Opioid Prescribing: Navigating the Ethical Battlefield
http://www.painweek.org/story/opioid-prescribing-navigating-the-ethical-battlefield/
This is a very interesting article, the only people quoted are TWO ATTORNEYS. They advise prescribers to do what is best for the pt and that they are not expected to be perfect, just reasonable. They also suggest that a prescriber who elects not to treat pts could be guilty of MALPRACTICE ! Also the prescriber is apparently suppose to be a “mind-reader” in determining if the pt is trying to mislead (lying) to the prescriber to get opiates about a SUBJECTIVE DISEASE ISSUES. Of course, if our judicial system shuts down a practice because a prescriber’s failure to miss some of these issues…and a pt or two over doses, commits suicide.. that the legit pts within the practice gets thrown to the street by the judicial system.. there is no responsibility of the judicial system for the resulting pts that can’t find new clinician that will treat their pain and/or commit suicide. IMO.. it would seem that our judicial system has set up the system as heads they win and tails the clinician loses… or course.. the chronic pain pts tend to always end up on the losing end.
As concerns continue to mount regarding opioid overdose, misuse, and abuse, https://801injured.com/car-accidents/ lawyers and guidelines regulating the prescribing of painkillers to patients have become stricter. Prescribers of narcotics are faced with more than just ethical dilemmas when making the decision to treat a patient with opiates; they are also being challenged on the legal front.
“Whether we are speaking in clinical, moral, ethical, or legal terms, the fundamental question remains: What is best for my patient?” said Stephen J. Ziegler, PhD, JD, associate professor in the Department of Public Policy at Indiana State University.
Kevin Barnard, a member of the National Association of Drug Diversion Investigators and formerly of the San Diego Police Department, and Jennifer Bolen, JD, a former US District Attorney and expert on medico-legal issues related to pain management, joined Ziegler in a panel discussion that centered around how physicians should handle situations in which they believe a patient is diverting or abusing pain medications, or both.With healthcare providers battling these issues on a daily basis, many in the medical community are wondering how decisions can be made effectively and efficiently. Recognizing when a patient is attempting to mislead a physician into providing painkillers is a responsibility of the prescriber. However, being able to make an educated decision to do what is best for the patient is not always easy.
“In many ways it comes down to how well equipped the physician is to perform patient assessment and screening for abuse; how well the physician understands and how easily the physician can access integrated care, including behavioral health support; and how much of the physician’s focus is money oriented vs patient centered,” Ms. Bolen said.
However, too much caution when considering medication for patients with pain can be harmful, as well.
“Clinicians who withhold the prescribing of opioids because they wrongly suspect that their patient is diverting have caused their patient to suffer, while clinicians who fail to take reasonable precautions to prevent abuse are fueling the abuse of opioids,” Dr. Ziegler warns.
Although it might save time, a strategy that avoids opioids entirely could essentially result in negative consequences for prescribers. Blatantly ignoring potential treatment options for a patient with pain could have both ethical and legal ramifications.
“For some clinicians, a blanket policy of withholding opioids may seem to be the safest route,” Dr. Ziegler explained. “Such an approach would reduce the amount of time they have to spend with a patient and it avoids any concern that their prescription will be diverted.”
“But such policies are not only unethical because they subordinate the patient’s needs, they can also expose the clinician to accusations of medical malpractice,” Dr. Ziegler cautioned.
The strategy behind prescribing opioids isn’t necessarily a clear one. There are numerous patient- and pharmacologic-related issues for a physician to consider before deciding whether or not to treat an individual with prescription painkillers.
“Ensuring access while preventing the abuse of opioids is not a zero-sum game and will remain an ongoing challenge for clinicians,” he said. “Patient assessment, screening for abuse, and integrated care all have a part in good patient care. Clinicians are not expected to be perfect, just reasonable.”
Filed under: General Problems
My wife was denied heart meds for severe hypertension, by three cardiologists. Apparently, after a ICU visit, minds were made up. Doctors would walk right into the appt, and literally ask her what she is doing here, and they cannot treat. Finally, a doctor out of the area, gave her Lisinopryl immediately. We cannot find an attorney for medical negligence, denial of equal rights access, and Medicare patient rights violations. These doctors are subcontracted with Medicare, so even though doctors can fire, there are the Medicare patient rights that supercede.
So, not sure how ones can sue for negligence for no pain meds as needed, for we cannot even find one decent attorney for unec worsened cardiac issues.