This month on Ethics Talk, Dr Sheryl Fleisch discusses strategies for delivering health services to people experiencing homelessness, including street psychiatry.

Clinicians must advocate for decriminalization of SUDs during pregnancy and for improving access to comprehensive, evidence-based care.

Clinicians diagnosing and treating potentially trafficked patients with co-occurring addiction and mental illness should guard against expressing negative biases.

Because research on the efficacy of approaches to addiction recovery is inconclusive, clinicians should recommend several, including 12-step approaches.

Dr Adam T. Perzynski joins Ethics Talk to discuss his article, coauthored with Dr Kurt C. Stange: “How Should Clinicians Ally With Patients Whose Health Is Unlikely to Be Improved by Even Numerous Clinical Encounters?”

Patients experiencing homelessness and mental illness face conditions and circumstances that deserve focused ethical and clinical attention.

Principles of respect for autonomy, beneficence, and nonmaleficence guide trauma-informed care. Care ethics should also support this framework for responding to the health needs of trafficked patients.

Uncertainty about which psychiatric interventions are palliative stems from psychiatry’s prioritization of symptom management regardless of diagnosis. 

Palliative psychiatry can facilitate compassionate resolution of ethical conflicts in end-of-life care decision making with persons with substance use disorders.  

Dr Brent M. Kious joins Ethics Talk to discuss his article, coauthored with Dr Ryan H. Nelson: “Does It Matter Whether a Psychiatric Intervention Is ‘Palliative’?”