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.
A guardian’s request to sterilize a woman with intellectual disabilities is not ethically justifiable unless the woman assents and it is to her benefit.
AMA J Ethics. 2016;18(4):365-372. doi:
10.1001/journalofethics.2016.18.4.ecas2-1604.
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.
Kristen N. Pallok and David A. Ansell’s “Should Clinicians Be Activists?” highlights how physician activists risk retaliation from “economically and socially” privileged physician leaders and organizational leadership who “have been trained to comply” with structural inequity.
AMA J Ethics. 2022;24(7):E694-696. doi:
10.1001/amajethics.2022.694.