Marijuana for medical purposes—expectations of good medical practice

For years, Canadians have seen the discussion over access to marijuana for medical purposes ebb and flow as attitudes shift, public policy changes, and more research becomes available.

Since the amendment to Health Canada’s regulations a year ago, the only legal access to marijuana is through licensed producers, obtained upon receipt of a physician’s authorization. In spite of its protestations at the time of the amendments, the College has had no option but to participate in the process. However, as the regulator, the College’s focus is not on the merits of medical marijuana as a therapy, but on the professional and ethical conduct of physicians who authorize patient access to marijuana as a therapeutic agent.

In the March/April edition of the College Connector, the College released an updated standard, Marijuana for Medical Purposes. Much of the standard was written based on the College of Family Physicians of Canada’s (CFPC) publication Authorizing Dried Cannabis for Chronic Pain or Anxiety (September 2014), as well as information provided by Health Canada, and other bodies.

Following the publication of the updated standard in March, the College was contacted by a number of registrants who were concerned that the CFPC document provided a set of recommendations only regarding the appropriateness of authorizing dried cannabis for certain patients, and that in some cases, there may be legitimate exceptions. Following an internal review, the College revised the standard to provide physicians a degree of flexibility in special circumstances, such as a palliative patient under the age of 25. The expectations of good medical practice outlined in the standard remain the same, and registrants are advised to review it carefully to ensure compliance.

The conversation on medical marijuana is ever-changing, and as further medical evidence is published or legal frameworks evolve, additional revisions to the standard may be necessary.