By Steven Newman
---- — On Feb. 3, 2010, Rodney Koon was pulled over for speeding in Traverse City. The officer found a marijuana pipe in his pocket along with a medical marijuana identification card, and the driver admitted to having smoked the drug earlier in the day.
Blood tests revealed that marijuana — it is illegal to drive with any amount in the blood stream — was still in his system when he was pulled over.
Grand Traverse County Prosecutor Al Schneider charged Koon with driving under the influence of a controlled substance, kicking off a major legal skirmish in the battle over the scope of Michigan's medical marijuana act. Both the District Court and the County Circuit Court have ruled against the prosecutor, citing the medical marijuana act and declaring it now legal to drive after "medicating."
The case — and the uncertainty it is creating — continues, as Schneider pledges to challenge the courts' interpretation of the marijuana act all the way to the Michigan Supreme Court; but no matter how it is eventually resolved it underscores the immense and nearly impenetrable haze of confusion still surrounding the act.
Perhaps nowhere is that haze thicker than around Michigan physicians juggling their calling to meet the medical needs of their patients with rules few seem to understand and on which even fewer agree.
The law sought to allow those with debilitating medical conditions to use marijuana to treat or alleviate the associated symptoms by enabling patients who have obtained written certification from a physician eligible to obtain a Registry Identification Card. The card prevents the patient from suffering any criminal or other penalty under Michigan law for the medical use of marijuana. It is unclear, however, whether it was intended to allow someone to operate a motor vehicle under the influence.
The Act remains a law in desperate need of clarification, not only for drivers, drug users and law enforcement but also for the physicians asked by their patients for written certification of need.
In the absence of legal guidance, physicians are left to ask themselves a number of potentially very difficult questions. What is the physician required to do before signing a certification? Is a simple exam enough? Should previous medical records first be obtained and reviewed? Can a "debilitating medical condition" be appropriately and ethically ascertained over the telephone?
It is a welcome sign that lawmakers in Lansing recently heard testimony and are now considering a package of bills that would provide some answers, including legislation that would better define a physician-patient relationship when it comes to providing certification.
Despite potential reforms, questions persist. Physicians are increasingly confronted with patients who request a certification but may not, in the physicians' judgment, be entitled to one. Some physicians may believe, in their best medical judgment, that marijuana does not provide a therapeutic value for the treatment of the statutory conditions approved by the state.
Whether a driver can medicate before getting behind the wheel of a car remains a little hazy.
About the author: Dr. Steven Newman is President of the Michigan State Medical Society, a professional association of more than 16,000 Michigan physicians; its mission is to promote a health care environment which supports physicians in caring for citizens through science, quality, and ethics in the practice of medicine.
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