My wife lives with constant pain from a chronic medical condition. One of the hard parts of this illness is the difficulty in getting enough medication to give her relief -- not because it is not available, but because doctors are reluctant to prescribe it. One physician quite prescribing some of her medications to any patient, and anoyhter tried to limit her to only enough to last two weeks between appointments (which would have more than doubled our out-of-pocket cost through insurance). Why? Because of federal prosecution of pain management doctors under drug trafficking laws.

That may change now, due to the recent Supreme Court decision on Oregon's assisted suicide law.

Doctors who specialize in pain management and their advocates are hoping that last week's Supreme Court decision upholding Oregon's assisted-suicide law will boost their efforts to defend colleagues accused by the government of illegally prescribing narcotic painkillers to their patients.

With dozens of doctors, pharmacists and patients now in jail or awaiting imprisonment after being convicted of drug trafficking, the specialists and their attorneys say the Oregon ruling supports their contention that prosecutors have reached improperly into the state-regulated practice of medicine.

"The prosecutors have been making a policy argument in court against the treatment of chronic pain as it's being practiced, and this Supreme Court decision makes clear that is not their role," said Eli Stutsman, an Oregon attorney who represented a doctor and pharmacist in the assisted-suicide case. He is now arguing appeals for several convicted pain doctors.

"Before I was just a lawyer with a legal analysis before the courts, but now I have a decision of the highest court of the land," he said.

The question is, will that decision be followed, or will doctors continue to be prosecuted for following the best medical practices?

Radley Balko, a policy analyst with the Cato Institute, a conservative Washington think tank, believes the government is being overly aggressive in prosecuting doctors, but he said he does not see the Supreme Court decision as a threat to the government's initiative against what it considers illegal prescribing.

"The justices carved out this little sphere of individual rights with the Oregon ruling, and I would hope that would migrate into the pain medication sphere," he said. "But I'm not all that optimistic because of other decisions they've made."

In particular, he noted, the court allowed the federal government authority to overrule state laws permitting the use of medical marijuana.

But John Flannery, attorney for a South Carolina doctor convicted in 2004 of illegally writing a handful of pain medication prescriptions after working at a pain center for only three months, said the decision has encouraged him about the prospects of an upcoming Supreme Court appeal of the case.

"The U.S. Supreme Court sent the Justice Department a powerful message, told them to back off, and to stop meddling in medical care in the states -- as it was none of their business," he said. "We can only hope that the courts don't stop with yesterday's decision, as there's more that the department's doing wrong -- terribly wrong."

The regulation of the practice of medicine is a state matter, not a federal one. The current federal proactice of prosecuting doctors for prescribing therapeutic dosages of medication is fundamentally wrong -- and hurts patients like my wife. The time has come for that practice to stop.

And I hope this decuision in the Oregon case brings such abuse of power to a sudden and permanent end.

Posted by: Greg at 01:45 PM | No Comments | Add Comment
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