ST. LOUIS, MissouriUnited 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.]