Friday, April 21, 2006

The Church should be pro-pot*


The New York Times has a news item today about the federal government's judgment of the medical benefits of smoking marijuana. That judgment, as you can see, was negative.

My question: so what?

The issue of "medical marijuana" is a serious moral one. Here's why.

It is a fundamental Catholic principle that those who are ill are entitled to receive palliative care and pain relief. Of course, if the patient can be helped to recover, that is the primary goal; but if that isn't at issue -- if a patient is still dying, either of a specific condition, or simply because of old age -- then the goal is to sustain life in a human way; we don't hasten death, but it can be allowed to come naturally. So someone facing a terminal cancer need not pursue further treatment whose prospects are uncertain; but neither should that person's death be "sped up," either; and ordinary care, such as food, water, bathing, comfort, pain relief, should continue as long as they can do some good, and don't do any harm.

But along the way, a suffering person should be helped to deal with suffering, and when the condition is terminal, certain common-sense things come into play.

For example: if someone is dying, and smoking cigarettes provides comfort, who cares about the health risks of tobacco, at that point?

Or, if someone is in pain, you give morphine; the patient can have more of it, even where it has other negative effects, so long as the intent is pain relief, not inducing death. Thus, you don't say to a patient, in pain -- "Sorry, but if we give you more morphine, that will inhibit breathing, and you might die. Keeping you alive is more important than relieving pain." No, the Church's answer is, intention is key: if the intent of another shot of pain-killer is to hasten death, or deny someone consciousness, that's immoral; but if the purpose is to provide comfort and ease; that's moral.

So, what's this have to do with "medical marijuana"?

Well, there are folks who say that marijuana provides comfort care. Are they all liars?

But, you say, experts tell us it doesn't help.

My response is, the expertise that matters most is the patient. If a patient says, smoking pot makes me feel better, on what moral basis should we deny that patient a joint? Is smoking marijuana immoral in a way that morphine, or, say, heroin, is not?

A legitimate response would be, the marijuana is unnecessary--as, apparently, heroin is. That's a legitimate response, if true -- i.e., we know that we can provide pain relief through other drugs, so yes, we don't use heroin for it (but recall, that's why heroin was invented).

But my concern is that the government has, in all this, seemed dismissive of this part of the question. The federal government's argument has been, we say marijuana is illegal, and our law must be upheld. Go find a substitute for marijuana!

That's not a position I can support from Catholic moral teaching.

Consider: when someone is facing this sort of terminal illness, here's what happens. A patient is wracked by a combination of pain, nausea, and inability to eat properly. In such situations, you try to find anything that helps, and you don't get clinical or "scientific" about it. "The only thing mom can hold down is such-and-such brand of ice cream--no other." You don't care why that's true, or if clinical trials can substantiate a special quality to brand-A ice cream; you just go buy all you can of it, and give it to mom as long as it works.

So the government says, "there's no reason why marijuana should help!" Yes there is, one reason, and it's enough -- the sick person says it helps!

Am I saying the government has no legitimate authority to regulate drugs? Not at all.

But I would say this -- it is the government that must prove why something must be illegal; not the citizen who must prove why something must be legal. I.e., I reject the present situation, requiring individual citizens having to battle the federal leviathan (note: states have attempted to deal with this, and the federal apparatus -- legislative, executive and judicial -- have acted as one to thwart that), to prove why different behaviors should be treated differently -- why using marijuana for relieving the suffering of dying people might be justifiably exempt from the "Drug War." I reject the idea that such suffering is an acceptable price to be paid for some larger purpose, which is . . . what?

So my point is, the federal government needs to accept these distinctions, and accommodate them. Will that make fighting drugs harder? Assume it would -- so what? Our Bill of Rights makes it (significantly) harder to punish rapists, murderers, even terrorists. Is it immoral to keep the Bill of Rights? Would it be more moral to scrap it, so less impedes our pursuit of criminals?

You tell me: if someone you loved is in misery, and said, "I wonder if a little pot would help?" -- what would you do? Would you:

a) Download the latest FDA study, and cite it to explain why expecting marijuana to help is illusory.

b) Explain the need for following the federal government's lead in the "Drug War".

c) Go figure out how to buy some pot?

* Update: it occurs to me some might fail to realize my headline is meant to be provocative, as in: feel free to discuss, herein, the proposition represented by the headline. Yes, I do tend to favor that position; but my purpose here is to discuss that proposition.

23 comments:

Jay Anderson said...

Probably none of the above, but certainly not (c).

Father Martin Fox said...

Jay:

In case I was unclear, my question presupposes that any alternative remedies have been pursued . . .

Jay Anderson said...

That's a tough one. I've never knowingly committed a criminal act, and I don't know that the narcotics laws of our country are so inherently unjust (even as applied in this particular situation) as to justify such an act of civil disobedience.

Maybe if I were ever placed in the situation you describe, I would change my mind, but then wouldn't I be guilty of having situational ethics?

I guess I don't have a good answer apart from lobbying for a change in the law.

Anonymous said...

I nursed two parents through terminal cancer. Father, if morphine, oxycontin, etc., don't work, pot sure isn't going to work. There are significantly better pain killers out there than pot.

Father Martin Fox said...

anonymous:

I am sorry for your loss, but I've been there, too, at least with my mom.

My understanding is that pot is not so much a painkiller, as that it relieves nausea.

And my point would be: it matters little whether or not I think it's effective, or the FDA does; only if a patient thinks it is effective.

Father Martin Fox said...

Jay:

I don't want to open the entire can of worms labelled "situational ethics," but in fact, that isn't an illegimate idea: of course a particular moral choice is affected by the situation. An easy example:

While it is normally illegal to speed, one can easily imagine situations when one would do so, with a clear conscience.

And many other examples could be cited where, in a specific instance, one could violate a law with a clear conscience -- and this without contesting the legitimacy of the law in question.

But with the drug laws in question, one can reasonably ask: is it a just law?

A related, real-world example:

Doctors who prescribe "too much" morphine or other narcotics come under scrutiny from the federal government, because of course the feds legitimately want to prevent trafficking in these controlled substances, under cover of medical practice.

However, the upshot -- so it has been reported here and there -- is that doctors are stingier with morphine, even with legitimate patients, because they don't want to be crosswise with the feds.

Result: people entitled to pain relief are denied sufficient pain relief. Secondary result? The idea that pain relief isn't available is bolstered, and this in turn is used to justify "assisted suicide."

In my judgment, if federal law, or enforcement of the same, has a chilling effect on legitimate medical practice, that is an unjust law.

St. Thomas Aquinas made the point that an unjust law is no law at all. At some point -- subject to prudence, of course -- it is appropriate, even necessary, to disregard unjust laws.

Jay Anderson said...

So, I suppose the question is whether narcotics laws, on their face or as applied, consitute "unjust laws".

Compared to something like legalized abortion, where we don't think it's appropriate to use any means necessary to protect the unborn, I'm not sure I can argue narcotics laws are per se "unjust".

Again, I'm not sure my position would hold were a loved one in the position you describe.

Father Martin Fox said...

Jay:

Yes.

I would say that a narcotic law could be, and would be, unjust to the extent it interfered with a legitimate, natural right: in this case, the right of any human being to have palliative care.

And, again, I would say this -- I reject the idea that the individual has to prove his case against the government; I think it should be the other way round.

I mean, on general social justice grounds, shouldn't our "preferential option" be for the weak, against the strong?

No one is talking about the rights of dope-heads or pushers, but simply the rights of a suffering person who says, gimme a joint, it makes me feel better. I don't consider that trivial, because the suffering is real. The only question for me is, is the relief real?

Jay Anderson said...

Another consideration for me is whether I'd be willing to put my family in jeopardy by going out and buying some pot from a potentially undercover narcotics officer.

Let's say, Heaven forbid, my wife had terminal cancer. In good conscience, I couldn't go buy her some pot because the last thing I'd want to see is my kids in foster care because Mommy's dead and Daddy's in jail.

Father Martin Fox said...

Jay:

Fair enough. But can you see how that makes my point?

Dave Oatney said...

I have no problem with legalizing the whacky-weed as a painkiller or any other supposed form of medication. What a person might choose to use to alleviate pain is that person's business, not the State's.

reader said...

My husband gets so nauseous *from* prescribed narcotic painkillers that he cannot take them even when he really needs them. (He had RXs for a painful surgical recovery and for an eye injury.) He's not sure whether they even relieve his pain well, or is the nausea too bad to notice. So I can certainly believe for some terminally ill people, not only might the strongest legal painkillers not make them "not care" about the nausea, but they might even cause or aggravate it.

Bernard Brandt said...

My first wife Carolyn, whom I believe to be a saint, and whom I loved more than my own life, died horribly of lung cancer. On occasion, when she was taking her OxyContin, she would joke: "I'd like a Brompton's Cocktail (a mixed tincture in equal parts of morphine, cocaine, and cannibis). If I had believed that she was serious, I would have done my best to have gotten it for her.

My second wife, Elizabeth, is a survivor of breast cancer, and has suffered mastectomy, chemotherapy, and radiation, as well as bilateral hip replacement and chronic lower back pain. She is in chronic and great pain, and the pain modalities which she is presently given cause nausea and digestive problems. Cannibis is the only modality which relieves the pain without those side effects.

I don't have to ask God to damn a government which attempts to prevent her from having access to the only means we know of of relieving her considerable pain. To my mind, it already is.

Bernard Brandt said...

By the bye, thank you for your post on the subject. Your willingness to do so shows me that you are a true priest, according to the order of Melchizedek, and not one of these sons of Eli, who tire the souls of the faithful, as well as the patience of God Himself.

tony c said...

The irony is that the cannibis plant remains a schedule 1 drug (no legitimate medical use) and yet a synthetic version of THC, the main psychoactive chemical in pot, is manufactured under the trade name Marinol, and is a schedule 2 or 3 controlled substance and is dispensed for the very reasons they say pot doesn't work.

And clearly the drug companies are still interested enough to continue to deveop new delivery systems for synthetics and natural derivitives, as the NYT article mentions.

As Catholics we have to realize that God's creation is inherently good. Our use, our intent, is what makes our interaction w/ creation sinful. God gave us poppies, tobacco, coca and cannabis hemp. We invented junkies, crack, cigarettes, and the dope dealer.

The history of laws in our country regarding the stuff of matter (The Prohibition Era for example) owe a lot to a Protestant Christian tradition that does not enjoy the Catholic undertanding of "stuff" and its right or wrong use.

The cannibis plant is interesting: hemp fibre is a durable fibre. All those ships that moved humanity across oceans had sails and ropes made from the stuff. (Canvas / Cannabis...)

And the pro-hempers say the seed oil is higher in Omega-3's (for all you salmon/mackeral eaters) than flax seed.

But even this: what is morally wrong w/ a bloke who grows a plant in his garden, and smokes a pipeful in the evening with his Chesterton instead of having 2 sherries? All things in moderation, the answer, I think, would be: nothing. Except that marijuana is illegal, and St. Peter's espistle tell us as Christians to respect the laws of Cesar and not give scandal to the Church.

In short: I've known rock-n-rollers, cancer patients, AIDS patients and old-timers. All will tell you: pot gives you the munchies and keeps you from puking. And if a plant from your yard does the trick, then you don't need the FDA or Pfizer or Smith Kline and Whomever. Which is only a bummer for the FDA and Smith Kline and Whomever.

Anna said...

Tony,

When the California law legalizing marijauna for medicinial uses, the Feds cracked down on everyone. There were some interesting test cases, none of which allowed the law to stand. This included people growing the plants just for their own use.

(It takes more than one plant to provide for a single patient, and just getting seeds may be illegal.)

As far as the pill vs smoke, I don't think that there has been a fair study done, due to Federal regulations. A fair study would make sure that the active compounds could be delivered in expected effective amounts. Also, the study would have to be a true double blind one, in which the patient and doctor could not tell which cigarettes contained the pot and which could not.

It only makes sense to me that the smoke might contain compounds that would not be present in the pill. (Compare the odor of cured tobacco and second hand cigarette smoke. Big difference). If you are sick, then smoke is definitely an easier method of drug delivery, especially if a person is sick to their stomach.

Personally, I am convinced that there is adequate antecdotal evidence to test smoked pot, in the correct concentrations of the active ingredients, in a scientific study. BUT it cannot be done under the current drug laws.

joeh said...

Some in pain want their loved ones to do a lot of things including end their lives. It is against the law to give them pot. You seem to be arguing if it makes them feel good, even if it is against the law, it is OK. Which laws are OK to break when someone is in pain and suffering with Cancer or any other major disease? There are pain killers that can be given legally.

Father Martin Fox said...

Joe:

Yes, I am arguing that if marijuana can relieve suffering, then the law is wrong to stand in the way. By what right does the government prevent suffering people from being relieved of their suffering?

Governments exist to serve people; not the other way around.

joeh said...

"By what right does the government prevent suffering people from being relieved of their suffering? "

So government has the obligation to OK anything to end suffering? WOW. Seems like this opens up a lot of very bad doors. It is clear Father that you are a priest and not a lawyer. Does the Catholic Church teach that it is OK to break laws to end suffering? Then robbing a bank to give money to the poor who are desperately in need would be something that the government should allow. Of course the government now robs the rich to give to the poor so this is not a great stretch except it does not allow the politician to get re elected if he allows someone else to play Robin Hood with someone elses money.
Father, I am sorry but the word naive comes to mind when I read your argument.

Father Martin Fox said...

Joe:

Do the words non sequitur mean anything to you?

I said nothing about the government doing anything to relieve suffering; I am objecting to the government criminalizing relief of suffering. You seem very deferential to government; I am not.

Just because the government makes something illegal, doesn't mean the government's judgment is right; and I have every right to advocate change in the law, as I have been doing.

Secondly, when a law prohibits doing a good act, a needed act of mercy, then the question of disobeying the law comes into question. I do not consider disobeying the law a minor matter, but neither is relieving human suffering.

Father Martin Fox said...

Joe:

Yes, the Church does indeed teach that it is okay, at times, to break the law, including to relieve suffering.

Pope Pius XII actually did that, during World War II, to relieve the suffering of Jews and others hounded by the Nazis and their lapdogs; and he orchestrated such disobedience throughout Europe.

If a nurse or doctor were ordered to remove a feeding tube from someone like Terry Schiavo, and refused to comply, I feel confident the Church would say that was the right thing to do, although a defiance of the law.

If the Congress enacts a law that says I may not provide, say, religious instruction to immigrants illegally in this country, I don't believe I would comply with that law.

I could go on -- but there are many instances where Church teaching allows for, if not actually demanding, that we disobey the law. St. Thomas Aquinas himself said, an unjust law is no law at all.

And in my judgment, to the extent that otherwise legitimate drug laws prevent relief of human suffering, they are unjust.

joeh said...

Father, I am sure you will not go back here to read this old post, but you did not answer my point. The law says robbing a bank is wrong and yet we have people in poverty starving to death. Do you sanction robbing a bank for the purpose of releaving suffering and hunger? We have many laws in place that seem to allow suffering. How far can we legally go to end abortion? How far do you advocate. You seem to have no issue with smoking pot and I would assume are an advocate of making it legal. If you make it legal for one, you make it legal for all by the rights of our court system. Kind of like abortion is OK for the "health" of the mother. Define "health". There is not restriction. Those are my points. Some people look at an issue as an isolated point and maybe in a way that makes sense. But you cannot make law for a single case without opening the doors. THERE IS A SLIPPERY SLOPE TO EVERYTHING AND WE MUST ALWAYS KEEP THIS MIND.

Omar Cruz said...
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