The Elder Law Forum

The Elder Law Forum By Michael Myers Need pain-control medication?

Become �terminal�

The U.S. justice system is capable of, and often does, dispense injustice. The U.S. healthcare system is capable of, and often does, dispense harm.

Occasionally, they come together to inflict both injustice and harm under circumstances suitable for the category, �But for the grace of God go I.� Such is the case of 46-year-old Richard Pacey, who suffers from multiple sclerosis and chronic pain from an automobile accident two decades ago.

He is presently in a Florida prison, in a wheelchair, serving a mandatory 25-year sentence for forging prescriptions because, �as a matter of principle,� he turned down a plea bargain that would have kept him out of prison. �The problem was getting the medicine from doctors who are afraid of the federal and local crusades against painkillers,� wrote New York Columnist John Tierney in describing Pacey�s plight in an op-ed piece titled �Punishing Pain.�

Pacey, who now receives better pain-control medication in prison than he could obtain on the outside, had tried every kind of non-drug therapy but �still curled up in a ball at night crying from pain,� his wife, an optometrist, testified. In court he found himself pitted against his longtime doctor and former friend who denied that he had given Pacey some of the prescriptions.

Pacey�s story echoes that of a friend of mine whose four-month dying experience I chronicled during weekly, taped interviews. Like Pacey, he described the reluctance of his longtime physician, an internist, to prescribe painkillers sufficient to relieve intractable pain caused by prostate cancer that had metastasized.

It was not until he was diagnosed as �terminal� � death within six months � that he was admitted to a hospice program and given access to the full array of pain-control medications now available to all physicians. He lived eight months, able to exchange pain relief for mental alertness, at his discretion.

But people like Pacey, who are not terminal, are caught between a politicized legal system shackled by mandatory sentencing requirements and licensing laws that force physicians to choose between professional security and patient pain.

Physicians usually choose job security. Prosecuting attorneys usually choose opportunistic law enforcement. And patients? They have the option of becoming terminal and entering a hospice program.

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