Dr Travis Rieder discusses his own experiences with opioids and the ethical challenges of “legacy patients,” and Dr Stephanie Zaza, president of the American College of Preventive Medicine, discusses the future of opioid research priorities.
The history of Western medicine chronicles a tension between ideologies of patient care—the holistic Hippocratic view and the specialization view, with a depersonalization of the patient that coincides with the rise of pathologic anatomy in the early modern era.
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.
A 3-step analgesic ladder was introduced in 1986 and needs change. Surgical interventions could reduce opioid use and motivate expansion of current pain management approaches.
AMA J Ethics. 2020;22(8):E695-701. doi:
10.1001/amajethics.2020.695.
John Meyer joins Ethics Talk to discuss how “human-centered” design can help remove barriers to care and forge solidarity between patients and clinicians, and multidisciplinary artist Eve Payor talks about her projects with the Atlantic Center for the Arts and how soundscape ecology can help us understand effective sound design in health care settings.