Certification

 “Modern medical research has confirmed the beneficial uses of cannabis in treating or alleviating the pain, nausea and other symptoms associated with a variety of debilitating medical conditions…”        -The State of Illinois 

Patients who wish to apply for a medical cannabis registry identification card must have their qualifying debilitating medical condition certified by a physician.

The physician must:

  • Have a bona-fide physician-patient relationship with the qualifying patient. The bona-fide physician-patient relationship may not be limited to issuing a written certification or a consultation simply for that purpose.
  • Have responsibility for the ongoing care and treatment of the qualifying patient's debilitating condition, provided that the ongoing treatment and care shall not be limited to or for the primary purpose of certifying a debilitating medical condition or providing a consultation solely for that purpose.
  • Complete an in-person full assessment of the patient's medical history and current medical condition, including a personal physical examination prior to completing the physician certification. The assessment of the qualifying patient's current medical condition shall include, but not be limited to, symptoms, signs, and diagnostic testing related to the debilitating medical condition.
  • Certify the qualifying patient is under the physician's care, either for the qualifying patient's primary care or for his or her debilitating medical condition or symptoms of a debilitating medical condition.

A physician's certification of a qualifying condition does NOT constitute a prescription for medical cannabis. The certification is an acknowledgment of the diagnosis. 

The Physician Written Certification form is on the Illinois Department of Public Health website, under the Medical Cannabis Patient Registry Program. (The Physician Written Certification form must be submitted by the physician, not the patient.)

http://www.dph.illinois.gov/topics-services/prevention-wellness/medical-cannabis 

 

Compassionate Use of Medical Cannabis Pilot Program Act

http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=3503&ChapterID=35

 

The Joint Commission on Administrative rules:Section 946.300 of the Dept. of Public Health regulations.

http://www.ilga.gov/commission/jcar/admincode/077/07700946sections.html

 

Interesting Fact:

Cannabis was listed in the United States pharmacopeia national formulary from 1850 until 1942. It was prescribed for various conditions including labor pains, nausea, and rheumatism.

 

Precedent

Please understand that the following is not intended to serve as legal advice, a substitute for your own due diligence or in any way commentary on the positions established by your affiliated hospitals or employers. The information contained herein is intended to provide you with some insight to they types of precedent that exists in other states, federal courts and the rights specifically detailed in the Illinois Compassionate Use of Medicinal Cannabis Pilot Program Act.

Beginning in 1996 with California’s Compassionate Use Act, 23 states and the District of Columbia today have laws that allow sick patients to legally obtain and use medical cannabis. Although this wave of legalization is strong today, and safe access to the plant in every state seems inevitable, federal officials originally challenged California’s progressive law.

Shortly after California’s adoption of legal medical cannabis (via a popular vote that captured 56 percent of voter approval), federal officials threatened to revoke doctors’ ability to prescribe the substance to patients for medical use.

The federal government’s attempt to thwart California’s new law was met by a strong response from a group of doctors and patients. A lawsuit was filed against the federal government by Dr. Marcus Conant, an AIDS specialist. The suit argued that the government’s effort to quiet doctors who believed in the medical efficacy of cannabis was a violation of the First Amendment. The underlying court held that "Given the doctrine of constitutional doubt, the government’s construction of the Controlled Substances Act cannot stand. The government should be permanently enjoined from (i) revoking any physician class member’s DEA registration merely because the doctor makes a recommendation for the use of medical marijuana based on a sincere medical judgment and (ii) from initiating any investigation solely on that ground. The injunction should apply whether or not the doctor anticipates that the patient will, in turn, use his or her recommendation to obtain marijuana in violation of federal law."

 

Based on Condant, a doctor is allowed to discuss the merits of medical marijuana with patients. A doctor is also permitted to deliver written or oral recommendations to the patient suggesting that they try cannabis. Thus, a doctor telling a patient, even in writing, "Cannabis may help you" or "You really should consume cannabis, it will help" is acceptable. A doctor is NOT permitted to provide a patient with cannabis. Nor can a doctor prescribe cannabis — doctors cannot prescribe Schedule I controlled substances.

Rather than advise the patient on how to or where to obtain the medicine, doctors should refer the patient back to the details of the Illinois program and the resources provided by the Department of Health.

The American Medical Association, in Article III of the Principles of Medical Ethics, wrote: "A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient."

Again, based on the federal precedent established by the Federal Court of Appeals in Conant, physicians in states without medical cannabis laws are also permitted to recommend cannabis to their patients based on First Amendment rights of physicians and patients. However, if located in states with medical cannabis laws, physicians must comply with individual state requirements when writing recommendations for cannabis.

 

If we can assist with questions regarding Illinois' Medical Cannabis Pilot Program, please feel free to reach out to our Community Outreach Coordinator, Christine Karhliker at ckarhliker@hcillinois.com.