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.
Jennifer D. Byrne, LCSW, CADC, Katie S. Clancy, MSW, and Isabell Ciszewski, LCSW
Social work perspectives on whether prescribers should authorize opioid refills emphasize the importance of multidisciplinary approaches to patient self-determination.
AMA J Ethics. 2020; 22(8):E658-663. doi:
10.1001/amajethics.2020.658.
Considering chronic opioid use when planning elective surgery would likely enhance team communication, decrease stigma, and facilitate care transitioning and long-term planning.
AMA J Ethics. 2020; 22(8):E664-667. doi:
10.1001/amajethics.2020.664.
Mandating processes that are not evidence based generates distress among patients and clinicians, so physician advocacy in national, state, and local policymaking is key.
AMA J Ethics. 2020; 22(8):E668-674. doi:
10.1001/amajethics.2020.668.
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.
Pain is the most common reason patients seek health care. The AMA Pain Care Task Force suggests how clinicians can offer good pain care and become savvy about situating themselves in the health care system to do so.
AMA J Ethics. 2020; 22(8):E709-717. doi:
10.1001/amajethics.2020.709.