Legacy patients are so-called because their opioid use behaviors express past, aggressive opioid prescribing by a clinician. Managing their pain and dependence justly is ethically complex.
AMA J Ethics. 2020;22(8):E651-657. doi:
10.1001/amajethics.2020.651.
Jennifer D. Byrne, LCSW, CADC, Katie S. Clancy, MSW, and Isabell Ciszewski, LCSW
Social work perspectives on whether prescribers should authorize opioid refills emphasize the importance of multidisciplinary approaches to patient self-determination.
AMA J Ethics. 2020;22(8):E658-663. doi:
10.1001/amajethics.2020.658.
Considering chronic opioid use when planning elective surgery would likely enhance team communication, decrease stigma, and facilitate care transitioning and long-term planning.
AMA J Ethics. 2020;22(8):E664-667. doi:
10.1001/amajethics.2020.664.
When the patient delivers a low-birth-weight infant that requires extensive time in the neonatal intensive, should she be held responsible? Where do we draw the line? More importantly, on what basis do we draw the line?
Using the patient’s worldview to challenge his or her decision and establish a treatment plan—implying the view is shared by the physician when it is not—could be seen as manipulative and deceptive.