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Law specifically authorizes medical use: Section 7 (a) "The medical use of marijuana is allowed under state law to the extent that it is carried out in accordance with the provisions of this act."
Medical Use of Marijuana - "Medical use" means the acquisition, possession, cultivation, manufacture, use, internal possession, delivery, transfer, or transportation of marijuana or paraphernalia relating to the administration of marihuana to treat or alleviate a registered qualifying patient's debilitating medical condition or symptoms associated with the debilitating medical condition.
Physicians - [Section 3(f)]"Physician" means an individual licensed as a physician under Part 170 of the public health code, 1978 PA 368, MCL 333.17001 to 333.17084, or an osteopathic physician under Part 175 of the public health code, 1978 PA 368, MCL 333.17501 to 333.1755.
The law requires a qualifying patient to present a written certificatation to the Department in order to obtain a Registry ID Card. This remains confidential. “Written certification" means a document signed by a physician, stating the patient's debilitating medical condition and stating that, in the physician's professional opinion, the patient is likely to receive therapeutic or palliative benefit from the medical use of marijuana to treat or alleviate the patient's debilitating medical condition or symptoms associated with the debilitating medical condition. The written certification is not a prerequisite to asserting the Affirmative Defense.
Law provides absolute legal protections to the doctor. The Physician (defined by the act) shall not
- be subject to arrest, prosecution, or penalty in any manner, or denied any right or privilege, including but not limited to civil penalty or disciplinary action
- by the Michigan board of medicine, the Michigan board of osteopathic medicine and surgery, or any other business or occupational or professional licensing board or bureau,
- solely for providing written certifications, in the course of a bona fide physician-patient relationship and after the physician has completed a full assessment of the qualifying patient's medical history,
- or for otherwise stating that, in the physician's professional opinion, a patient is likely to receive therapeutic or palliative benefit
- from the medical use of marihuana to treat or alleviate the patient's serious or debilitating medical condition or symptoms associated with the serious or debilitating medical condition
- failing to properly evaluate a patient's medical condition, or
- otherwise violating the standard of care for evaluating medical conditions.
Physicians as Gatekeepers – There is no provision whatsoever in this law that allows anyone to second guess a licensed physician’s professional judgment. This includes not only the judgment that marijuana is likely to produce therapeutic or palliative benefits but also the judgment as to whether your condition meets the statutory criteria. This statutory scheme has three different options that allow the specific list to be expanded substantially. As shown below, if a medical condition is not on the specific list of conditions immediately below, you can qualify if you determine, in your professional judgment that that your patient has, “A chronic or debilitating disease or medical condition or its treatment that produces 1 or more of the following: cachexia or wasting syndrome; severe and chronic pain; severe nausea; seizures, including but not limited to those characteristic of epilepsy; or severe and persistent muscle spasms, including but not limited to those characteristic of multiple sclerosis.Even more expansive is the very general criteria set for umbrella affirmative defense, immediately below. It includes any “serious medical condition” in addition to “debilitating medical condition” and does not require any “chronic and sever pain” or any of other specific symptoms.
The Gatekeeper's Statement [Section 8(a)1]:
This statement is for the umbrella Medical Purpose Affirmative Defense, available regardless of participation or not in the Registry ID Card program. It sets a different standard than that required under the "written certification" statement. Notice this statement refers to patient's "serious or debilitating medical condition or its symptoms", which gives you much more leeway than the "debilitating medical condition" standard, and provides more discretion than the general criteria too, which is, “debilitating medical condition” and does not require any “chronic and sever pain” or any of other specific symptoms. The element of the defense that directly relies on the doctor's unbridled discretion is a statement, written or oral:
A physician (Licensed MD or Osteopath) has stated that
- in the physician's professional opinion
- after having completed a full assessment of
- the patient's medical history
- and patient's current medical condition
- which assessment was completed in the course of a bona fide physician-patient relationship
- that the patient is likely to receive therapeutic or palliative benefit from the medical use of marijuana to treat or alleviate the patient's serious or debilitating medical condition or symptoms of the patient's serious or debilitating medical condition.
Registered Qualifying Patients - [Section 3(f)]. "Qualifying patient" means a person who has been diagnosed by a physician as having a debilitating medical condition. Must have a registry identification card, or legal equivalent if department fails to issue. [Section 9(b)].
Specific Medical Conditions listed in Statute
“Debilitating medical conditions":[Section 3 (a)1]
Applies to these medical conditions and the treatment of the following conditions:
- Positive status for human immunodeficiency virus
- Acquired immune deficiency syndrome
- Hepatitis C
- Amyotrophic lateral sclerosis (ALS - Lou Gehrig's Disease)
- Crohn's disease
- Agitation of Alzheimer's disease
- Nail patella
- New conditions can be specified: [Section 3 (a)3] Applies to any other medical condition or its treatment approved by the department, as provided for in section 5(a).
General Diseases , Medical Conditions, and treatment not listed but authorized in Statute: Open ended definition of "Debilitating medical condition" includes any other conditions below [Section 3(a)2]
- A chronic disease or its treatment
- A chronic medical condition or its treatment
- A debilitating disease or its treatment
- A debilitating medical condition or its treatment
if it produces any of these symptoms or side effects:
- cachexia or wasting syndrome;
- severe nausea;
- seizures, including but not limited to those characteristic of epilepsy; or
- severe and persistent muscle spasms, including but not limited to those characteristic of multiple sclerosis.
The Department shall not issue a Registry Identification card to a qualifying patient who is under the age of 18 unless:
- qualifying patient's physician has explained the potential risks and benefits of the medical use of marihuana to the qualifying patient and to his or her parent or legal guardian;
- The qualifying patient's parent or legal guardian submits a written certification from 2 physicians;
- and the qualifying patient's parent or legal guardian consents in writing to: (A) Allow the qualifying patient's medical use of marihuana; (B) Serve as the qualifying patient's primary caregiver; and (C) Control the acquisition of the marihuana, the dosage, and the frequency of the medical use of marihuana by the qualifying patient.
Physician Notice to Department - Card Revoked: If a registered qualifying patient's certifying physician notifies the department in writing that the patient has ceased to suffer from a debilitating medical condition, the card shall become null and void upon notification by the department to the patient. [Section 6(f)]
Confidentiality Rules: [Section 6(h)]
- Applications and supporting information submitted by qualifying patients, including information regarding their primary caregivers and physicians, are confidential.
- Department must maintain a confidential list of the persons to whom the department has issued registry identification cards.
- Individual names and other identifying information on the list is confidential and is exempt from disclosure under the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.
- Department shall verify to law enforcement personnel whether a registry identification card is valid, without disclosing more information than is reasonably necessary to verify the authenticity of the registry identification card.
- A person, including an employee or official of the department or another state agency or local unit of government, who discloses confidential information in violation of this act is guilty of a misdemeanor
- Department employees may notify law enforcement about falsified or fraudulent information submitted