http://www.veteransformedicalmarijuana.org/content/pain-contracts-cooperation-or-coercion
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Pain Contracts: "Cooperation" or Coercion?
"Pain contracts" are signed agreements between a patient and a doctor specifying the terms and conditions under which the doctor agrees to treat a patient's chronic pain with opioid medications. These contracts typically include provisions which require patients to comply with the doctor's treatment recommendations, submit to random drug screening, refrain from the use of alcohol or illegal drugs, and keep their appointments. These contracts also usually specify that a patient may be discharged from the doctor's care or denied further treatment for any violation of the agreement. Though they sometimes go by different names, such as “pain management contracts,” “narcotic contracts,” “opioid contracts,” etc., they are generally known as “pain contracts” and thus imply a legally-binding, contractual relationship between the doctor and patient. They are used almost exclusively for opioid medications. For a typical example of a pain contract, click here (pdf download).
Pain Contracts are another result of the DEA's war on pain patients and their doctors. Doctors use pain contracts to cover their rear; as proof to the DEA and other law enforcement agencies that they are properly supervising those patients who get opiates. An additional benefit to doctors is that they serve to dissuade patients from filing lawsuits who have been discharged for failing to follow the rules. They treat pain patients as suspects in advance. But are these contracts really legally binding? Definitely not.
These “contracts” are not legitimate, legally-binding contracts. They are essentially one-sided demands from your doctor, signed under duress, which treat you as a suspect in advance, rob you of your privacy and your right to be an active participant in your own health care and your rights to accept or refuse treatments, and allow the physician to renege on his moral and ethical duty to treat you with a pseudo-legal agreement that you signed with the moral equivalent of a gun pointed at your head.
To understand the nature of the gun pointed at your head, you have to understand the concept of “duress.” Under contract law in most states and common law countries, a contract is unenforceable if it is signed under duress. As an example, if someone says you must sign this contract or I'll kill you, that is clearly duress, and that contract will usually be unenforceable. Similarly, when a doctor says you will sign this contract and abide by its terms or I will withhold medication from you (essentially sentencing you to torture until you can find another doctor) that is also very clearly duress. Add to that the danger of being medically blacklisted for violating one of these contracts, or even for refusing to sign one, and it is as if the doctor has a gun pointed at your head. You do not have the option of not signing the contract and still receiving medical care."
We have little choice...