The Ethics of Opiate Use in Health Care

THE ETHICS OF OPIATE USE IN HEALTH CARE
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The ethics of opiate use in health care
The opioid epidemic has been known as the worst drug crisis in American history. Devastating consequences of the opioid epidemic include the highest increases in opioid abuse and related overdoses, just as the rising frequency of babies encountering withdrawal syndrome due to opioid use and misuse during pregnancy. According to the moral framework of Care Ethics, medical practitioners should consider opioids as the last drug of choice for pain to prevent long term use, addiction and overdose to prescribed patients.
Ms. Z is a divorced, and a 40-year-old female was one of my patients admitted to cascade hospital with a diagnosis of major depression and generalized anxiety disorder. Ms. Z had total Knee replacement surgery six months before this hospitalization. Oxycodone 5mg every four hour was presented to her by her Doctor. Ms. Z was consuming Oxycodone 5 mg and reported insufficient pain control with negative capability in caring for herself and her children. The usage of oxycodone by Ms. Z increased to 15mg for six months. However, after six-month, Ms. Z was unsuccessful in reducing her medication dose. Although she requested help so that she can discontinue the medicine. Ms. Z got admitted to the detox center for seven days then 14 days to drug rehabilitation. Ms. Z discharged home, but a few weeks later she became depressed, anxious, unhappy, craving for those medications, started cutting her arms and legs. Ms. Z brought to our hospital for treatment of depression, generalized anxiety, and self-harm. Ms. Z was a danger to herself; lost custody of her children and her job was at risk. Her boyfriend also refused to continue her relationship with her.
In Ms. Z's case, the moral framework of care ethics can be used. Opioids must be considered by medical practitioners as the last drug of choice for the pain to prevent overdoses, addiction, and usage to prescribed patients as per the moral framework of Care Ethics.
In Ms. Z's case, some of the moral principles were at risk. For considering decisions related to prescription of opioid, the physicians can consider the fundamental ethical principles of justice, respect for autonomy, nonmaleficence, and beneficence as they need to assure that the proper management and assessment of the pain of the patients is performed. Principle of nonmaleficence tells us to avoid risk (Munson & Lague, 2017, p. 934). Physicians who are prescribing opiate should educate patients and offer different therapy to control pain to prevent risks from long term use of opioid.
Premise One: If when the physicians gave Ms. Z oxycodone drug as a treatment for her condition, the benefits on its usage did not outweigh the harm caused by the drug then it was wrong. (According to the principle of nonmaleficence)
Premise Two: When the physicians gave Ms. Z oxycodone as a treatment for her condition, the benefits on its usage did not outweigh the harm caused by the drug.
Conclusion: Administration of oxycodone drug on Ms. Z may not have explored all the pain management options and other ethical issues but took into consideration one premise only, never abandon any patient who is in pain. Since the pain management team was never involved, it was wrong in all premises to prescribe the drug for Mr. Z.
Form:    ModusPonens Premise one. If X, then Y.
Premise two. X
Conclusion. Y
Administration of oxycodone to Ms. Z was morally wrong according to the principle of nonmaleficence. The harm caused by the usage of oxycodone which is an opiate drug outweighed the benefits it offered to the patient. As indicated in the case study, it led to addiction and immediately she left taking the drugs, harm would be caused such as unhappiness, general anxiety and depression. At a certain point she even started cutting her arms and legs. According to the principle of nonmaleficence, the duty of the nurse is to protect the life of the patient by avoiding doing harm (Woodbury, 2015). The doctor did not adequately inform the patient on the available treatment options other than the usage of the opiate drug. The doctor also knew that the usage of the opiate drug would have harm on the patient. Due to addiction, Ms. Z cannot do without the drug and the withdrawal symptoms such as depression, general anxiety and self-harm. It has also affected her life negatively since she loves her job and loved ones. The physicians should have administered other forms of treatment rather than administering oxycodone.
Premise one: If when the physicians gave Ms. Z oxycodone drug as a treatment for her condition, the benefits on its usage did not outweigh the harm caused by the drug then it was wrong. (According to the principle of nonmaleficence).
Premise two: When the physicians gave Ms. Z oxycodone as a treatment for her condition, the benefits on its usage did not outweigh the harm caused by the drug.
Conclusion: It was wrong for the physicians to administer oxycodone drug on Ms. Z.
Argument: According to the principle of nonmaleficence, administration of oxycodone, an opiate, to Ms. Z was morally wrong. The reason is because from the case study, the drug led to such health complications as addiction and an intense withdrawal characterized by unhappiness, general anxiety and an acute depression. The administration of the drug also led to problems in her social life since the moment she stopped the drug, she started neglecting and associating negatively with her family members and co-workers (Fischer et al., 1999)
Someone might argue that Premise one is false. The actual implication of Premise one is that the opiate drug has no benefits at all since its harmful effects outweigh its benefits. However, one might argue that the drug has several benefits which include relieving mild to acute and shooting pain, called paroxysmal pain. The individual might also argue that oxycodone is highly prescribed to patients in the later stages of cancer disease.
Paying close attention to the situation of Ms. Z, it is clear that the pain in her heath condition could have been relieved by any other pain-relieving drug or anti-biotic other than oxycodone. This is because the pain was not sharp and acute enough to be prescribed the opiate drug. The administration of the drug instead left her addicted, desperate, lonely and harmed (Jacobson, 2015).
Well, it cannot be argued that the drug did not entirely help her. The doctor knew exactly the reason for the prescription and the harmful effects of the drug. The doctor also knew the right amounts of the drug to be prescribed to a single patient but what Ms. Z did wrong was accepting to take Oxycodone whenever she felt pain and in order to comfort her terminal condition. This in turn led to addiction and other harms associated with withdrawal.
One might at first agree with the principle of nonmaleficence that people should act in ways that do not harm, inflict evil and cause pain to others. That is correct. On the other hand, the same person might argue that it cannot be considered a violation of the principle of nonmaleficence if the person causing pain to another person is attempting to help save their lives. In this case, th...