Medicinal Cannabis Review Highlights Dilemmas Facing Healthcare Profes

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Nurses have a responsibility to respect and support patients who use cannabis for medicinal purposes, but must stay within the law and follow professional guidance at all times, according to a research review in the September issue of the Journal of Clinical Nursing.

 

Dr Anita Green and Dr Kay De-Vries studied more than 50 published papers, together with professional and Government guidance documents, official reports and media coverage, from 1996 to 2009.

 

They point out that the fact that the cannabis is usually obtained illegally can have consequences for those who choose to use it for its medicinal value and create real dilemmas for the nurses and other healthcare professionals who care for them. For example, it is vital that any drug use is recorded on the patient's medical records for their own safety, but many patients may be unhappy for that to happen.

 

"Nurses are increasingly likely to deal with patients using medicinal cannabis and it is important that they put their personal views to one side and deal with the health consequences of that drug use" says Dr Green, a Nurse Consultant for the Sussex Partnership NHS Foundation Trust and Visiting Fellow at the University of Brighton.

 

"The literature on the medicinal use of cannabis repeatedly refers to changes that could improve people's quality of life, like improved sleep, a better appetite and reduced depression, and these perceived benefits have led to greater usage.

 

"However, it also states that far more research is needed and it is very important that patients are fully aware of the legal consequences of taking cannabis, together with the physical and psychological effects it may have on them.

 

"Nurses and other healthcare professionals need to be well informed about the medicinal effects of cannabis and how this can interact with other medication the patient is being prescribed. It is also vital that the patient's cannabis use is accurately documented in their records and that other professionals, such as pharmacists, doctors and substance misuse teams are brought in to provide advice, with their permission."

 

Cannabis, which has been widely used as a herbal remedy since ancient times, was brought to Western Europe at the beginning of the 19th century by Napoleonic soldiers who had been fighting in North Africa.

 

Its medicinal use was advocated in European and American medical articles as far back as 1849, but was banned in the UK in 1928 after UK delegates at an international opium conference were persuaded that cannabis caused insanity.

 

"Our review shows that the general view of integrating cannabis derivative medications into mainstream medical use remains extremely cautious" says Dr Green. "Most of the research we studied indicated that there was a need for more clinical trials examining the optimal administration routes and dosing regimes.

 

"It is repeatedly pointed out in the literature that the development of cannabis and isolated synthetic cannaboids for medicinal purposes is still in its infancy and has a long way to go.

 

"The aim of our study was to review the literature and to raise awareness of the questions and dilemmas facing the medical profession, specifically nurses, when it comes to caring for patients who use cannabis for medicinal reasons.

 

"We hope that the review which looked at the research published into the pharmacological qualities of cannabis and its use in palliative care, for example cancer, multiple sclerosis and motor neurone disease - will stimulate further debate.

 

"In the meantime, it is vital that nurses and other healthcare professionals act within the law and follow the guidance laid down by their professional organisations."

 

The authors say that the review highlights the real dilemmas created for the medical profession by the medicinal use of cannabis.

 

"Nurses have a caring responsibility to maximise their patients' quality of life, but should they also be reminding them that the medicinal use of cannabis remains illegal?" asks Dr Green. "Or should they respect the patient's right to take the drug and just make sure that it does not conflict with any other treatment, such as prescribed medication?

 

"It is clear that further debate is essential and that nurses need ongoing support and guidance to help them tackle these thorny dilemmas and provide the best healthcare they can for their patients without compromising their professional integrity."

 

Date: 3 September 2010

Source: Wiley - Blackwell, AlphaGalileo Foundation.

http://www.medicalnewstoday.com/articles/199826.php

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"Nurses have a caring responsibility to maximise their patients' quality of life, but should they also be reminding them that the medicinal use of cannabis remains illegal?" asks Dr Green. "Or should they respect the patient's right to take the drug and just make sure that it does not conflict with any other treatment, such as prescribed medication?

 

"It is clear that further debate is essential and that nurses need ongoing support and guidance

there is no shortage of irey guidance here

check this

An Individual's Right to Accept or Refuse Treatment or Select Alternative Treatment

 

In Canada, the Ontario Court of Appeal, in Malette and Shulman, awarded damages against a doctor who transfused blood into a patient who was unconscious as a result of a motor accident, but who carried a card saying that she would refuse blood transfusions. In delivering the court's judgment Justice Robins stated:

 

"A competent adult is generally entitled to reject a specific treatment, or all treatment, or to select an alternate form of treatment, even if the decision may entail risks as serious as death and may appear mistaken in the eyes of the medical profession or of the community. Regardless of the doctor's opinion, it is the patient who has the final say on whether to undergo the treatment. ... The doctrine of informed consent is plainly intended to ensure the freedom of individuals to make choices concerning their medical care. For this freedom to be meaningful, people must have the right to make choices that accord with their own values regardless of how unwise or foolish those choices may appear to others."

 

Justice Robins added:

 

"Recognition of the right to reject medical treatment cannot be said to depreciate the interest of the state in life or in the sanctity of life. Individual free choice and self-determination are themselves fundamental constituents of life. To deny individuals freedom of choice with respect to their health care can only lessen, and not enhance, the value of life. The state's interest cannot properly be invoked to prohibit Mrs Malette from choosing for herself whether or not to undergo blood transfusions."

 

Justice Robbins also stated:

 

"The right to determine what shall be done with one's own body is a fundamental right in our society. The concepts inherent in this right are the bedrock upon which the principles of self determination and individual autonomy are based. Free individual choice in matters affecting this right should, in my opinion, be accorded very high priority."

 

In England, in Re T (Adult: Refusal of medical treatment) the House of Lords has made it plain that the right to refuse medical treatment extends even to the point where refusal will result in the likely or certain death of the patient. Lord Donaldson acknowledged that there is an:

 

"absolute right to choose whether to consent to medical treatment, to refuse it or to choose one rather than another of the treatments being offered ... notwithstanding that the reasons for making the choice are irrational, unknown or even non- existent."

 

Lord Donaldson also said:

 

"This situation gives rise to a conflict between two interests, that of the patient and that of the society in which he lives. The patient's interest consists of his right to self-determination - his right to live his own life how he wishes, even if it will damage his health or lead to his premature death. Society's interest is in upholding the concept that all human life is sacred and that it should be preserved if at all possible. It is well established that in the ultimate the right of the individual is paramount."

 

In Australia, the same doctrine has been affirmed by superior courts.

 

In F against R the Supreme Court of South Australia considered a surgeon's duty to inform the patient of the risk that an operation will not succeed in its aim. Chief Justice King stated:

 

"The governing consideration is the right of every human being to make the decisions which affect his own life and welfare and to determine the risks which he is willing to undertake."

 

In Rogers and Whitaker, the High Court stated that:

 

"the courts have also adopted the principle that, while evidence of acceptable medical practice is a useful guide for the courts, it is for the courts to adjudicate on what is the appropriate standard of care after giving weight to "the paramount consideration that a person is entitled to make his own decisions about his life."

i have the individual rights to choose cannabis therapy as an alturnitive treatment

 

its i human Right to Accept or Refuse Treatment or Select Alternative Treatment

i select cannabis therapy

thanx for your support nursey

i have a right to live right

forward cannabis

heal de people

heal da land