A Critical Regulatory Issue in Health Care
A Critical Regulatory Issue in Health Care
Health care legal issues today are an uphill climb due to not having a full understanding of case laws and why we have them. One of the most controversial issues today is prescribed marijuana for the terminally ill. This has been a legal battle for years in the health care industry, especially for those who suffer from chronic illnesses such as cancer. Marijuana is an illegal drug that many physicians and patients believe it aids in relieving pain and side effects of chemotherapy and radiation treatments, which is very debilitating for many patients and cause many more issues for the patient. The states of California and Oregon have investigated the medicinal uses of marijuana closely. The differences in states approval or disapproval can be seen clearly with these two states. California for example views marijuana as a “Schedule I drug, meaning it can be possed and used to aid in survival and pain reduction for terminally ill patients. Yet, Oregon can legally permit physicians to prescribe the drug under Schedule II and patients can use the drug to end their lives.” (George J. Annas, J.D., M.P.H. 2006)
The real question is whether or not the U. S. Congress had authority constitutionally and the autonomy to make a decision, since this would fall under the Commerce Clause. U. S. Supreme Court ruled that the clause gave them the power, the right, and the ability to regulate marijuana grown at home for personal medically related uses as it had “to regulate the amount of wheat a farmer grew on his farm for personal consumption.” (George J. Annas, J. D., M.P.H. 2006) The fact of the matter is this, it could have been prescribed legally by a physician was irrelevant. This is a very slippery area for the health care industry and all those who prescribe medical marijuana are under the Controlled Substance Act (CSA) of 1970. The CSA set standards and regulations for controlled substances in one of a five schedules that is based on the potential for dependence and abuse. Also it puts our legal system at a crossroad when considering; what is possession of an illegal drug and those who distribute or deal illegal drugs.
This places the system in an area for a litany of legal battles which have included the health care system on what is considered legal and what is not legal. Of course this opens the can of worms on assisted suicides. The ruling of that would have to come from the U. S. Attorney General to determine whether prescribing drugs for suicide was not a “legitimate medical practice”, “As required by the CSA and writing such a prescription could therefore result in revocation of one’s registration certificate with the Drug Enforcement Administration (DEA) and federal criminal prosecution.” (George J.Annas, J.D., M.P.H. 2006) Supreme Court rulings in cases of assisted suicide are an issue because they try and keep a general consensus at state level. The state court officials who are part of the executive branch are responsible for administering specific statues and are allowed to interrupt the meanings of cases involving the CSA.
Therefore, it is very important to learn and know the statues and laws of the state in which the individual resides since the laws vary from state to state. The question of what constitutes a legitimate medical practice is open to interpretation and can be argued that the CSA prohibits doctor assisted suicide with the use of controlled substances. The use of Schedule II drugs is not a “legitimate practice”, thus causing the ruling in the state of California but, not in Oregon. This decision was reached because states have the right under federalism basic principle to regulate the practice of medicine and it is a state-regulated activity. The U. S. Congress does not have authority to make it federally regulated under the CSA. However, 20 states in the U. S. allow medical marijuana usage for terminally ill patients. This number is expected to grow, although, 20 states ruled it legal for medical purposes; it is still illegal under Federal Law.
The issue of assisted suicide controlled substance abuse and medical marijuana have some interesting outcomes because the laws of the land take a strong stance to decriminalize marijuana as some state have already; it will reduce the number of prisoners in the prison population. From a medical stand point the benefit of prescribing the drug far outweighs not prescribing it because of the fear physicians have about being prosecuted and having their medical licenses revoked. However, the street pharmacist would be able to have the same benefit of protection under the CSA, since we give longer sentences for drug dealing than we do murder. All things considered, the objective behind medical marijuana and the benefits it provides to the terminally ill or a person who suffers chronic pain shows a positive sign that it helps to relieve and aid in pain management.
It’s time for public health officials, state regulators, and health scientist to bring (make) changes in health care when it concerns medical marijuana. Medical marijuana can be manufactured as a controlled substance and regulated to meet the standards in quality care and quality control. The standards can be met by establishing and monitoring results through follow ups and collection of clinical evidence.
Medical marijuana has been a hot topic for years and will continue to be a hot topic in the years to come, yet it still benefits the people who need it. In many cases, people will continue to self-medicate to help with pain relief. Marijuana is an herb that is natural and in many cases safer than pain killers offered by large pharmaceutical companies. It has been proven that marijuana slows down response and gives the person the munchies. Yet the drugs from pharmaceutical companies can cause much worse damage from liver and kidney malfunctions as well as heart problems. So, which is better?
George J. Annas, J. D., M. P. H. (2006) Congress Controlled Substances and Physician
Assisted Suicide—Elephants in Mouse Holes, The New England Journal of Medicine