Medical and clinical professions

Clinical judgement is meant to guide treatment, yet current regulation prevents prescribers from using the route that may offer the fastest and safest relief. Smoking should never be a preferred option. Clinicians and patients should however be free to consider the full range of clinically appropriate options without being fettered by legislation.

Many effective medicines carry risks; they’re used because the benefits outweigh the risks. Cannabis should be judged by the same standard.

Click here to read excerpts from Discrimination by Design relating to medical and clinical sectors.

1) What is the clinical rationale for smoked medication delivery?

The clinical rationale for smoked medication delivery is speed of onset. This enables patients to titrate accurately for acute symptoms which can escalate in real time. No other form of delivery currently achieves these two outcomes.

2) How does current law constrain professional judgement?

Regulation 16A(3) prohibits clinicians from prescribing the only form that may be clinically appropriate. The briefing examines how this fetters clinical discretion and exposes prescribers to ethical conflict.

3) Does prohibition of smoked delivery align with GMC and NICE guidance?

Professional standards require treatment based on individual need and best evidence. The analysis compares regulatory barriers with duties under GMC Good Medical Practice and NICE principles.

4) What are the patient-safety implications of enforced substitution?

When patients are forced onto slower or less effective routes, risks rise – including loss of symptom control.

5) How can policy evolve to support evidence-based prescribing?

The Home Office has commissioned the Advisory Council on the Misuse of Drugs (ACMD) to review the impact of legal changes to allow the use of medicinal cannabis, introduced in 2018. This advice was commissioned in 2025 and not expected to report until 2028. This leaves patients, clinicians and lawyers in limbo for another three years. That’s just until Government gets the report, not until it starts to take action. Does that seem reasonable?

Briefing document download

Clinicians are effectively prohibited from prescribing the only form of medication that may be clinically appropriate. Discrimination by Design examines how this anomaly arose – and how it can be remedied. Click the button below to view and/or download the document in PDF format.

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