Painful Lessons

With the U.S. Supreme Court considering whether terminal patients have a constitutional right to physician-assisted suicide, the American Medical Association remains firmly opposed to the idea. But in December the AMA announced an educational campaign, including national, regional, and local training conferences, aimed at reducing the demand for such extreme measures. Among other things, the conferences will urge doctors to make sure they do all they can to relieve their patients' pain.

That injunction might seem commonsensical–it is, after all, part of the Hippocratic oath–but physicians are often reluctant to prescribe adequate amounts of narcotic painkillers. "Opiophobia" results from unreasonable fears about addiction and not-so-unreasonable fears about attracting attention from state regulators or the Drug Enforcement Administration. (See "No Relief in Sight," January.)

"Many physicians don't understand that not only does a patient have the right to refuse life- sustaining treatment, but he also has the right to receive high doses of morphine to control his pain," Dr. Judith Ahronheim, deputy executive director of Choice in Dying, told the Chicago Tribune. "Because these doctors were not trained well in medical school, they really need help now."