One of the many doors money and power often open gives access to opioids where they would otherwise be withheld without strict oversight and management. Elvis Presley provides perhaps the most famous example of unmanaged access to drugs.
An older generation was far more likely to understand itself and its social world in terms of sin and virtue, vice and godliness. Lack of self-control and weakness of will were moral failings to be avoided. That sort of language has fallen on hard times.
Those in prison are less healthy than the general population, are far more likely to have engaged in high-risk behaviors that can result in organ damage, disease and disability, and age more rapidly than nonincarcerated individuals do.
This case illustrates how emergency physicians find themselves with an empty toolbox and must compromise to meet their responsibilities to patients and themselves.
A major contributor to the lack of medicines in developing countries is an intellectual property regime that allows proprietary drug companies with intellectual property monopolies to charge high prices and maximize profit.
Undocumented patients in the United States with end-stage renal disease receive “compassionate” dialysis. Such patients oscillate between being marginally well and “ill enough” to receive dialysis while clinicians wrestle with complicity in a system that both offers and withholds life-saving therapy.
AMA J Ethics. 2018;20(8):E778-779. doi:
10.1001/amajethics.2018.778.