American College of Physicians: Internal Medicine — Doctors for Adults ®


Policy Briefs

College endorses bill to improve pain management

ACP-ASIM is supporting a new bill that calls for a stronger federal role in ensuring that patients who suffer from severe pain, particularly those who are chronically ill or are at the end of life, receive the best pain management available.

The Conquering Pain Act of 1999, which was introduced last month by Sens. Ron Wyden (D-Ore.) and Connie Mack (R-Fla.), proposes several short-term and long-term approaches to achieve better pain management. The bill would give physicians and other health care professionals better access to information on assessing and treating pain. It also would make the health care system more accountable for responding to patient concerns regarding pain.

At a Capitol Hill briefing that followed the bill's introduction, ACP-ASIM Immediate Past President Harold C. Sox, MACP, said that current estimates show that more than 75% of patients with advanced stages of cancer suffer moderate, severe or very severe pain. Another study found that for half of conscious patients, family members reported the patients were in moderate to severe pain at least half the time.

Dr. Sox pointed out that the Collge has worked on initiatives to increase awareness of pain management among physicians. "But we can't do it alone," he added. "A problem of this magnitude requires a federal presence."

To promote pain management, the Conquering Pain Act of 1999 urges the federal government to better coordinate its pain management activities, to support research on pain and to review Medicare payment policies and regulatory barriers that impede effective pain management. In the long run, Dr. Sox said, the bill "will provide a road map for policy makers as they develop long-term solutions."

College supports initiatives to reduce gun violence

ACP-ASIM is calling for stronger legislation that would restrict gun sales to individuals younger than 21 and would promote firearm designs that make guns difficult for children to use.

"Reducing the exposure of children and young adults to firearms is clearly a preventive action that can help save lives," College President Whitney W. Addington, FACP, said in a press statement. "In light of the information being reported concerning the methods used to obtain firearms by the Columbine shooting suspects [in Littleton, Colo.], we support the need for much greater scrutiny of firearm sales."

ACP-ASIM supports the following policy initiatives for reducing gun violence:

  • The purchase of handguns should be made contingent upon completing an appropriate educational program on firearm safety.
  • The five-day "cooling off" waiting period of the Brady Act should be re-established.
  • All firearms should incorporate safety features such as trigger locks that make them child-proof to the largest extent possible.
  • All firearms kept at home should be kept locked and unloaded.
  • Handguns should not be sold to minors, individuals with criminal records or individuals who are considered a threat to themselves or to others.
  • Individuals who sell handguns illegally should be subject to stronger penalties and criminal prosecutions.
  • Permits for carrying concealed weapons should only be issued to those persons with special needs.

For more on this topic, see the Feb. 1, 1998, issue of Annals of Internal Medicine.

Policy briefs compiled by Janice Simmons, a Washington, D.C. writer specializing in health care.

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