve and promote the health of all the people of Oregon. To prevent 
unnecessary death and disability, improve the health status, and reduce the 
per-capita cost of illness care for all Oregonians." The ethics of medicine 
and nursing describe a philosophy of compassion that is at the "root" of 
medical practice. Caring for others is a fundamental quality of civilized 
society.

Oregon voters clearly expressed themselves in November 1998. Their wishes 
have only partly materialized.

Edward Glick, RN has been practicing nursing since 1983 in a variety of 
clinical settings including AIDS, medical, cardiac, ayurvedic, and 
currently, psychiatric at Good Samaritan Hospital in Corvallis, Oregon. He 
participated in writing and campaigning for The Oregon Medical Marijuana 
Act, (1998) and is a member of the DHS's Debilitating Medical Conditions 
Advisory Panel (2000).

Ed is founder of "Contigo-Conmigo", an Oregon educational non-profit 
corporation (1999), and a co-Chief Petitioner on OMMA-2.

Ed Glick is author of The Oregon Medical Marijuana Guide- A Resource for 
Patients and Health Care Providers, (2001). Ed can be reached at