Rated NC-17: Why Voluntary Euthanasia of Children is Dead Wrong

by Dr. Patricia Mayer, Bioethics Program Alumna (2009)

Belgium just became the first country in the world to extend the option of voluntary euthanasia to children under the age of 12.  Voluntary euthanasia of adults has been legal in that country since 2002, but the Belgian parliament has now decided to remove age restrictions from the current law.

This decision raises both ethical and medical questions.  For a patient to qualify, the current law in Belgium requires the patient to make the request, be in unbearable pain, be assessed by two doctors and a psychiatrist or psychologist, and have consent from their legal representative (usually the parents in cases involving children).

Medically, the phrase “unbearable pain” makes little sense in this context.  Physical pain can be controlled with current medical therapy.  It is true that sedation to unconsciousness might be required to achieve complete pain relief in rare cases, but it is not true that physical suffering cannot be controlled. From a physical standpoint, the phrase “unbearable pain” is ambiguous and inapplicable.

Unbearable mental pain or suffering is different, and palliative care cannot guarantee relief from that kind of suffering in all cases. However, the determination that a patient is experiencing unbearable mental suffering must be made by a patient with decision-making capacity. As a society, however, we do not believe children, particularly those under the age of 12 have complete decision making-capacity. Their brains are not developed enough, nor do they have the life experience to always make rational choices.

This underdeveloped decision-making capacity is why we have laws stipulating how old children must be before they can engage in certain tasks or consent to specific acts, such as driving, drinking, voting, and serving in the military.  We rate movies to prevent children from attending those that we deem inappropriate because of extreme violence or sexual content.  We have statutory rape laws under which a child cannot legally consent to sexual intercourse under any circumstances (except marriage) until a specified age is reached.   We also do not allow children the right of refusal; they cannot refuse to be vaccinated, to go to school, to live with parents or guardians, or to accept needed medical treatment except in rare situations..

These laws exist because we believe underage children are not capable of making decisions of great magnitude, or decisions that might later prove harmful to them.  They are not capable of making autonomous decisions the way adults are, so we limit the autonomy of children in all kinds of ways.  Thus it makes little sense to allow a child, who cannot even choose what movie to watch, to request death.

This does not mean that we should not listen to children.  The terminally ill child who has “had enough” should certainly be involved in decisions to forgo further aggressive or life-prolonging treatments.  Such a request should be carefully considered and a decision reached in conjunction with loved ones and the medical team.  Terminally ill children, like all terminally ill persons, should have access to effective palliative care.

Grandma got it right: Johnny doesn’t (always) know what’s best.  Killing him at his request, no matter how ill he is, is surely not the right course of action.

[The contents of this blog are solely the responsibility of the author and do not represent the views of the Bioethics Program or Union Graduate College.]

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Forgiving Fred Phelps

by Sean Philpott, Director of the Center for Bioethics and Clinical Leadership

Fred Phelps, one of the most reviled men in the United States, died last week. Mr. Phelps was the founder of the Westboro Baptist Church, a virulently homophobic organization known for its “God Hates Fags” slogan.

Members of the Westboro Baptist Church have been conducting anti-gay protests since 1991, but the group gained national prominence in 1998 when it picketed the funeral of Matthew Shepard. As most people know, Mr. Shepard was a young man from Wyoming who was robbed and beaten to death by two men who targeted him because he was gay. His murder and the subsequent trial of his assailants, dramatized in the award-winning play The Laramie Project, helped to raise public consciousness about anti-gay bullying and hate crimes against sexual minorities.

The Westboro Baptist Church now conducts an average of six or more protests a day. Church members routinely picket the funerals of other gay men, particularly those who were the victims of hate crimes or who died of HIV/AIDS. They also protest at performances of The Laramie Project, at concerts given by musicians deemed to be LGBT-friendly, at Jewish and Muslim religious services, and even at the funerals of soldiers killed in Iraq or Afghanistan. Those wars, Church members believe, are divine punishment for “[our] evil nation for abandoning all moral imperatives that are worth a dime.”

Despite the fact that Mr. Phelps and his followers believe that my husband and I are directly responsible for all of the ill fortune that befalls Americans, I do not celebrate his death. While I am not going to mourn the passing of a hate-filled man such as Fred Phelps, I’m not going to take perverse happiness in it either. In fact, I find it sad that he left this world without a chance to find peace, love, redemption and forgiveness.

Many of my friends and family find this a bit shocking. When I posted this sentiment on Facebook, for example, one colleague commented that she’d have a hard time finding forgiveness for a guy who, by picketing the funerals of combat soldiers, put grieving families through so much additional pain.

I see it quite differently. People like Fred Phelps are exactly the ones that need our forgiveness. Moreover, forgiving those who have hurt us — particularly those who have done nothing to deserve forgiveness — gives us great power and strength. This is a lesson that I learned several years ago after having lunch with a remarkable woman named Eva Mozes Kor.

Ms. Kor is a Holocaust survivor. At the age of 6, Romania-born Eva and the other members of her family were sent to the infamous Auschwitz concentration camp. While there, Eva and her twin sister Miriam were the subjects of horrific medical experiments by Dr. Josef Mengele. Despite this, they both survived and were liberated by Allied forces near the end of the war. Eva eventually emigrated to the US while her sister moved to Israel. Together, they founded an organization called CANDLES (Children of Auschwitz Nazi Deadly Lab Experiments Survivors), through which they began to locate other survivors of Dr. Mengele’s research and to publicize the experiences of Holocaust survivors.

But Ms. Kor also did something completely unexpected and extremely controversial. Fifty years after the liberation of Auschwitz, on the very site where so many died, Eva announced publicly that she forgave the Nazi’s for what they had done to her. She didn’t deny that inhumane atrocities had occurred in the camps, nor did she believe that these crimes should be forgotten. She simply forgave those that had wronged her, freeing herself from decades of victimhood and suffering.

Hearing this story from Ms. Kor inspired me to do the same in my life. I forgave a former employer for a myriad of wrongs, letting go of my anger while still embracing the management lessons that I learned. I even forgave my former stepfather for a decade of mental and physical abuse, recognizing that my own compassion is a direct response to his lack of caring and concern.

I believe that Fred Phelps deserves the same. In fact, we should even thank Mr. Phelps and his followers for their hate-filled rhetoric. By taking the same rhetoric and opinions spouted by many ‘good Christians’ to the extreme — through slogans like “God Hates Fags” and “Thank God for Dead Soldiers” — the Westboro Baptist Church showed just how pervasive and perverse homophobic attitudes are. It’s even possible that many of the recent advances in gay rights wouldn’t have been achieved without Fred.

Thank you, Mr. Phelps, for being a role model for kind and caring people around the world. You and the others like you teach us what we should strive not to be. I only hope that you find the love and compassion in the next life that you so sorely lacked in this one.

[This blog entry was originally presented as an oral commentary on Northeast Public Radio on March 27, 2014. It is also available on the WAMC website. Its contents are solely the responsibility of the author alone and do not represent the views of the Bioethics Program or Union Graduate College.]

16 and Pregnant: The Tragic Case of Rennie Gibbs

by Jacob Dahlke, Bioethics Program Alum (MSBioethics 2012)

Rennie Gibbs was 15 years old when she found out she was pregnant. In late 2006, then 16 and pregnant 36 weeks, she was admitted to a hospital in Lowndes County, MS, diagnosed with fetal demise and induced to gave birth to a stillborn baby named Samiya. A urine test detected marijuana and cocaine in Ms. Gibbs’ system upon admission. An autopsy revealed that Samiya’s death was most likely due to the umbilical cord wrapping around Samiya’s neck, causing blood supply to be cut off. But that interpretation of the autopsy report is not what was given days after Samiya’s death, when Samiya’s death was ruled a homicide and Ms. Gibbs was subsequently indicted for murder. The claim was that, because Rennie had smoked crack during her pregnancy, she had caused the death of her baby. Under Mississippi statute, that constitutes murder if one’s acts are “eminently dangerous to others and evincing a depraved heart, regardless of human life, although without any premeditated design to effect the death of any particular individual”. A judge is expected to rule later this week as to whether the case will continue or be dismissed.

On its face, the legal perspective would seem laughable were it not real. The case highlights the problems of Mississippi’s medical examinations and the ‘medical examiner’, Steven Hayne.  I use quotations because of Hayne’s reputation for being, well, spectacularly corrupt. For example,

       “Here’s how it works: Each county in Mississippi elects a coroner to take the lead in conducting
       death investigations. The job requires no prior training, medical or otherwise – only a high
       school degree. If a death appears to have been caused by criminal activity, the coroner will
       consult with the local district attorney. Between the two of them, they’ll then refer the body to a
       private medical examiner for an autopsy. If a crime did occur, that medical examiner will likely
       then be asked to testify at trial. The system … encourages prosecutors and coroners to send
       bodies and the fees that come with them to medical examiners they trust … it undermines the
       notion of an adversarial criminal justice system. Medical examiners who have a financial 
       incentive to keep prosecutors and coroners happy end up testifying against indigent 
       defendants who can’t afford to hire their own experts to review the state expert’s work. At the
       center of all of this is a Rankin medical examiner Dr. Steven Hayne, the man who over the last
       20 years has come to dominate Mississippi’s autopsy business.” (emphasis mine)

(Much more on Hayne has been excellently written by Radley Balko; it is interestingly infuriating, but you may wish to shower after. Mississippi seems to have improved since severing ties with Hayne in 2008 and contracting services out to a company from Tennessee).

Perhaps more interestingly, Ms. Gibbs’ attorneys appear poised to challenge the medical evidence associating prenatal cocaine use with fetal harm, which may further bolster their case. Researcher Deborah A. Frank’s affadavit indicates there is “no consistent association between cocaine use during pregnancy and serious fetal harms; … no convincing evidence that prenatal cocaine exposure is more strongly associated … than exposure to… tobacco and alcohol”. Their argument: there simply is no causal connection between the drugs in in Ms. Gibbs’ system and the Sayima’s death. Besides that, there were only trace amounts of a derivative of cocaine, which is a significant departure from the “cocaine toxicity” indicated by Hayne in the autopsy report.

But I am less interested in the legal perspective of the case than I am about the ethical ones. For example, what if anything does this case say about reproductive rights in Mississippi?

It may be relevant to consider Ms. Gibbs’ actions from one of two perspectives. First, what if Ms. Gibbs did not want to have a baby? Second, what if she did want to have the baby? This puts her case into a sort of discussion about abortion rights, and focuses on her actions as a function of her intent. While intent does not seem to matter in terms of Mississippi law, it can matter ethically.

Let’s consider first if Ms. Gibbs did not want to continue her pregnancy. As a teen, consideration is often given to parents’ wishes for their children. Children do not yet have the capacity to make decisions for themselves and we thus seek the decision from parents. This autonomy is something that emerges over time, congruous with a person’s development to adulthood when decisions can be made independently and autonomously. As children begin to demonstrate this ability to consider their own decisions and their impact, the decision-making process moves from assent (parents consenting, and the child agreeing) to consent (child consenting). Ms. Gibbs was at that threshold when this transition typically occurs, meaning she would likely have had the ability to make the decision about her pregnancy autonomously.

If we are to assume that Ms. Gibbs did not want to continue the pregnancy, but could not get an abortion, then her options may have been further limited. Could Ms. Gibbs’ drug use constitute actions taken to terminate the pregnancy on her own? It would be difficult for anyone to legally prove her intent, but from an ethical perspective it matters. If she were trying to terminate the pregnancy on her own by using or abusing drugs, then her situation could be considered similar to an abortion. This is at least plausible, since abortion would have been rather difficult for Ms. Gibbs at the time. Lowndes County sits on the eastern border with Alabama, about 120 miles west of Birmingham. The closest clinic is in Tuscaloosa, AL, 60 miles away. While they appear to address the needs of MS women, the mere fact of having to cross state lines to get an abortion may be a barrier. There is exactly one clinic that provides abortion in Mississippi, 150 miles away in Jackson. It seems to face consistent pressure and scrutiny to even keep its doors open. Her age would have been a barrier, though; in Mississippi consent is required by both parents, with exceptions for judicial permission or medical emergency (threatening the life of the mother). If she were attempting to abort the fetus in the absence of professional assistance, it would likely be ethically justified, although not recommended. The risk of harms would be much greater than a clinically assisted abortion – both to Ms. Gibbs and to a potential baby that essentially survives an abortion attempt with likely significant health problems. But justified still, since Ms. Gibbs could evaluate the benefits and harms of continuing the pregnancy versus ending it in this way. Autonomy allows a person to make choices that appear unwise and even sometimes unsafe based on this evaluation of benefits and harms.

Perhaps it is wrong to construct a narrative around Ms. Gibbs’ actions that indicates her desire to end the pregnancy. Perhaps she did indeed wish to have the baby, meaning that her actions tell a different story. For an autonomous individual (if we presume she is) to make decisions that definitively add risk to a situation, there are a couple of likely reasons. The first and most likely is a lack of understanding that the specified action (drug use during pregnancy) can cause harms. In this regard, there could be a entire volume of reasons for why Ms. Gibbs was not educated on these matters, none of which matter except for noting that they exist. The second reason that may have compelled Ms. Gibbs to her actions is also likely, in my opinion: She was a teenager, and teenagers (in addition to gaining autonomous capabilities) tend to test the limits imposed on them, and this can often be expressed in using various drugs. Even if there was some correlation between her drug use and her stillborn baby (remember, there is not), it is difficult to see how charging a teenager with murder would improve anything, except as perhaps some ‘cautionary tale’ to warn other teens not to do drugs or get pregnant. Except that doesn’t work.

I cannot say that a better health care system, or better schools that teach responsible sexuality, or better access to abortion, or any other broad factor could have avoided this scenario. But I do envision a situation in which we do have all of those things, and I imagine if this would then be a ‘cautionary tale’ for others. Instead, in reality, I fear that it represents ‘more of the same’.

[This blog entry was originally posted in a slightly different form on Mr. Dahlke’s blog on March 19, 2014. Its contents are solely the responsibility of the author alone and do not represent the views of the Bioethics Program or Union Graduate College.]

I Heard It Through the Grapevine: Ethical and Legal Considerations of HIV Disclosure

by Jacob Dahlke, Bioethics Program Alum (MSBioethics 2012)

Nebraska’s highest court ruled last week that an Omaha-area woman can pursue her lawsuit against a local clinic that she alleges disclosed her HIV-positive diagnosis. The case began in 2010, with the plaintiff, known only as C.E., visiting a diagnostic lab in Omaha as a part of a health insurance application. After sending the results to another lab, C.E.’s lab results arrived to her local physician’s clinic, Prairie Fields in Fremont, 30 miles NW of Omaha. C.E. was told at her consultation in the fall of 2010 of her positive diagnosis for HIV. She had initially asked for her results from an employee and former high school classmate Kristy Stout-Kreikemeyer, who appeared to see the results but deferred the actual disclosure to C.E. to a staff physician assistant. C.E. was told the test was inconclusive, and she agreed to take another test. Barely more than 24 hours later C.E. was contacted by an ex-boyfriend, Jonathan Karr, to ask about how she was, having heard from another mutual acquaintance, Jamie Goertz, that she had “full blown AIDS”. It is alleged by C.E. that Kristy Stout-Kreikemeyer told Jamie Goertz about the diagnosis, and that Prairie Fields is also responsible for this violation of her privacy.

While the details of the case may seem to read like a sort of tabloid story, the ethical issues remain real. What are the public health implications of disclosing vs. keeping private STI diagnoses, including HIV? What are medical facilities’ obligations regarding such disclosures? Does the public have a right to know such private details about individuals? How does the size or intimacy of the community change the issue, or should that be irrelevant?

Let’s begin with some lingering unknown factors. First, it remains unknown C.E.’s actual HIV status, and I would anticipate it will remain unknown to the general public, even through the course of her future trial. While her initial screen was positive, it was recommended by the clinic that she have another, more definitive test performed in order to rule out false-positive screen. According to the CDC, “(f)urther testing is always required to confirm a reactive (preliminary positive) screening test result.” While the court paper refers to only an initial ‘blood test’, it would remain possible that the test would provide a false-positive result, meaning that the test indicated the presence of HIV antibodies when there were none. This would have been why the PA at Prairie Fields wanted C.E. to return for a follow up, more definitive test.

What does this have to do with privacy and public safety? The first is that C.E. was not diagnosed with having HIV; she only screened positive for it. Not until C.E. undergoes (underwent) the second test and is positive there, would she be considered HIV-positive. This may matter for C.E. from a legal standpoint because her lawsuit may include some claims to libel, in which the defendants publicly slandered her, saying she has a disease that she doesn’t. From a public perspective, the only reporting that is to be done is to the appropriate health departments. This was appropriately not yet done by the clinic, since a confirmed positive diagnosis was not present. The purpose in reporting to health departments is tri-fold: 1) it can aid the patients who may need treatment by connecting them to local resources and by providing local context to their disease; 2) it helps to identify and support sex partners who may not yet be infected, or partners who are at risk of infection, or partners who may be infected but who do not yet know; and 3) it can help to track disease patterns and trends, thus ensuring that appropriate resources are being devoted. It is done confidentially to ensure that a patient maintains control (autonomy) over their own healthcare decisions, including the circumstances (who, what, when, where, why, how) of telling others.

It is perhaps obvious to say that a case like this can lead to a loss of trust between patient and physician in a community. Confidentiality is a benchmark of quality healthcare. Patients are ill, concerned, and otherwise vulnerable; healthcare providers are there to have intimate and personal conversations with patients that are often not discussed with even the most privileged of the patients’ inner circle of friends and family. In the event that C.E. had a negative confirmatory test for HIV, it should have been up to her to share her ‘close call’ with whomever, including no one. Likewise, were she to test positive, the ability to at least control the context of her telling her sexual partners ought to have been hers. But that did not happen, due to someone’s (alleged) violation of her privacy.

Instead, what transpired highlights why confidentiality in healthcare is so important. C.E. was instead left to defend herself against her community, which appears to quite closely knit and connected to each other for long periods of time. What should have been a conversation between C.E. and her physician was instead being talked about at a local bar, which led eventually to her ex-boyfriend (and father to one of C.E.’s children) asking her about it. Breach of confidentiality is obviously not a problem that exists only in rural or small communities, but in this case it sure seems like it was exacerbated by it.

[This blog entry was originally posted on Mr. Dahlke’s blog on March 18, 2014. Its contents are solely the responsibility of the author alone and do not represent the views of the Bioethics Program or Union Graduate College.]

Barbie’s Dream Body

by Theresa Spranger, Bioethics Program Alumna (MSBioethics 2012)

When you were a kid did you ever want to look like Barbie?  No?  Me neither…her breasts were too big and her waist too small.  I always figured she would break in half in real life, or at least have chronic back pain.

Blondie Bennett though, has always dreamed of becoming a real life Barbie doll.  She says that she was obsessed with Barbie as a kid and has modeled her life after the doll. Blondie-Bennett-poses-for-a-photograph-in-Los-Angeles-3161482

Now 38, she has had five breast enhancement surgeries and at this point makes Dolly Parton look “natural”.  She also has regular Botox injections and lip fillers to make her appear plastic and doll like.  Believing that “natural is boring,” she has gone to extremes to make herself into a living doll.

The most extreme of her actions is to participate in hypnotherapy sessions multiple times a week.  The goal of this hypnotherapy is to lower her IQ.  Her ultimate desire is not only to resemble Barbie in looks, but also to become brainless like the doll as well.  To hear Blondie in her own words, please watch this video.

In my humble opinion, it appears that this desire to become Barbie even to the point of brainlessness masks a deep psychological pain in this woman.  To purposefully work to forget your life and become ignorant of the world seems to me a red flag to deeper issues.

However, we aren’t here to judge or fix this woman.  I chose to write about her story for two reasons: 1, I found it fascinating and 2, I think it is an interesting way to highlight an important issue in our country.  The current trend in laws and policies makes us increasingly financially responsible for and beholden to one another.

Take the healthcare law for instance.  With health insurance being subsidized by tax payers, we have a financial interest in our fellow citizens staying healthy.  Right now Blondie’s rent is paid by a “special guy” and some of her procedures funded by other gentlemen in her life.  I presume that one day, as she ages, these gravy trains will cease to run.  Where then will her money come from?  What if she suffers back problems from the weight of her super enhanced bosom?  What if her treatments to become brainless work so well that she is unable to enter the workforce or even care for herself because of her forgetfulness?  Since she chose to put herself in that position, should American tax payers foot the bill for her future care?

If the answer is yes, doesn’t that give us a vested interest in her behavior now?  We see this idea play out in campaigns against: smoking, drinking in excess, eating junk food, not exercising, using recreational drugs, etc.  I am not saying that we should encourage these behaviors by any means, but since we are now financially tied together through healthcare, whether or not people stop the high risk behavior has a direct effect on the wallet of every tax payer.

Blondie Bennett may have a contingency plan for her future and continue to live a self-sufficient life.  However, her eccentric life choices are an interesting case study for how involved we should be in the choices of others when the future cost of those choices could fall on our shoulders.  Whether or not you agree with the changing healthcare system it will inevitably lead to new discussions and decisions regarding healthcare rationing as it relates to risky health behaviors.

Mulling over interesting and quirky stories like this one, could give us good practice for the deeper and more complicated questions we are sure to face in the future.

[This blog entry was originally posted in a slightly edited form on Ms. Spranger’s blog on March 18, 2014. Its contents are solely the responsibility of the author alone and do not represent the views of the Bioethics Program or Union Graduate College.]

Reefer Madness: Why US Federal Policies on Medical Marijuana Don’t Make Sense

by Sean Philpott, Director of the Center for Bioethics and Clinical Leadership

While I was on the phone with a colleague from Denver last week, our conversation turned inevitably to the topic of marijuana. Colorado legalized recreational use of the drug via popular referendum in 2012, creating the world’s first fully regulated marijuana market. The first commercial sales occurred this past January, with $15 million in sales reported in the first month alone.

Despite this, my friend patiently explained, the “Mile High City” isn’t full of mile-high residents. Tight regulation of the market and increased spending on anti-drug messages, coupled with the drug-testing policies of private employers, makes it unlikely that most Coloradans will be ‘passing the dutchie ‘anytime soon.

While I don’t smoke marijuana I do support the decriminalization of its recreational use. However, I suspect that few states will be following the lead of Colorado and Washington State anytime soon. More likely is the continued legalization of marijuana for medical use. Twenty states and the District of Columbia have laws that allow this. Fifteen other states are considering such legislation, including New York.

The Empire State is the only one in the Northeast without a medical marijuana law, but that may change soon. Governor Cuomo recently proposed reviving a defunct 1980 law — the Controlled Substances Therapeutic Research Act — that would allow marijuana’s limited use. Under the proposed plan, the New York State Department of Health would oversee a program in which 20 hospitals will be allowed to prescribe marijuana as part of a pilot project to look at the drug as a treatment for life-threatening conditions like Dravet syndrome.

I find the Governor’s proposal somewhat stupid. Legal and logistical problems aside, this limited program would add little to existing research on the safety and effectiveness of marijuana as a medical treatment.  But at least it’s a step in the right direction. If only the federal government were so open minded.

Not only has the US federal government not passed a medical marijuana law, it still actively prosecutes those who grow, distribute or smoke marijuana. In 2013, for example, the US Department of Justice spent over $300 million investigating, arresting and prosecuting medical marijuana distributors.

Currently, the federal government regulates marijuana under the Controlled Substances Act of 1970. Drugs that fall under that Act are classified into one of five categories based on their potential for abuse and medicinal value. Marijuana is considered a Schedule 1 drug, the most dangerous and restrictive classification that exists. According to the US Drug Enforcement Agency (DEA), which enforces the Controlled Substances Act, marijuana has a high potential for abuse and no accepted medical use.

By contrast, the DEA considers cocaine to be a Schedule 2 drug. It is highly addictive, but it has been used as a topical anesthetic (particularly in the treatment of certain cancers). The prescription painkiller Oxycontin, which accounts for almost half of all drug overdose deaths in the United States, is also a Schedule 2 drug. Ketamine, an anesthetic that is also a commonly used ‘date rape’ drug, is a Schedule 3 drug. Alcohol and tobacco — two highly addictive and widely abused drugs with no known medicinal benefit — are not included in the DEA’s schedules of controlled substances.

This doesn’t make sense. Marijuana shouldn’t be a Schedule 1 controlled substance. Consider the issue of addiction and abuse. One of the arguments against the legalization of marijuana — either for medical purposes or for recreational use — is that it is a so-called gateway drug. Opponents of legalization argue that people who smoke marijuana are more likely to abuse cocaine, heroin, or other illicit drugs.

That is not true. Decades of research into the addictive properties of marijuana have found scant evidence that the drug is more likely to be abused than a drug like Xanax. We’ve known this fact for years. A 1944 study conducted by the US National Academy of Science found no evidence that marijuana was physiologically addictive. While more recent studies suggest that some users can be psychologically hooked on its use, the risks of mental addiction to marijuana are far lower than for other commonly used prescription drugs.

Questions of addiction aside, more troubling is the DEA’s characterization of marijuana as a drug with no medicinal properties. That is patently false. Prior World War 2, in fact, marijuana was routinely prescribed in the US as a treatment for neuropathic pain. Moreover, hundreds of studies have demonstrated the benefits of the drug for treatment of pain and nausea in cancer and AIDS patients. The drug also helps control epileptic seizures and delays loss of vision in patients with glaucoma.

There are still some concerns about the long-term health effects of using marijuana — particularly since the smoke also contains a variety of carcinogenic compounds — but for people facing life-threatening or debilitating illness those risks are well worth the relief that marijuana provides.

It’s time to change the federal approach to medical marijuana. There’s no reason why marijuana is Schedule 1 controlled substance or why federal agents routinely shut down dispensaries that sell the drug to patients.

[This blog entry was originally presented as an oral commentary on Northeast Public Radio on March 13, 2014. It is also available on the WAMC website. Its contents are solely the responsibility of the author alone and do not represent the views of the Bioethics Program or Union Graduate College.]