Tag: drug abuse

Bioethics Blogs

Politics of Pain: Investigating the Ethics of Palliative Care as a Global Human Right

by Alix Masters

Within the last decade, strides have been made in the field of global health policy to extend the reaches of palliative care universally.  In 2014, the World Health Organization formally declared palliative care a global human right.[1] This development in global health policy is a positive one when we consider the medical politics of pain relief across racial difference.  Both in the United States and abroad, there is a long medical history of discriminatory practices against certain groups of people with regard to pain management—including withholding necessary pain medication altogether.  Therefore, in many ways the declaration of palliative care as a human right is a necessary step in ensuring all peoples, regardless of identity, have their pain taken seriously by the medical establishment and have their comfort made a medical priority.  When we consider how different cultures negotiate beliefs around death and pain relief, however, the issue of palliative care as a universal human right becomes more complex.  For example, countries with strong histories of Buddhist thought and culture have traditionally opposed the ideology of palliative care.[26]  In Buddhism, suffering is considered an inextricable part of life and masking this suffering through medical intervention is looked down upon.[2]  For example, Vietnam, a country with a culture strongly imbued with Eastern Buddhist values, has a long history of rejecting palliative care and pain medications in general.[26]  Due to this, the World Health Organization’ declaration that palliative care is a universal human right could also be understood as a Western organization blatantly ignoring Buddhist cultural traditions. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Fordham University’s Dr. Celia Fisher Awarded APA Ethics Educator Award for Outstanding Contributions to Ethics Education

Click to view slideshow.

Fordham University’s Center for Ethics Education Director Dr. Celia Fisher, PhD is the 2017 recipient of the ninth annual American Psychological Association (APA) Ethics Committee Ethics Educator Award for her outstanding contributions to ethics education at the national level! Dr. Fisher was presented with the award earlier this month by APA Ethics Committee Chair Patricia L. Watson, PhD, at the 125th APA Annual Convention in Washington, D.C.

Psychologists are awarded the Ethics Educator Award for demonstrating outstanding and innovative contributions to the profession of psychology through ethics education activities. These ethics education activities include presentations, workshops, publications and more.

Dr. Fisher is the Mary Ward Doty University Chair in Ethics at Fordham University, a professor of Psychology and the director of Fordham University HIV and Drug Abuse Prevention Research Ethics Training Institute. In addition to chairing the 2002 revision of the American Psychological Association’s Ethics Code, Fisher’s Decoding the Ethics Code: A Practical Guide for Psychologists is now in its fourth edition from Sage Publications. Dr. Fisher’s federally funded research programs focus on ethical issues and well-being of vulnerable populations, including ethnic minority youth and families, active drug users, college students at risk for drinking problems, LGBT youth and adults with impaired consent capacity.

Please visit Dr. Celia Fisher’s webpage for more information about her work, as well as the Fordham University Center for Ethics Education Research page.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Fordham University’s Dr. Celia Fisher Awarded APA Ethics Educator Award for Outstanding Contributions to Ethics Education

Click to view slideshow.

Fordham University’s Center for Ethics Education Director Dr. Celia Fisher is the 2017 recipient of the ninth annual American Psychological Association (APA) Ethics Committee Ethics Educator Award for her outstanding contributions to ethics education at the national level! Dr. Fisher was presented with the award earlier this month by APA Ethics Committee Chair Patricia L. Watson, PhD, at the 125th APA Annual Convention in Washington, D.C.

Psychologists are awarded the APA Ethics Committee Ethics Educator Award for demonstrating outstanding and innovative contributions to the profession of psychology through ethics education activities. These ethics education activities include presentations, workshops, publications and more.

Dr. Fisher is the Mary Ward Doty University Chair in Ethics at Fordham University, a professor of Psychology and the director of Fordham University HIV and Drug Abuse Prevention Research Ethics Training Institute. In addition to chairing the 2002 revision of the American Psychological Association’s Ethics Code, Fisher’s Decoding the Ethics Code: A Practical Guide for Psychologists is now in its fourth edition from Sage Publications. Dr. Fisher’s federally funded research programs focus on ethical issues and well-being of vulnerable populations, including ethnic minority youth and families, active drug users, college students at risk for drinking problems, LGBT youth and adults with impaired consent capacity.

Please visit Dr. Celia Fisher’s webpage for more information about her work, as well as the Fordham University Center for Ethics Education Research page.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Recovery Navigators: How an Overlooked ACA Program Could Be a Tool in Addressing the Opioid Crisis

By Matthew J.B. Lawrence Research indicates that one of many challenges in addressing the opioid epidemic is getting people who are theoretically eligible for government-funded drug abuse treatment through CHIP or Medicaid to actually make use of those programs when their … Continue reading

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Drug abuse, suicide and hopelessness

A recent article in the Hastings Center bioethics forum caught my eye. It was titled “Removing the Stigma from Stigmatopin to Help Curb Opioid Dependence”. The author, Chelsea Cox, had created the term Stigmatopin to try to help make her case that marijuana should be used as a treatment for opioid dependence to reduce the high rate of deaths from opioid overdose that we are seeing in our country. Opioid dependence is a serious problem and creative thoughts about how to deal with this very difficult problem are welcome, but it seems to me that substituting one dependence for another misses the mark.

Another recent article in First Things titled “Dying of Despair” by Aaron Kheriaty, a psychiatrist and director of the Medical Ethics Program at University of California Irvine School of Medicine, helped me focus my thoughts on why treatment with marijuana falls short of what we need to do for those who are dealing with opioid abuse. Kheriaty’s article is focused on another serious problem in our society, the rising rate of suicides, but he connects the two problems with the idea that substance abuse and suicide are both problems that have hopelessness and isolation with the loss of meaningful interpersonal relationships as an underlying cause. While there may be some situations in which substituting the controlled use of one narcotic such as Suboxone or methadone for the uncontrolled use of another such as heroin may be an appropriate step in the treatment of some patients with opioid abuse and marijuana could possibly play a role in that type of process, the real answer to dealing with this serious problem is dealing with the reasons why people become involved with substance abuse in the first place.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

How Can You Take Part in Clinical Research? Looking Beyond “First in Human”

For a remarkable journey through the front lines of clinical research, I’d like to invite you to join me in viewing First in Human, which premieres tonight at 9 p.m. ET on the Discovery Channel. This three-part docuseries, to be aired August 10, 17, and 24, provides an unprecedented look inside the NIH Clinical Center here in Bethesda, MD, following four of the many brave patients who’ve volunteered to take part in the clinical trials that are so essential to medical breakthroughs.

You’ll learn about what it’s like to take part in an experimental trial of a new treatment, when all standard options have failed. You’ll see that the NIH Clinical Center and its staff are simply amazing. But keep in mind that you don’t have to travel all the way to Bethesda to be part of outstanding, NIH-funded clinical research. In fact, we support clinical trials all across the country, and it’s often possible to find one at a medical institution near your home. To search for a clinical trial that might be right for you or a loved one with a serious medical problem, try going to ClinicalTrials.gov, a web site run by NIH.

According to a national survey conducted a few years ago, 16 percent of respondents reported that they or a family member had participated in a clinical trial [1]. But among adults with cancer, participation in clinical trials is estimated to be only about 3 percent [2].

These numbers need to go up! Not only do clinical trials offer sick people who have no other options a chance to receive experimental treatments that may extend or save their lives, such work is essential for advancing scientific knowledge in ways that will benefit the health of future generations.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

How Much Should Your Boss and the U.S. Department of Labor Know About Your Opioid Prescription History?

As the
price of health care and uncertainty about health insurance coverage increases,
employers are taking more of an interest in their employees’ health. Indeed,
this is not a new trend as the United States health insurance system has been
employment-based since its creation. However, this trend may seem more
justifiable when the federal government also takes an interest in employees’
health.  From a public health
perspective, monitoring a society’s health is very important but it must be
balanced against the individual’s privacy interest as well as the harms and
benefits of that monitoring. There is also the issue of who/what is the most
appropriate entity to be doing the monitoring.

On June
27, 2017,
the
United States Department of Labor announced
it
will officially be
monitoring
use of opioid prescriptions by workers
under the
Federal Employees’ Compensation Act, which is the law surrounding the worker’s
compensation system.  The announcement
expressed a safety concern based on overdoses and addiction of opioids in the
midst of our current opioid crisis.

When an
employee files a worker’s compensation claim,
the
employer must be notified
and the employer
has access to the health records included in that claim
.
The employer’s access to health records is limited to whatever is included in
the claim and is justified based on the premise that the employer has an
interest in the worker’s compensation claim. However, this new monitoring
system means that an employer will now have access to its employees’ opioid
prescription history, as this is information the U.S. Department of Labor will
be monitoring as part of the worker’s compensation process.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

How Much Should Your Boss and the U.S. Department of Labor Know About Your Opioid Prescription History?

As the
price of health care and uncertainty about health insurance coverage increases,
employers are taking more of an interest in their employees’ health. Indeed,
this is not a new trend as the United States health insurance system has been
employment-based since its creation. However, this trend may seem more
justifiable when the federal government also takes an interest in employees’
health.  From a public health
perspective, monitoring a society’s health is very important but it must be
balanced against the individual’s privacy interest as well as the harms and
benefits of that monitoring. There is also the issue of who/what is the most
appropriate entity to be doing the monitoring.

On June
27, 2017,
the
United States Department of Labor announced
it
will officially be
monitoring
use of opioid prescriptions by workers
under the
Federal Employees’ Compensation Act, which is the law surrounding the worker’s
compensation system.  The announcement
expressed a safety concern based on overdoses and addiction of opioids in the
midst of our current opioid crisis.

When an
employee files a worker’s compensation claim,
the
employer must be notified
and the employer
has access to the health records included in that claim
.
The employer’s access to health records is limited to whatever is included in
the claim and is justified based on the premise that the employer has an
interest in the worker’s compensation claim. However, this new monitoring
system means that an employer will now have access to its employees’ opioid
prescription history, as this is information the U.S. Department of Labor will
be monitoring as part of the worker’s compensation process.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Pharmaceutical Company Removes Opioid Opana from Market Due to Addictiveness

Pharmaceutical company Endo has declared that it will be retracting its opioid Opana ER, a potent and addictive pain medication, from the market in light of a June 2017 FDA withdrawal request. Citing the drug’s “public health consequences of abuse,” the FDA appeal historically marked the first time the administration has cited drug abuse concerns in a drug withdrawal request. In a July 6th company news release about the pull, Endo reiterated its confidence in the “safety, efficacy, and favorable benefit-risk profile” of Opana when “taken as prescribed,” but stated that it will be voluntarily complying with the FDA request.

According to the Centers for Disease Control and Prevention, the US is confronting a sweeping opioid overdose epidemic that killed over 33 000 people in 2015 alone. The drug withdrawal could signify greater attention to the responsibilities of pharmaceutical companies in the face of bioethical challenges such as drug addiction and abuse.

Endo noted that it “has taken significant steps over the years to combat misuse and abuse,” which involved altering the Opana formula in 2012. It also changed the pills’ form into one more difficult for addicts to crush into a powder, which consumers can do to initiate a stronger high. Yet, data has indicated that many consumers alternatively inject the drug to achieve similar effects. Opana is considered twice as potent as the oft abused opioid OxyContin.

Like other opioids, Opana binds to the areas of the brain that manage pain and emotions. The medication combats pain by intensifying dopamine levels in such areas, and initiates strong euphoric feelings and pain relief that the brain becomes increasingly accustomed to over time.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The Crisis of Our Era: Can we find a way to talk about it?

So much of the fate of our planet, the human race, and all of God’s creatures depends on humans having an objective, causal understanding of the pressing problems we face and then, on that basis, developing some reasonably effective practical means by which those threats can be ameliorated—it’s called, using human intelligence and being connected to reality, at least reality with a small “r”, as in empirical reality. Just think of the causes of threats such as climate change, transmittable diseases and drug resistant viruses, gun violence, drug abuse, hunger, unemployment, poverty, lack of healthcare coverage, and on and on. Without reasonably sound knowledge of the causes of these threat humans are rendered helpless and vulnerable. And even with sound knowledge, without a practical, yes political, means, in the form of sound public policy, of collective action, to ameliorate them, we are cannot take meaningful action, and are still rendered helpless and vulnerable. Currently, in the United States there is vast disagreement not only over how best to formulate policy solutions to some our most pressing problems, there is often no agreement over how to understand the problem or even whether or not a problem exists. Climate change and gun control are two prominent examples. 

The fact that climate change is real and greatly accelerated by human activity is a fact about which there is clear scientific evidence. Practically all scientific societies, science academies, and governmental and intergovernmental agencies, are in complete agreement, which means the evidence for this empirical claim being true is about as compelling as anything we know about the natural phenomena.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.