This third era of opioids ruining thousands of US lives follows a first era of iatrogenic addiction stemming from the Harrison Act of 1914, and a second was marked by changes in pain treatment attitudes between 1950 and 1970.
AMA J Ethics. 2020;22(8):E729-734. doi:
10.1001/amajethics.2020.729.
As high-tech care decisions led to value clashes in hospital corridors, ethics committees developed to respond to diverse viewpoints, families’ concerns, and clinicians’ moral distress. They now exist in almost all US health care organizations.
AMA J Ethics. 2016;18(5):546-553. doi:
10.1001/journalofethics.2016.18.5.mhst1-1605.
Transitions in relabeling personalized medicine as precision medicine, precision health, or wellness genomics reflect shifting the locus of responsibility for health from individuals to clinicians and in shifting focus from genetic risk to genetic enhancement.
AMA J Ethics. 2018;20(9):E881-890. doi:
10.1001/amajethics.2018.881.
Beyond consensus that pain is “an unpleasant sensory and emotional experience,” its biology remains poorly understood, and options for its treatment remain frustratingly inadequate.
The causes of many health behaviors are deeply rooted in our culture, and using a counseling model that assumes individual control and responsibility for these behaviors can cause patients to feel hectored instead of helped.