Even where marijuana has been legalized, do the dangerous side effects of the drug militate against its use?

Does compassion for the patient override concerns of possible longterm harm?

Under which circumstances may a patient put himself into a potentially harmful situation?

If the non-medicinal properties of marijuana promote a feeling of wellbeing so that a patient feels relief, does that constitute a valid reason to write a prescription?

A historic halachic responsa offering the best argument for the halachic priority of medicinal need superceding the dreaded Dina D'iMalchuso's cannabis prohibition, in a sober and pious way.

Our regard for civic obedience and responsibility
may indeed be a yardstick of our ability to sanctify God's Name
and be a light to the nations.

Because marijuana is an illicit drug,
one might assume that it is halachically prohibited, as well.

However,
dina d'malchuta dina does not apply to matters of issur v'heter-
obligatory or prohibited activities, such as Shabbat, kashrut, inheritance or divorce. It applies only to monetary, commercial or civil law,
and not to religious law.

Since alleviation of pain and suffering is a religious obligation,11 then dina d'malchuta dina does not apply.

Wow.

Furthermore,
some poskim [rabbinic decisors] stipulate that dina d'malchuta dina is only binding when it does not oppose Torah law,
i.e. only when it relates to matters not dealt with explicitly by the halachah.

Rabbi Shlomo Ibn Adret (Rashba) cautions us that the Torah is of primary and paramount importance for the Jewish people.

Were we to defer to the law of the land to regulate every activity, we would effectively nullify much of Jewish law and abrogate the Torah itself.

However, to rule a certain way because it is the law of the Gentiles is forbidden, and it is prohibited by the Torah. If we were to accept this argument, we would nullify the first-born son's rights of inheritance and uproot all of jewish law. What need would we have for holy books written for us by Rebbi and Ravina and Rav Ashi; Jews could simply teach their children the laws of the Gentiles and build altars in the Gentile houses of study.

God forbid that such a thing ever happen to the Jewish people; God forbid. The Torah itself would wear sackcloth.

There are those who suggest that dina d'makhuta dina applies only to dinei malkhut, i.e. those areas in which the State has legitimate interests needed for the proper administration of government and for the smooth functioning of society. These include taxes, roads, traffic regulations, safety, etc. Laws that infringe on the social, interpersonal, judicial, cultural, religious and personal areas of life are excluded from dina d'makhuta dina and are regulated by Torah law.

Who is this guy writing?

"Dr. Wallace Greene received his B.A., M.A. and Ph.D. degrees from Yeshiva University and has taught courses in Ancient and Medieval Jewish History, Rabbinics, Talmud and other Judaica at Yeshiva University, Queens College, Upsala College, and Columbia University. ...he presently is Director of Jewish Educational Services for the United Jewish Appeal Federation of Northern New Jersey. Dr. Greene has given hundreds of lectures across North America on a wide range of topics and for a broad spectrum of groups and is author of dozens of articles on topics related to Jewish education in publications such as Journal of Jewish Education, Jewish Book World, Jewish Education News, The Jewish Week, and the Journal of Jewish Communal Service"

Sounds like a legit source to me. But, having scanned google, looking for discussion of this statement, haven't found any public controversy over it. The legend at the bottom of the page implies that it was given over by an American Jewish Congress summer event. I wonder how it was received? I hope mentioning it here doesn't get him in to trouble, he sounds like arighteous, g-d fearing fella. Check out his response to religious concerns over collegiate assimilation. And his kids to the third generation are religious, bli ayin hara!

Casuistic and philosophical arguments can also be mustered to nullify dina d'makhuta dina in this case.

State officials will not prosecute patients who use medical marijuana, and the prospect of federal enforcement is fairly remote. This then begs the question of defining dina d'makhuta dina in our case.

Does it refer to laws on the books or only to laws that are enforced?
Logic would dictate that dina d'makhuta dina only applies to laws that are enforced.

Just as a king is only a king if he has loyal subjects, so too laws that are not enforced eventually lose their status as laws.

At issue, however, is still the question of the feasibility and advisability of a physician prescribing marijuana. In those states where it is legal there seems to be minimal risk. In states where it is still illegal, how far must an observant physician go to help alleviate pain and suffering by prescribing marijuana?