Opiophobia and Opioignorance Is Interfering with "Human Right" to Pain Control


For more than a decade reason has done considerable reporting on the drug warriors' campaign against pain doctors. In 1997, Jacob Sullum reported the story of David Covillion in "No Relief in Sight". Doctors spooked by Federal drug warriors refused to treat Covillion. He was so desperate that he eventually sought out Jack Kevorkian's help to end his life. Incredibly, it was Kevorkian who referred Covillion to Dr. William Hurwitz who agreed to treat him. But as Sullum reported Virginia pulled Hurwitz's license because he allegedly overprescribed pain meds.

In 2004, Sullum reported in "Trust Busters" that Hurwitz was eventually convicted by federal prosecutors on bogus charges of being "a major and deadly drug dealer."

In June, 2006, reason contributor Maia Szalavitz's article "The Doctor Wasn't Cruel Enough," told the relatively happy story in which one physician, Dr. Paul Heberle was found not guilty of drug running. During his prosecution, Dr. Heberle couldn't treat his patients. Unfortunately, one didn't wait for the verdict--she could no longer endure her pain, so she committed suicide.

In August, 2006, in "The Accidental Drug Trafficker," Jacob Sullum reported that a Federal Appeals Court had overturned Dr. Hurwitz's conviction. While Hurwitz's case was wending its way through the courts, two of his patients committed suicide. Despite Hurwitz's victory, Jacob Sullum argues in "Good Cop. Bad Doctor," that his travails with the drug warriors effectlively spread fear throughout the medical community such that most doctors are afraid to adequately treat pain.

Now the International Analgesia Research Society has published an op/ed in its professional journal arguing:

Pain management as a human right is a moral imperative that will help medicine return to its humanist roots. Acknowledging this right is a crucial step in reversing the public health crisis of under-treated pain… Ironically, despite widespread support for improved pain control, United States physicians are experiencing pressures that may drive them to under-treat pain.

The excellent reason articles cited above outline some of the "pressures." I am generally against the notion of positive human rights--that is "rights" that require that people must involuntarily provide some material benefit to other people. However, the article that accompanies the op/ed in the journal Anesthesia and Analgesia makes a lot of sense when it notes:

Reasons for deficiencies in pain management include cultural, societal, religious, and political attitudes, including acceptance of torture. The biomedical model of disease, focused on pathophysiology rather than quality of life, reinforces entrenched attitudes that marginalize pain management as a priority. Strategies currently applied for improvement include framing pain management as an ethical issue; promoting pain management as a legal right, providing constitutional guarantees and statutory regulations that span negligence law, criminal law, and elder abuse; defining pain management as a fundamental human right, categorizing failure to provide pain management as professional misconduct, and issuing guidelines and standards of practice by professional bodies.

A good first step would be for states and Congress to pass legislation that allows professional medical societies to set standards and guidelines for using pain meds rather than let the DEA make those decisions. Whether or not adequate pain management is a human right, it is certainly right for doctors to relieve the suffering of their patients.

Addendum: Just to be clear: Of course, you should be allowed to put whatever substance you want in your body and to enjoy and/or suffer the consequences thereof.