CA DRs must tell patients about pain relief
By Maggie Fox, Health and Science Correspondent
WASHINGTON, July 13 (Reuters) - A new ruling by the U.S. Department of Health and Human Services will force doctors and other health care workers in California to tell patients they have the right to pain medication, activists said on Tuesday. They said they hoped the ruling would not only eventually make pain relief more available to all Americans, but might also give desperate patients an alternative to suicide.
U.S. hospitals and doctors are currently very reluctant to give even dying patients the drugs they need to control pain. ``It's a scandal,'' Barbara Coombs Lee, executive director of the Compassion in Dying Federation, said in an interview. She cited a 1995 study that show patients in the United States often do not get adequate pain relief. ``It revealed that most people die in moderate to severe pain in hospitals,'' she said. ``I think that was a wake-up call.''
The new ruling came from the federal Health Care Financing Administration (HCFA), which oversees Medicare and Medicaid, in the form of a reply to an inquiry from the Compassion in Dying Federation, which said it received the news on Friday.
"We are ecstatic,'' Coombs Lee told a news conference. Her group wrote to the agency to see if the 1990 federal Patient Self-Determination Act, which was meant to force health care providers to tell patients what decisions they could make about their own care, could be used to give them information about pain medication. ``No one has ever applied it before to decision-making about pain relief,'' Coombs Lee said.
The activists had found a possible route -- the 1997 California Pain Patients Bill of Rights which allows, in part, the prescription of unlimited amounts of painkillers within the discretionary bounds of ``good medicine.''
In a letter to the group dated June 25, HCFA administrator Nancy-Ann Min DeParle agreed.
``We have concluded that the Patient Self-Determination Act may be interpreted to require Medicare and Medicaid providers in California to inform patients of their right under California state law to request or reject the use of effective pain treatment,'' the letter reads. `
`We think this will have a major impact on end-of-life care of people in California and, potentially, people all over the country,'' Coombs Lee said.
Oregon Sen. Ron Wyden, a Democrat, said the ruling should encourage support for his proposed Conquering Pain Act, which is co-sponsored by Florida Republican Sen. Connie Mack.
``We have a chance to finally bring together those who are for assisted suicide and those who oppose assisted suicide ... in the cause for better pain management,'' he said.
The bill would help increase access to information on pain management, create family support networks and identify barriers to reimbursement for pain medication within the federal-state Medicaid and Medicare programs.
Oregon legalized physician-assisted suicide in October 1997, establishing guidelines that let doctors write lethal prescriptions for patients likely to die within six months.
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