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.
Prevention efforts can marginalize patients by stigmatizing certain behaviors, so distinguishing individual professionals’ preferences about those behaviors is critical.
AMA J Ethics. 2019;21(6):E536-539. doi:
10.1001/amajethics.2019.536.
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.
The stigma associated with HIV has diminished with its spread among the heterosexual population and the development of effective treatments. This normalization may justify assuming a more traditional public health perspective about mandatory prenatal screening.