Ethical Dilemma in a Substance Abuse and Addiction Case
The Ethical Dilemma
Patient Y visits a rehabilitative facility to address complications developed during an on-going chemotherapy treatment. He wants to stop the procedure because of the side effects, which include nausea, fatigue, loss of appetite, and hair loss. Medical marijuana is his last option, although he has a history of opioid abuse and there are fears that the patient might become an addict of the pain management therapy. The 36-year-old father is a recovering addict who has taken tobacco for 17 years and was recently diagnosed with lung cancer. An ethical dilemma ensues from his case because any compassionate healthcare service provider would administer the medical marijuana, although the patient’s medical history presents the possibility of substance addiction. In addition, he might use the medical marijuana as a gateway drug to abuse narcotics, which would exacerbate his condition.
Ethical Boundaries
Sensitivity to medical background. It is essential to maintain the conversation on the current condition and not previous addictions, although the past reflects the future. The patient’s addiction to tobacco and the subsequent lung cancer diagnosis should be contextualized but emphasis on the two subject areas might be depressing to the client.
Limits to information disclosure. Mr. Y should only disclose information relevant to the context of pain management. Other issues on family dynamics and previous treatments should surface when necessary and limitations must exist to avoid making the patient uncomfortable.
Privacy. Y’s privacy must be protected. Their data and identity should be in safe places that only authorized personnel should access. Additionally, nobody should contact their oncologist unless under instruction and permission. The rationale is to observe professionalism and accord the patient respect.
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The Ethical Decision-making Process
Stating the problem: The client has tried available pain management techniques for chemotherapy treatment but none is effective. He approaches a medical marijuana clinic for help.
Knowing the facts: Patient Y has a history of substance abuse and there are fears that marijuana might be addictive. A possibility is that he would use marijuana as a gateway drug. His cancer was caused by tobacco smoking, which means he might have a past relationship with drugs if introduced to medical marijuana.
Identifying the required information and relevant factors: The client is a father of one and is a single parent. His family dynamics leave him as the sole decision-maker in a critical situation.
Developing options and listing concerns: He is desperate to manage pain, which means that medical marijuana is recommended. However, other strong prescription drugs exist to manage the pain, although they are equally addictive. Cognitive behavioural therapy is a third option since it is a holistic treatment approach with long-term benefits, as Magill et al. (2019) recommend.
Evaluating options: It is important to evaluate options based on the risk of harm, publicity, defensibility, reversibility, and professionalism (Guidolin et al., 2022).
Recommending an action plan: In this context, cognitive behavioural therapy meets the standards. It is reversible, not addictive, and effective.
Implementing the action: Cognitive behavioural therapy will only be effective if the client is willing. In this case, it is essential to consider an intervention that is good for the patient and not what they want.
The only area that requires supervisor consultation is the implementation of an action plan. It will require an Interprofessional team to administer cognitive beavioral therapy. The client will require support from the oncologist, a psychotherapist, an occupational therapist, a fitness expert, and a family therapist. The will address all the underlying areas before they offer holistic treatment.
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References
Guidolin, K., Catton, J., Rubin, B., Bell, J., Marangos, J., Munro-Heesters, A., … & Quereshy, F. (2022). Ethical decision making during a healthcare crisis: a resource allocation framework and tool. Journal of Medical Ethics, 48(8), 504-509.
Magill, M., Ray, L., Kiluk, B., Hoadley, A., Bernstein, M., Tonigan, J. S., & Carroll, K. (2019). A meta-analysis of cognitive-behavioral therapy for alcohol or other drug use disorders: Treatment efficacy by contrast condition. Journal of consulting and clinical psychology, 87(12), 1093.
