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Medical Marijuana: Legal and Ethical Issues

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The following presents the topic of medical marijuana with related legal and ethical issues.... More...
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Medical Marijuana Legal and Ethical Issues Introduction The following presents the topic of medical marijuana with relatedlegal and ethical issues Ethical codes from different organizations toinclude AMA ACA APA AAMFT and CAMFT are referred to as well as stateand federal laws The discussion begins with a presentation of medicalmarijuana with issues related to its use and concerns Next the legalhistory of medical marijuana and ethical and legal issues related to theuse of medical marijuana are presented with references from ethical codesand laws

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3). .," (p. Journal of Drug Issues, 34(4), 751-77 .Pacula, R. " (p. 2). Ethical Issues Related to Medical Marijuana Use There are several issues related to the use of marijuana to treatpatients for medical conditions. andself-determination" (p. . Competence, 2. (2 2). State medical Marijuana laws: Understanding the laws and their limitations. (2 6). To begin with the physician must providecompetent care and respect human dignity, respect the law and seek tochange requirements that are not in the best interest of the patient,provide appropriate care, and be responsible to improve the community andpublic health (AMA, 2 1). Marijuana is used to treatconditions identified by the IOM and CMA; these include chemotherapy-induced nausea and vomiting, AIDS wasting syndrome, intractable pain, andterminal illness. Issue #4: Imposing Personal Values. (2 5). 3), relates to the need to protect thepatient and guard them from harm. In addition, healthcare providers from alldisciplines must apply related ethical codes when treating a patient usingmarijuana for treatment. APA General Principle E, Respect forPeople's Rights and Dignity, states that psychologists must "respect thedignity and worth of all people, and the rights of individuals to . At this time,studies show that medical marijuana legalization has not led to increaseduse of marijuana in adolescents and young adults. Retrieved October 4, 2 7 from http://www.apa.org/ethics/code2 2.htmlCAMFT (California Association of Marriage and Family Therapists). L., Chriqui, J. ACA Code of Ethics, Section A,The Counseling Relationship, A.11 Termination and Referral, A.4.b. Retrieved October 4, 2 7 from http://www.camft.org/CamftBenefits/whatiscamft_ethnic1.htmlCohen, P. respect for human dignity and rights" (p. The White House Office of National Drug Control Policy formallyrequested research regarding the use of medical marijuana in 1997 (Greene,2 6). Accordingto VII: "a physician shall recognize a responsibility to participate inactivities contributing to the improvement of the community and thebetterment of public health" (p. . Issues related to treating these patients includewhether or not a client should be able to come to individual or grouptreatment while high on marijuana and whether or not the therapist shouldtreat this patient even if not high during treatment. (2 2). . . Physician Ethical Considerations. Cohen reported that the Chinese used marijuanato treat many conditions to include constipation and rheumatism. CAMFT Ethical Standards Part I, 1.Responsibility to Patients, 1.4 (2 2) states, a marriage and familytherapist must "respect the right of patients to make decisions and helpthem to understand the consequences . . Findings showed thatmarijuana use did not increase from 1995 to 1999 but attitudes aboutmarijuana did change. Principle I Responsibility to Clients, 1.8 from the AAMFTCode of Ethics (AAMFT, 2 1) states: "marriage and family therapistsrespect the rights of clients to make decisions and help them to understandthe consequences . .. Thus,the physician must be aware of study findings related to the possiblenegative impacts of legalizing marijuana for medical use. Indeed, it was fearedthat legalizing marijuana would not only increase its use but would leadyouths to the use of other substances. " (p. Other states havesimilar laws and all are subject to interpretation. 5). Sending the wrong message: Did medical marijuana legalized in California change attitudes about and use of marijuana? Indians,Africans, medieval Europeans, and ancient Greeks also used marihuana totreat malaria, dysentery, and fevers. Dispensing medical marijuana: Some Halachic Parameters. . AMA principles of medical ethics. A fourth issue is when a therapist imposestheir own personal values related to the use of marijuana to treat medicalconditions. Atherapist must not provide services that are beyond the boundaries of theircompetence and this may include the treatment of a patient who usesmarijuana to treat a medical condition. Recommendations fromthe Institute of Medicine (IOM) are used. Issuessuch as whether or not the counselor should allow the patient to come totreatment while high on marijuana bring up ethical concerns. AAMFT Code of Ethics. Khatapoush and Hallfors (2 4)conducted a study to examine the effects of Proposition 215 and othersimilar state laws. Thus, state laws began to allow the useof medical marijuana and federal enforcement was remote (Greene, 2 6). The New England Journal of Medicine, 353(21), 2291-6.APA (American Psychological Association). C. The physician must providecompetent care and respect human dignity while ensuring that the patient isnot harmed, as stipulated by AMA Principles of Medical Ethics (AMA, 2 1):I. Marijuana was typicallyprescribed to treat lack of appetite. Welfare of Those Served by Counselors, A.1.a. (2 5). This report also noted that marijuana serves as ananalgesic for those suffering from nausea due to chemotherapy Alzheimer's,muscle spasms, migraine headaches, appetite and weight loss due to AIDS,arthritic pain, and glaucoma. 4Avoiding Harm (APA, 2 2) states: "psychologists take reasonable steps toavoid harming their clients/patients . ACA (2 5) Code of Ethics, Section A, The CounselingRelationship, A.1. Issues ofavoiding patient harm and therapist competence are initial concerns. Marijuana use canbe habit forming and smoking marijuana is subject to the concerns relatedto smoking in general (Greene, 2 6). As this principle relates tothe use of medical marijuana, the physician must determine if marijuana usewould benefit their patient, based on empirical evidence, and seek to makechanges that allow for this treatment while respecting the law. APA Ethical Standards, 2. Attitudes increased toward accepting the use ofmarijuana to treat medical conditions. (Cohen, 2 6). with populations and in areas only within the boundaries oftheir competence, based on their education training, supervised experience,consultation, study, or professional experience" (p. J. Retrieved October 4, 2 7 from http://www.aamft.org/resources/LRMPlan/Ethics/ethicscode2 1.aspACA (American Counseling Association). There are many anecdotal reports ofmedical marijuana being used to treat medical conditions (Cohen, 2 6). . 5).Principle III Professional Competence and Integrity, 3.11 from the AAMFTCode of Ethics (AAMFT, 2 1) states: "marriage and family therapists do notdiagnose, treat, or advise on problems outside the recognized boundaries oftheir competencies" (p. Some promote theability of a physician to discuss the use of marijuana and recommend it asa form of therapy while others support a broader legislation that allowsfor prescription for marijuana. Attitudes and marijuana use among 16 to 25 years oldin California and ten other states were examined. . . J. The Raich Court held that CSA could beenforced by the Drug Enforcement Administration against two people who weregrowing marijuana for medical use according to Proposition 215. . The physician must make the possible risks of marijuana useknown to the patient and allow them to make their own informed decision.According to III: "a physician shall respect the law and also recognize aresponsibility to seek changes in those requirements which are contrary tothe best interests of the patient" (p. Legal History of Medical Marijuana California law provides an example of similar laws in at least nineother states. (2 6). . Healthcare Provider Ethical Concerns. Professional Competence, C.2.a. While federal legislation is notin favor of the legalization of marijuana for medical purposes, Courtrulings have not overturned state laws. Issue #3: Client Rights. Medical Marijuana: Legal and Ethical Issues Introduction The following presents the topic of medical marijuana with relatedlegal and ethical issues. At this time the Institute of Medicine investigated the potentialhealth benefits and risks of medical marijuana and its cannabinoidcompounds. Short-term use of marijuana for patientswith symptoms that are debilitating and not relieved by approvedmedications was recommended with treatment that is administered withmedical supervision and institutional review board guidance. Application of this principle to theuse of medical marijuana includes the notion that the physician must notparticipate in anything that would harm the health of the public. Retrieved October 4, 2 7 from http://www.cirp.org/library/statements/ama/Annas, G. 4). For the first ethical issue related toprotecting patients from harm and guarding the welfare of a client who usesmarijuana to treat medical conditions, there are related ethical codesacross disciplines. . .promote the welfare of clients" (p. 2). Jumping frogs, endangered toads, and California's medical-marijuana law. (2 4). 4). At this point researchfindings support the positive outcomes related to marijuana use to relievesymptoms and note that this use has not resulted in increased marijuana useoverall. " (p. 2). Summary and Conclusions In summary, there are many laws and ethical issues related to the useof marijuana to treat medical conditions. ACA code of ethics. Boundaries ofCompetence states: "Counselors practice only within the boundaries of theircompetence, based on their education, training, supervised experience,state and national professional credentials, and appropriate professionalexperience . Ethical principles of psychologists and code of conduct 2 2. . Physicians in the United States usedmarijuana in the 184 s and marijuana was listed as a recognized drug in theUnited States Pharmacopeoia from 185 to 1942. Human Relations, 3. 1). For example, a counselor may need to deal with a patientsuffering from a disease who is using marijuana to reduce symptoms. States beganto legalize medical marijuana but the United States Supreme Courtdetermined that medical necessity does not justify the use of marijuanaeven thought state laws allow it. The discussion begins with a presentation of medicalmarijuana with issues related to its use and concerns. What is CAMFT. Other organizations only consider lawsthat remove criminal penalties for patients who possess, use, or growmarijuana according to physical recommendation. Issue #2: Competence. and to minimize harm where it isforeseeable and unavoidable" (p. Clients taking oral pill forms of medical marijuanaparticipate in all AOD activities (individual and group counseling) andthose smoking marijuana may participate only in individual sessions; allmust adhere to guidelines (no signs of intoxication). Pacula, Chriqui, Reichmann, and Terry-McElrath (2 2) reported thatwhile federal government formally opposes the use of medical marijuana, theDistrict of Columbia and 26 states have laws that allow the use ofmarijuana to treat medical conditions as of 2 . This law became a focus when people began to grow marijuana fortheir medical purposes. . 1Boundaries of Competence (a)(APA, 2 2) states: "psychologists provideservices . Next, the legalhistory of medical marijuana and ethical and legal issues related to theuse of medical marijuana are presented with references from ethical codesand laws. One of the concerns related to thelegalization of medical marijuana is that this would increase the use ofthis substance and pose a threat to today's youth. A report released by the Institute stated that research mustdetermine the physiological effects of cannabinoids and their therapeuticvalue to relieve pain. A., & Terry-McElrath, Y. Medical Marijuana Marijuana has been used to treat medical conditions since as early as27 B. Thus, state laws varyaccording to the types of provisions they cover, the illnesses and symptomsthey cover, and the source of supply allowed. PrimaryResponsibility: "The primary responsibility of counselors is to . Ethical codes from different organizations, toinclude AMA, ACA, APA, AAMFT, and CAMFT, are referred to as well as stateand federal laws. As this relates to the useof medical marijuana, the physician must respect the rights of the clientand provide them with the option to use all researched solutions to medicalproblems. Medical marijuana, compassionate use, and public policy: Expert opinion or vox populi? The Hastings Center Report, 36(3), 19-22.Greene, W. This law protects physicians,patients, and caregivers who possess or cultivate marijuana for medicinaluse according to physical recommendation, from criminal prosecution (Annas,2 5). California legalized medical marijuana, with California'sCompassionate Use Act (Proposition 215). . "A physician shall be dedicated to providing competent medical care . Ethical standards part I. Retrieved October 4, 2 7 from http://www.counseling.org/Resources/CodeOfEthics/TP/Home/CT2.aspxAMA. APA Ethical Standards, 3. ACA Code of Ethics, Section C, ProfessionalResponsibility, C.2. Professional Competence and Integrity, 3.1 (2 2)states that a marriage and family therapist must "not assess, testdiagnose, treat, or advise on problems beyond the level of their competenceas determined by their education training, and experience. meaningful decisions about theirtherapy" (p. The interpretation anduse of these laws varies among different medical groups. Raich was a woman who used marijuana as a drug andthis resulted in the relief of pain and increased strength which resultedin her being able to walk again. (2 1). Another issue is client rights, which may be violated when atherapist refuses to treat the patient due to their use of marijuana totreat their medical symptoms. Thus, physician use ofmedical marijuana would increase the health of the community if used withcare to avoid negative health risks such as lung disease. When a therapist refuses to treat a patient using marijuanadue to personal bias, this denies the patient their right to treatment. F., Reichmann, D. At thistime the Court did not rule against Proposition 215 or demand that thestate of California bring criminal charges against those using marijuanafor medical relief according to physician recommendations (Cohen, 2 6). . CAMFT EthicalStandards Part I, 3. CAMFT Ethical Standards (2 2) PartI, 1. Despite the possibility that medical marijuana use can alleviate painand treat patients with AIDS or those receiving chemotherapy, there may benegative consequences of legalizing medical marijuana. PersonalValues states: "Counselors are aware of their own values . and avoidimposing values that are inconsistent with counseling goals . This is followed by a summary and conclusions. Each professional must reviewempirical findings and laws and determine their own views on the subject,while guarding the welfare of their client.ReferencesAAMFT (American Association for Marriage and Family Therapy). M. References from Ethical Codes of Conduct Issue #1: Avoid Patient Harm. The question of legal focus was whether federalpower under the Controlled Substance Act of 197 (CSA) was enough tooverride California's laws when plants were grown in the state and no otherstate was involved. . 9). Journal of Public Health Policy, 23(4), 413-439. An example of today's use of marijuana to treat illness is found inthe Lassen County Health and Social Services Policy. Healthcare providers otherthan physicians must deal with patients using marijuana for medicalpurposes. (2 2). The Alcohol and OtherDrug Programs Department (AOD) operates under the Medical Policy of thisorganization. State laws such as Proposition 215in California allow patients to possess, use, and cultivate marijuana formedical purposes if recommended by their physician. 2). Responsibility to Patients (2 2a) and Principle I Responsibility toClients from the AAMFT Code of Ethics (AAMFT, 2 1), states that a marriageand family therapist must "advance the welfare of families andindividuals," (p. 6). (2 1). 5). While ethical codes from the AMA, APA, CAMFT, AAMET, and ACAguide healthcare providers, they do not prevent the treatment of peopleusing marijuana for medical purposes. . Judaism, 55(1/2), 28-38.Khatapoush, S., & Hallfors, D.

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