Friday, September 12, 2008

"Just the facts, Ma'am, Just the Facts

(Jack Webb - main character, in TV series FBI, 1950's)

Myra Christopher
President and CEO
Center for Practical Bioethics

Good ethics start with good facts. The fact is: today doctors have medications and techniques to treat pain effectively. Nevertheless, many doctors do not.

One of the major reasons physicians give to explain this discrepancy is their fear of legal and regulatory oversight associated with prescribing "controlled substances" which are critical to effectively treat patients with chronic and terminal pain. This phenomenon is referred to as the "chilling effect."

A study conducted by the Center for Practical Bioethics, Federation of State Medical Boards (FSMB) and National Association of Attorneys General (NAAG) was published this week (9/09) in Pain Medicine, the journal of the American Academy of Pain Medicine. According to the best available data and records, only about one in 1,000 practicing physicians was sanctioned or tried for improperly prescribing pain medications from 1998 to 2006.

This research and that of others also indicates that there are a handful of cases where physicians have been treated unfairly. Charges have been brought and dropped; physicians have been found not guilty, or verdicts have been overturned on appeal.

It is critical that law enforcement, regulatory agencies and the medical community work collaboratively to see that all Americans receive treatment for pain when needed, that investigations of physicians alleged to have mishandled prescription drugs are efficient and fair, and that in those rare instances when physicians have engaged in criminal behavior they are denied the privilege of practicing medicine.

On September 22, the Center, FSMB and NAAG will convene a roundtable in Washington, DC to discuss these critical issues.

Good ethics do indeed start with good facts. It is our hope that this study will help responsible physicians place their locus of concern on treating pain in an informed and effective manner, not on the very small risk that they might do something that could subject them to scrutiny.


News Release, Few physicians actually tried or sanctioned for improperly prescribing pain medications, September 9

Legal risk for prescribing painkillers is small, study says, American Medical News, September 8

Treating Doctors as Drug Dealers: The DEA’s War on Prescription Painkillers, Ronald T. Libby, Cato Institute, June 16, 2005

Balanced Pain Policy Initiative

What do you think? Please view and leave comments by clicking on "comments" after this post.

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