ABCD Exchange : September 1998 : QuickScan - News in Brief

Upfront - Community Coalitions & EOL Care
President's Letter - Suffering in Nursing Homes
Public Policy - Pain Relief
On the Hill - Coalition to Improve Pain Management
Research - Physician Misunderstanding of PAS & Euthanasia
Research - Women's Distrust of Physicians

News and Notes on End-of-Life Care

New York - Last month, New York Governor George Pataki signed a bill eliminating "the requirement that triplicate prescription forms be used by doctors to dispense . . . narcotic pain relievers to patients." According to the AP/Albany Times Union, sponsors of the measure said the new law "will prompt New York doctors to prescribe pain medication more often for seriously ill patients." Many organizations, including the committee sponsored by the Institute of Medicine, have spoken out against triplicate prescription forms, which were developed as a way to monitor opioid prescriptions to prevent abuse among patients and doctors. The forms themselves are onerous to use and, some suggest, prevent doctors from prescribing adequate amounts of painkillers. The law also changes definitions of "addict" and "habitual user," so that doctors will not have to report patients who are legitimately taking controlled substances to the State Department of Health. Although many support the new law, consumer advocates remain cautious. The Times Union quotes Arthur Levin, director of the Center for Medical Consumers, as saying, "I don't believe these types of laws are the reasons that doctors don't manage pain well. Change has to be in the way doctors are educated and in the way doctors are disciplined." (Based on reports from the Last Acts news service.)

Portland, OR - Oregon Human Resources announced on August 18 that the deaths of 10 patients who obtained prescriptions for lethal medications have been reported to the state's health division. Of these, eight died after taking the medication, and two died from their diseases, said Dr. Katrina Hedberg, medical epidemiologist. "All ten reports received by the Division documented full compliance with the provisions of the Act," she said, and all were deemed capable of making and communicating healthcare decisions, all received a medical evaluation from a second physician, and all complied with the 15-day waiting period between requests. The average age of those who obtained the prescriptions was 71; five were men and five were women. Nine of the 10 were cancer patients.

Washington, D.C. - The American Society of Pain Management Nurses (ASPMN) joined the Pain Care Coalition to speak out against the proposed Lethal Drug Abuse Prevention Act. ASPMN joined other pain organizations in briefing the media and Hill staff on the effects this legislation could have on pain management. ASPMN President Pamela Bennett, B.S.N., R.N., said, "More than any other chronic condition, pain crosses all lines of age, race and gender, and is still severely undertreated. This legislation could compound this problem by creating an environment in which healthcare professionals are reluctant to prescribe adequate treatments, fearing scrutinization and misunderstood intent." Bennett noted, "The focus of our attention needs to be on improving the access and delivery of adequate pain management, especially in the case of end-of-life care." The ASPMN is an organization of 1400 nurses seeking to promote care of patients in pain by providing education, supporting professional standards, advocating for patients, and supporting research.

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