Treating Workers as Essential Too: An Ethical Framework for Public Health Interventions to Prevent and Control COVID-19 Infections among Meat-processing Facility Workers and Their Communities in the United States.

Meat is a multi-billion-dollar industry that relies on people performing risky physical work inside meat-processing facilities over long shifts in close proximity. These workers are socially disempowered, and many are members of groups beset by historic and ongoing structural discrimination. The combination of working conditions and worker characteristics facilitate the spread of SARS-CoV-2, the virus that causes COVID-19.

Engaging Disability Rights Law to Address the Distinct Harms at the Intersection of Race and Disability for People with Substance Use Disorder.

This article examines the unique disadvantages experienced by Black people and other people of color with substance use disorder in health care, and argues that an intersectional approach to enforcing disability rights laws offer an opportunity to ameliorate some of the harms of oppression to this population.

Structural Discrimination in Pandemic Policy: Essential Protections for Essential Workers.

An inordinate number of low wage workers in essential industries are Black, Hispanic, or Latino, immigrants or refugees - groups beset by centuries of discrimination and burdened with disproportionate but preventable harms during the COVID-19 pandemic.

It is Not the Patient, It is the System: Commentary on "How Advanced Directives Help When Patients Refuse Life-saving Treatment Because of Their Substance Use".

Serious infections are common in patients with opioid use disorder who use injection drugs. Clinicians are often frustrated by the complexity and uncertainty involved in managing these patients, who also have a high rate of discharges against medical advice. The commentary addresses a proposal for a substance use advance directive that would bind the patient to involuntary future treatment, even over their contemporaneous objections.

Invisible No More: The Impact of COVID-19 on Essential Food Production Workers.

From the farms to the packing plants, essential workers in critical food production industries keep food on our tables while risking their and their families' health and well-being to bring home a paycheck. They work in essential industries but are often invisible. The disparities illuminated by COVID-19 are not new.

Disability Discrimination Against People With Substance Use Disorders by Postacute Care Nursing Facilities: It is Time to Stop Tolerating Civil Rights Violations.

People with substance use disorders (PWSUDs), including opioid use disorder (OUD), continue to face widespread discrimination, including in health care. As hospitals increasingly provide more appropriate and integrated care for PWSUDs, nursing facilities that provide postacute care are receiving more referrals for patients whose diagnosis of substance use disorders is acknowledged rather than ignored. A concerning number of these facilities refuse to admit or treat PWSUD, especially those with OUD receiving opioid agonist therapy (OAT).

Professional decision-making in medicine: Development of a new measure and preliminary evidence of validity.

Introduction: This study developed a new Professional Decision-Making in Medicine Measure that assesses the use of effective decision-making strategies: seek help, manage emotions, recognize consequences and rules, and test assumptions and motives. The aim was to develop a content valid measure and obtain initial evidence for construct validity so that the measure could be used in future research or educational assessment.

Methods: Clinical scenario-based items were developed based on a review of the literature and interviews with physicians.

Introduction: Living with Pain in the Midst of the Opioid Crisis.

This symposium includes twelve personal narratives from individuals impacted by the current opioid crisis. Three commentaries on these narratives are also included, authored by four experts-three scholars in the field of bioethics and one nationally recognized science reporter and best-selling author. The goal of this symposium is to explore the personal impact of public discourse and recent policy about the opioid crisis on people living with chronic pain.

Defining Misprescribing to Inform Prescription Opioid Policy.

Prescription opioid policies too often reflect over a century's worth of moralizing about the nature of opioid use disorder, the value of pain, and the meaning of suffering. The social and legal penalties to prescribers run in one direction-avoid overprescribing, however defined, at all costs. The lack of shared definitions is problematic for formulating and evaluating opioid policy.

Exploring unnecessary invasive procedures in the United States: a retrospective mixed-methods analysis of cases from 2008-2016.

Background: Unnecessary invasive procedures risk harming patients physically, emotionally, and financially. Very little is known about the factors that provide the motive, means, and opportunity (MMO) for unnecessary procedures.

Methods: This project used a mixed-methods design that involved five key steps: (1) systematically searching the literature to identify cases of unnecessary procedures reported from 2008 to 2016; (2) identifying all medical board, court, and news records on relevant cases; (3) coding all relevant records using a structured codebook of case characteristics; (4) analyzing each case using a MMO framework to develop a causal theory of the case; and (5) identifying typologies of cases through a two-step cluster analysis using variables hypothesized to be causally related to unnecessary procedures.

BETWEEN A ROCK AND A HARD PLACE: CAN PHYSICIANS PRESCRIBE OPIOIDS TO TREAT PAIN ADEQUATELY WHILE AVOIDING LEGAL SANCTION?

Prescription opioids are an important tool for physicians in treating pain but also carry significant risks of harm when prescribed inappropriately or misused by patients or others. Recent increases in opioid-related morbidity and mortality has reignited scrutiny of prescribing practices by law enforcement, regulatory agencies, and state medical boards. At the same time, the predominant 4D model of misprescribers is outdated and insufficient; it groups physician misprescribers as dated, duped, disabled, or dishonest.

Legal authority to preserve organs in cases of uncontrolled cardiac death: preserving family choice.

The gap between the number of organs available for transplant and the number of individuals who need transplanted organs continues to increase. At the same time, thousands of transplantable organs are needlessly overlooked every year for the single reason that they come from individuals who were declared dead according to cardio pulmonary criteria. Expanding the donor population to individuals who die uncontrolled cardiac deaths will reduce this disparity, but only if organ preservation efforts are utilized.