Ethics and Epidemics

Julie Aultman, Ph.D., has seen elderly patients, health care providers and young adults struggle with addiction. The director of the bioethics certificate program and professor of family and community medicine at NEOMED brought her real-world experience to a panel titled Treating Opioid Addiction during the 2018 Poynter Kent State University Media Ethics Workshop.

Dr. Aultman was joined on the panel by a chiropractor who makes it a point to avoid prescribing opioids; a father who lost his son to a drug overdose; and a clinical pharmacologist who is the manager of an addiction services program at a local children’s hospital.  

Journalists gathered at Kent State to hear their insights into the ethical considerations of an epidemic that continues to overwhelm communities and families.

Looking for solutions

How would each panelist change things for the better? Dr. Aultman sorted her answers into two categories. As a researcher, she said, she consistently works to connect people from different professions and walks of life to get people out of their silos. In that way, she’s much like the workshop organizers, looking for a holistic approach to solving real-life problems, not reducing people to an addiction.

And as an educator, she guides her students – whether they are pursuing degrees in medicine, pharmacy or medical ethics and humanities — to recognize the biases they may have against patients. To combat prejudices and stereotypes, she often discusses the social determinants of health (where people are born, grow, live, work and age) and helps raise awareness of hidden or structural bias.

As co-panelist Michelle Bestic, Ph.D., clinical pharmacologist and manager of Addiction Services Program for Akron Children’s Hospital candidly shared, “We’re individuals treating individuals. We bring those prejudices and prior experiences with us when we treat patients.”

Bias may play a role in how health care professionals, as well as ordinary citizens, feel about the use of   naloxone, a medication that can be administered to reverse an overdose. Controversy has swirled from ordinary citizens over use of naloxone, with the thought that using the life-saving medication encourages drug users to continue their pattern, not try to change.

Dr. Bestic suggested thinking of addiction as a disease state. If a patient has asthma, they need an inhaler. If a patient has severe allergies, they need an EpiPen. Narcan is the inhaler and EpiPen equivalent for people addicted to opioids.

But concerns still linger, especially about elementary-aged students being taught how to administer the medication. Dr. Aultman put it this way: Teaching young children to use the life-saving drug could be the tool they need to save their parents’ lives, if their parents are overdosing.  

Dr. Aultman shared a scenario about a 22-year old man who needed a heart valve replacement — not his first, but his second, due to the stress he had put on his heart from using opioids for an extended period of time. This patient lacked family support, since not only was he fighting addiction; his family was, too. On top of that, he did not have health care or access to Medicaid.

As a researcher, Dr. Aultman understands the medical needs. And as a professor teaching future health professionals, she wants her students to appreciate the nuances of ethical dilemmas that sooner or later they are likely to face. 

 

The 2018 Poynter Kent State University Media Ethics Workshop was a partnership between KSU and the nationally recognized Poynter Institute, based in St. Petersburg, Florida. Another panel during the day-long event featured the team of journalists that won a Pulitzer Prize for its coverage of the opioid epidemic.

Watch the full recording of the Treating Opioid Addiction panel.

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