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Ashcroft Decision on Opioids Is Blow to End-of-Life Care

Ashcroft Decision on Opioids Is Blow to End-of-Life Care

ST. LOUIS, Missouri—United States Attorney General John Ashcroft
"is putting a spoke in the wheel" of end-of-life care, said Karen
Stanley, RN, MSN, AOCN, FAAN. In a decision designed to prevent the
implementation of Oregon’s Death With Dignity Act (allowing assisted
suicide), Mr. Ashcroft overturned a previous ruling stating that prescribing
opioid pain relievers in accordance with Oregon’s Act would not violate the
federal Controlled Substances Act.

Interferes With Palliative Care

The new decision, Ms. Stanley said, allows the US Drug Enforcement Agency to
question the intent of any physician who prescribes pain medication to a
patient who dies shortly thereafter. This "absolutely interferes with
palliative care," she said.

Ms. Stanley, a consultant on cancer care, pain management, and end-of-life
issues, coordinated the Institute on End-of-Life Care at the Oncology Nursing
Society’s Second Annual Institutes of Learning.

During an interview at the meeting, she said that Mr. Ashcroft’s decision
"is one of the most important issues in end-of-life care. It is setting us
up for less-than-adequate pain management. I hope something can be done."

If the order stands, she said, "I believe pain management across the
board will suffer mightily. It will reinforce those physicians already averse
to using opioids and make those using them more wary. This will be an excuse to
prescribe less-than-effective analgesia."

[Editor's Note: A federal judge has blocked the attorney general’s order until a
hearing scheduled for March 2002.]

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