BROOMALL, Pa., March 31, 2023—The Biden administration’s proposed rule change limiting the circumstances in which physicians can prescribe controlled medications without an in-person evaluation protects vulnerable patients, including those who will be victims of physician-assisted suicide, and promotes strong physician-patient relationships while preserving the benefits provided by telemedicine.

Under the proposed rule, a physician can prescribe up to a thirty-day supply of non-narcotic controlled medications, such as diazepam and barbiturates, to a patient without an in-person evaluation. To continue prescribing after this point, the physician must either evaluate the patient in person or receive a referral from a physician who has done so. Currently, a physician can prescribe such medications indefinitely via telemedicine. Exacerbated by the COVID-19 pandemic, mental health diagnoses, self-medication, and drug overdoses have increased significantly. This burden falls most severely on patients who are indiscriminately prescribed controlled substances after these medications cease to be a proportionate means of achieving their legitimate medical purpose. The risk of fraud, abuse, and negligence escalates when controlled medications can be obtained indefinitely without physicians’ truly engaging with their patients to address their best interests. At its worst, this practice is tantamount to patient abandonment.

In a public comment submitted to the federal government, The National Catholic Bioethics Center (NCBC) supports public policy that attenuates these challenges, while at the same time not negatively impacting the needs of those experiencing chronic pain. For these and other patients, telemedicine has the potential to promote and enhance the physician-patient relationship, especially when societal and demographic forces challenge that relationship. However, often more than a prescription is needed. Also needed is engagement within an established physician-patient relationship with a trusted health care professional, which can address the psychosocial factors that can lead to substance abuse more effectively than less-personal virtual encounters.

In addition to the administration’s proposed requirements, the NCBC recommends that no medications be prescribed pursuant a state’s “Aid in Dying” or “Death with Dignity” law without an in-person evaluation. Marie Hilliard, a senior fellow of the NCBC and a registered nurse, states, “Compassionate care of those who are suffering, regardless of the cause, never should require the elimination of the patient as a method of pain control. No patient should be prescribed a lethal dose of a medication, but to do so without an in-person medical evaluation is the ultimate abandonment of a patient by the health care professions and by government agencies that allow this to occur.”

The National Catholic Bioethics Center provides education, guidance, and resources to the Church and society to uphold the dignity of the human person in health care and biomedical research, thereby sharing in the ministry of Jesus Christ and his Church. The NCBC envisions a world in which the integral understanding of the human person underlying Catholic teaching on respect for human life and dignity is better understood and more widely embraced in America and worldwide. More information can be found at ncbcenter.org.

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