The Ethical Dilemma Of Caring For A Patient

It is important to look at ethical dilemmas in a systematic way, thus increasing the chance of achieving a solution that gives the best possible outcome. An ethical problem solving model taken from American sources (Paradise and Siegelwaks, 1982; Austin et al., 1990) was used to develop a six-step process to follow, in order to achieve this (Bond 2010, pg. 227). This process informs this paper, and I am in the role of counsellor.

Opioid drugs are some of the most widespread pain medications that we have in this country; indeed, the fact is that opioid analgesic prescriptions have increased by over 300% from 1999 to 2010 (Mitch 989). Consequently, the number of deaths from overdose increased from 4000 to 16,600 a year in the same time frame (Mitch 989). This fact becomes even more frightening when you think about today; the annual number of fatal drug overdoses in the Unites States now surpasses that of motor vehicle deaths (Alexander 1865). Even worse, overdose deaths caused by opioids specifically exceed those attributed to both cocaine and heroin combined (Alexander 1865).

The United States of America has had a war against drugs since the 37th president, Richard Nixon, declared more crimination on drug abuse in June 1971. From mid-1990s to today, a crisis challenges the health department and government on opioid regulation, as millions of Americans die due overdoses of painkillers. Opioids are substances used as painkillers, and they range from prescription medications to the illegal drug, heroin. Abusing these substances can cause a dependency or addiction, which can lead to overdoses, physical damages, emotional trauma, and death. To ease the crisis, physicians are asked to depend on alternatives to pain management. Law enforcement cracks down on profiting drug-dealers and heroin abusers. People are warned against misusing opioids. The controversy begins for those who suffer from chronic pain, because they depend on opioids. There’s so a correlation to the 1980s cocaine epidemic, and people are upset over racial discrimination. Nonetheless, the best way to avoid this crisis is to recover the people at risk, reduce inappropriate opioid description, and have a proper response.

Research has shown that there are several organizations and active advocates who are working on pain management problems to face this public health issue. The following establishments involve: The American Academy of Pain Medicine, Institute of Medicine, and American Pain Society and many for-profit and nonprofit organizations are also working at different level towards pain management. Most specifically, the IOM has been devoted to studying pain and its consequences on individuals, the healthcare system, as well as on government (IOM, 2011).

Mike Alstott knows first-hand how opioids, when used correctly, can play an important role in managing pain and helping people to function, but he is also keenly aware of the growing crisis of opioid misuse and overdose. More American adults are dying from misusing prescription narcotics than ever before. An estimated 35 people die every day in the U.S. from accidental prescription painkiller overdoses resulting from things like not taking a medication as directed or not understanding how multiple

Considerable cautions have been obtained throughout the United States to decrease the misuse of prescription opioids and helps to minimize opioid overdoses and related complications. Even though the pain medications have a significant part in the treatment of acute and chronic pain situations, it sometimes happen that the high dose prescription or the prescribed medications, without having enough monitoring, can create bad outcomes. It is always a dilemma for the providers to find who is really in need of pain medications and to identify those who are questionably misusing opioids.

It is important for our culture in western society to educate doctors on how to modify and limit their prescribing behavior so that less people become dependent on opioid medication. Doctors must start limiting and monitoring the number of opioid prescriptions they administer to patients. Limiting the number of prescriptions will lower the chances for potential abuse within patients, as well as lower the ease of access and circulation of opioid medication on the streets.

Apply the ethical decision making model presented in week one lectures (adapted from Beemsterboer, 2010; Velasquez et al, 2009) to the case study.

In fact, there was thought to be more of a need for them. Before the last two decades, opioids were used for cancer related or acute pain. However, in the 1990s chronic non cancer patients got attention because people nationally felt there was a shortage in patients receiving opioids, thus making them deprived of adequate pain management. Because of this, clinicians were encouraged to treat chronic non-cancer pain and patients in hospice care more often than they were used to. It was also encouraged to use high doses of opioids for long periods of time (Cheatle). The idea that providers seemed overly cautious about these medications caused a large increase in opioid prescriptions from health care providers. Threat of tort and litigation for some doctors that were deemed for not prescribing enough to alleviate pain of patients was also a concern for doctors This quickly turned a shortage of prescription opioids into a national prescription opioid abuse epidemic in under twenty years. From 1999 to 2010, the amount of prescription opioids sold to hospitals, pharmacies, and doctors offices quadrupled, and three times the number of people overdosed on painkillers in this time (Garcia). While some patients have benefitted from the increased sales and loose guidelines of prescription opioid analgesics, the increasing in opioid misuse, abuse, and overdose is truly daunting. As a nation, we need to back track, and

Doctors and clinical prescribers have discovered their role in curtailing the increased opioid prescriptions in America. It is without a doubt that they play a role in facilitating the opioid misuse endemic in the past by being enablers of the situations. When patients ask for pain medications, they do not take time to analyze the pain complaints or suggest alternative medications other than opioids. Even in instances when one doctor declines to offer a patient an opioid prescription for their pain needs, the patient is likely to find another who will give the prescription. However, there has been wide recognition of the opioid misuse endemic such that clinical prescribers are practicing more vigilant prescribing and are advocating opioid-free

Persistent pain has psychological and social implications for daily life. It can severely limit an individual’s ability to work and be a productive member of society and decreases quality of life. In the face of increasing stigma and barriers to care, patients are struggling to procure the legal medications that alleviate their debilitating pain.

Now, let's see how learning about the Four Ethical Lenses and a simple method for decision-making can help you resolve a typical ethical dilemma. Ready?

For a given ethical dilemma, there is usually a dominant pair. Frequently, more than one must be considered, and sometimes all four. But, as Kidder

In the article “Brief Research Report Defining Chronic Pain Ethics” it discusses the current issues in the diagnosis and treatments of chronic pain. A program called The Pain Action Initiative: A National Strategy (PAINS) conducted several focus groups in five cities of the US. These groups consisted of people with pain, providers, insurance and pharmaceutical industry representatives, law enforcement agents, and advocacy groups who came up with various issues dealing with chronic pain. The groups came up with six main subjects which included: disparities, quality care, trained professionals, chronic pain awareness, opiod use and multimodal therapy.

Determine the ethical course of action for the following three scenarios from the perspective of each of the three philosophical approaches: consequentialism, deontology, and virtue ethics. Then, complete the matrix below by writing a few sentences stating the ethical course of action and the reasoning from that approach’s perspective. Clearly differentiate the reasons for each of the three approaches.