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.
Critical skills required to weigh decisions with serious consequences, manipulate information rationally, and choose wisely are skills that are likely to be impaired by frontal lobe injury that results in personality change.
The greatest pressure to resuscitate the extremely low-birth-weight infant often results from successful marketing efforts that lead families to expect that their premature infants will be cute and healthy.
Physicians new to a case might object to an established care plan. Practice variation, clinical momentum, and how value is assigned by different parties to acute care and comfort measures can each contribute to conflict in these cases.
AMA J Ethics. 2018;20(8):E699-707. doi:
10.1001/amajethics.2018.699.