The Medical Freedom Channel

During my just-completed sojourn in the Northeast, I let this space remain unchanged. I apologize if this concerned anyone, although I did in all fairness continue to post fresh news and commentary most of the days during my “working vacation,” and saw no negative comments in the interim. Anyway, herewith, an effort to remedy all that:

In the last week, there were two major stories affecting healthcare issues, both involving government agencies. One was splashed over the pages and websites of just about every news-gathering organization in the country; the other got far less ink, but might end up having far more effect on our lives in the long run. We all heard about the Food & Drug Administration’s decision to approve limited over-the-counter availability of the so-called “morning-after pill” (Plan B) for emergency contraceptive measures. Not so widely known was the appeals court decision that freed pain-specialist Dr. William Hurwitz, ruling that the Drug Enforcement Administration could not assume criminal intent in a physician prescribing medication to alleviate pain.

As for the Plan B story, let’s begin by celebrating the fact that a woman in America, caught between risking conception – from a rape, failed condom or even sudden impulse – and contemplating abortion a month later, can now add the extra precaution of the “morning-after pill” to her arsenal. Thanks to the FDA decision, long-delayed by politics as it was, starting in January, any woman over the age of 18 will be able to legally purchase the Plan B regimen from her local pharmacy, although it will be another of those “behind the counter” things, like Sudafed and other things deemed “legal but controllable” by various government bureaucrats. (At this point we don’t know how the “pharmacist’s rights movement” will respond, but a woman seeking to “be prepared” might do well to consider a little window-shopping beforehand.)

The bottom line is this: No longer will adult women in this country be treated as mere “breed cattle” by the law enforcement wings of the federal bureaucracy. Nevertheless, there is a downside to the recent ruling: women under 18 (still defined as “children” by our legal and social system) will NOT be able to obtain these pills, unless a physician (presumably with the consent of a parent?) chooses to prescribe them.

The damper placed on all uses of Plan B by this restriction is obvious, since it appears to question the safety of the pills, which would be at least an appropriate concern for an agency established to ensure quality and effectiveness. The actual cause is more about knee-jerking from the conservative anti-sex patrols, who claim that providing this fallback to teenagers would “encourage promiscuity,” rather than providing an emergency measure immediately after such an indiscretion, before it became an issue of “aborting a fetus.”

On top of this, there’s the larger issue, which is clearly political: This reversal of a previous adamant decision by the acting head of FDA, one Andrew C. von Eschenbach, might now grease the wheels for his confirmation as actual FDA Commissioner by the Senate. Critics of the nomination have long held that Mr. von E has had far too many ties with the Big Pharmaceutical oligarchs, and would be a disaster if he were to consolidate his power-base with the official title.

However, once the baggage is set aside, the Plan B ruling must be seen in itself as a positive step toward promoting self-responsible sexuality, and for empowering women in making their own choices, long before the issue of abortion becomes a factor. True advocates of the “right to life” – that is, those who are sincerely concerned about ending the “murder of human beings” – should applaud this decision, as one more step in making abortions “rare, safe and a last resort.” As any physician can tell you, Plan B does not “kill” a fertilized egg, but merely helps to prevent it from implanting in a woman’s uterus; if the egg has already implanted, no number of Plan B pills can stop the process.

The other story, regarding the overturning of Dr. Hurwitz’s conviction, could have far wider implications. A three-judge panel representing the federal Court of Appeals for the Fourth Circuit reversed the doctor’s prior sentencing (25 years in prison for 50 counts of criminal “drug distribution”) for having prescribed opiate pain medication to at least one DEA agent posing as someone in chronic pain. According to reports, the court said the trial court had “inappropriately instructed the jury not to consider Dr. Hurwitz’s defense of acting in good faith.”

As noted in a story by the Drug Policy Alliance, which had participated in the appeal by filing its own amicus brief, the decision was significant well beyond the specific Hurwitz case, since “if his appeal had failed, the precedent would have negatively impacted the care chronic pain patients receive nationwide, and encouraged federal prosecutors to usurp the traditional roles of state medical boards in determining and enforcing standards of medical practice.”

http://www.drugpolicy.org/news/082406hurwitz.cfm

As the DPA’s release concludes, “Dr. Hurwitz and his patients are among the mounting casualties of the federal government’s war against pain patients in need of opioid analgesics and the physicians who provide these medications. As the Drug Enforcement Administration expands prosecution of pain doctors, growing numbers of doctors are dissuaded from providing effective treatment to patients suffering severe pain. They fear a criminal investigation into their prescription practices that could take place despite their beneficent medical intentions.”

The importance of this cannot be overemphasized. When people are truly in pain, whether acute or chronic, the first consideration must be alleviating that agony, so that their bodies may resume their own healing processes (or in extreme and allegedly “incurable” situations, those persons may endure and persevere with at least some measure of comfort). Allowing the DEA, or any other bunch of bureaucratic thugs, to make the decision about what is and is not “sufficient relief” has resulted only in halfway measures, restrictions on pain specialists in how much they can assist their patients, and the constant spectre of Big Brother overseeing every prescription. It is just possible that this ruling might begin to reverse this trend, and eventually restore the doctor-patient relationship that seeks to ease and/or eliminate pain in these long-term chronic sufferers.

And at some time down the road, we might even see the day when the DEA and its jackboot tyranny over what we wish to put into our own bodies, to alter or ameliorate our own physical or emotional conditions … ain’t nobody’s business but our own!