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Session of 1999
          SENATE BILL No. 104           By Committee on Public Health and Welfare           (By Request of the Health Care Reform           Legislative Oversight Committee)           1-21          

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11             AN  ACT concerning the healing arts; relating to pain management.
12      
13       Be it enacted by the Legislature of the State of Kansas:
14             Section  1. As used in this act:
15             (a) "Acute pain" means pain that is the normal, predicted physiolog-
16       ical response to an adverse chemical, thermal or mechanical stimulus and
17       is associated with surgery, trauma and acute illness. It is generally time
18       limited and is responsive to opioid therapy, among other therapies.
19             (b) "Analgesic tolerance" means the need to increase the dose of
20       opioid to achieve the same level of analgesia and does not equate with
21       addiction.
22             (c) "Chronic pain" means a persistent state of pain in which the cause
23       of the pain cannot be removed or otherwise treated. Chronic pain may
24       be associated with a long-term incurable or intractable medical condition
25       or disease.
26             (d) "Pain" means an unpleasant sensory and emotional experience
27       associated with actual or potential tissue damage or described in terms
28       of such pain.
29             Sec.  2. (a) Controlled substances, including opioid analgesics, may
30       be essential in the treatment of acute pain due to trauma or surgery and
31       chronic pain due to cancer or noncancer origins. Effective pain manage-
32       ment as a part of quality medical practice for all patients seeking treat-
33       ment for pain, acute or chronic, or as a result of a terminal illness is a
34       legitimate medical purpose in the usual course of professional practice.
35             (b) Medical management of pain by a physician should be based on
36       current knowledge and research and should include use of both phar-
37       macologic and nonpharmacologic modalities. When a patient has devel-
38       oped analgesic tolerance and suffers from unrelieved pain, the physician
39       may prescribe increased amounts of analgesic, including opioids, based
40       upon clear documentation of the unrelieved pain and sound clinical
41       grounds showing good cause for such deviation.
42             (c) The board of healing arts shall develop rules and regulations re-
43       garding pain management to allow for prompt treatment and adjustment
44       of the quantity and frequency of doses of medication according to the
45       intensity and duration of the pain.
46             (d) The health care professional shall discuss the risks and benefits
47       of the increased usage of controlled substances with the patient or the
48       patient's guardian if the patient is incompetent. Thereafter, an informed
49       consent and agreement for treatment must be signed by the patient, pa-
50       tient's family member or guardian.
51             (e) A health care professional who administers, prescribes or dis-
52       penses medication or procedures to relieve another person's pain or dis-
53       comfort, even if the medication or procedure may hasten or increase the
54       risk of death, does not violate K.S.A. 1998 Supp. 21-3406, and amend-
55       ments thereto, unless the medications or procedures are knowingly ad-
56       ministered, prescribed or dispensed with the intent to cause death.
57             (f) No disciplinary action before the board of healing arts or violation
58       of K.S.A. 1998 Supp. 21-3406, and amendments thereto, assisting suicide,
59       shall be brought against the health care professional who complies with
60       this act and the rules and regulations adopted by the board of healing
61       arts concerning this issue.
62        Sec.  3. This act shall take effect and be in force from and after its
63       publication in the statute book.