Report Title:

Pain Patient's Bill of Rights

Description:

Gives rights to pain patients. Authorizes doctors to prescribe medically necessary dose of controlled substance to treat intractable pain. Protects doctor from disciplinary action. Allows refusal to so prescribe but requires informing patient of other doctors who use opiates to treat chronic intractable pain.

HOUSE OF REPRESENTATIVES

H.B. NO.

1839

TWENTY-SECOND LEGISLATURE, 2004

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to pain patient's bill of rights.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:

"Chapter   

pain patient's bill of rights

§   -A Pain patient's bill of rights; findings. The legislature finds that:

(1) The State has a right and duty to control the illegal use of opiate drugs;

(2) Inadequate treatment of acute and chronic pain originating from cancer or noncancerous conditions is a significant health problem;

(3) For some patients, pain management is the single most important treatment a physician can provide;

(4) A patient suffering from severe chronic intractable pain should have access to proper treatment of pain;

(5) Due to the complexity of their problems, many patients suffering from severe chronic intractable pain may require referral to a physician with expertise in the treatment of severe chronic intractable pain. In some cases, severe chronic intractable pain is best treated by a team of clinicians in order to address the associated physical, psychological, social, and vocational issues;

(6) In the hands of knowledgeable, ethical, and experienced pain management practitioners, opiates administered for severe acute and severe chronic intractable pain can be safe; and

(7) Opiates can be an accepted treatment for patients in severe chronic intractable pain who have not obtained relief from any other means of treatment.

§   -B Bill of rights. This section shall be known as the pain patient's bill of rights. For the purposes of this section, "intractable pain" means a pain state in which the cause of the pain cannot be removed or otherwise treated and for which, in the generally accepted course of medical practice, no relief or cure of the cause of the pain is possible or none has been found after reasonable efforts, including but not limited to evaluation by the attending physician and one or more physicians specializing in the treatment of the area, system, or organ of the body perceived as the source of the pain.

(1) A patient suffering from severe chronic intractable pain has the option to request or reject the use of any or all modalities in order to relieve severe chronic intractable pain;

(2) A patient who suffers from severe chronic intractable pain has the option to choose opiate medications to relieve severe chronic intractable pain without first having to submit to an invasive medical procedure, which is defined as surgery, destruction of a nerve or other body tissue by manipulation, or the implantation of a drug delivery system or device;

(3) The patient's physician may refuse to prescribe opiate medication for the patient who requests a treatment for severe chronic intractable pain. However, that physician shall inform the patient of physicians who specialize in the treatment of severe chronic intractable pain employing methods that include the use of opiates;

(4) A physician who uses opiate therapy to relieve severe chronic intractable pain may prescribe a dosage deemed medically necessary to relieve severe chronic intractable pain;

(5) A patient may voluntarily request that the patient's physician provide an identifying notice of the prescription for purposes of emergency treatment or law enforcement identification; and

(6) Nothing in this section shall be construed to:

(A) Expand the authorized scope of practice of any licensed physician;

(B) Limit any reporting or disciplinary provisions applicable to licensed physicians and surgeons who violate prescribing practices; and

(C) Prohibit the discipline or prosecution of a licensed physician for:

(i) Failing to maintain complete, accurate, and current records documenting the physical examination and medical history of a patient, the basis for the clinical diagnosis of a patient, and the treatment plan for a patient;

(ii) Writing false or fictitious prescriptions for controlled substances scheduled in the Federal Comprehensive Drug Abuse Prevention and Control Act of 1970, 21 U.S.C. 801 et seq. or in chapter 329, Hawaii Revised Statutes;

(iii) Prescribing, administering, or dispensing pharmaceuticals in violation of the provisions of the Federal Comprehensive Drug Abuse Prevention and Control Act of 1970, 21 U.S.C. 801 et seq. or of chapter 329, Hawaii Revised Statutes;

(iv) Diverting medications prescribed for a patient to the licensed physician's own personal use; and

(v) Causing, or assisting in causing, the suicide, euthanasia, or mercy killing of any individual; provided that it is not "causing, or assisting in causing, the suicide, euthanasia, or mercy killing of any individual" to prescribe, dispense, or administer medical treatment for the purpose of treating severe chronic intractable pain, even if the medical treatment may increase the risk of death, so long as the medical treatment is not also furnished for the purpose of causing, or the purpose of assisting in causing, death for any reason."

SECTION 2. In codifying the new sections added by section 1 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.

SECTION 3. This Act shall take effect upon its approval.

INTRODUCED BY:

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