A Question of Moral Obligation

by Jack

Do we, as a rich and enlightened society, have a moral obligation to do everything we can to help people with self-imposed heroin or opioid addictions? In the case of opioid addiction, it is estimated that about 40,000 people die each year from an overdose. In response, pressure is being put on doctors to use extremely conservative care when prescribing pain medication.

We are told by medical authority that all addictions are a disease, but does that free the patient from personal responsibility if the addiction was a personal choice?

To illustrate what we are fighting, i.e. the power of an opioid addiction, the courts felt that incarceration of addicted pregnant women in order to protect the unborn child was the right thing to do, but then it turns out the expectant mothers were inducing premature births in order to get back out on the streets. Babies were born into the prison toilet and their little lives were flushed away just so the mother could get high.

The Journal of American Medicine reports: “…they will do anything to get drugs, they are unreliable, agitating, manipulative, and they play games with other people. They are considered to be poorly motivated to stop using drugs.” This is a pretty reprehensible person. So, should we establish some reasonable preconditions to addiction treatment? Many doctors say yes, and ad that ethical guidelines for treating addicted patients is way overdue.

Does cost to society matter? Narcan aka Naloxone, is a popular remedy that revives overdosed patients by neutralizing the opioid effects. The costs vary from a $6500 life saving injection at the emergency-room to $138 a nasal spray given under less severe circumstances.

A recent news story reported a woman was admitted to the ER for a Narcan injection over 30 times in the past year. This prompted the local town council to put a limit on the number of trips to the ER they would cover. They would no longer have a blank check for irresponsible addicts. Their city policy now pays for ONLY three visits. Unfortunately, this places the hospital in an awkward position. They have a moral and financial issue to deal with because federal law says they must render lifesaving treatment, regardless of the patient’s prognosis or ability to pay.

Now considering all this, I ask you again, what should be our moral obligation to drug addicts? The Libertarian in me says, people should be free to get high, but then they are also responsible for the consequences. If you feel this way too, don’t you think it’s time we revisit that federal law that mandates lifesaving care at hospitals? I think times have changed and we need to rewrite the limits of a hospital’s liability for certain classes of patients.

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4 Responses to A Question of Moral Obligation

  1. Libby says:

    Jack, there is nothing “self-imposed” about addiction. You are waaaaaaay behind the curve on this.

    What I want to know is when the hell this country’s medical establishment decided it was ok to start prescribing this stuff for every little thing? Opioids have always been addicting, physically addicting, and there is nothing “morally deficient” anywhere in this … unless you want to go after the nation’s pharmaceutical industry … I’m reasonably certain their marketing strategies figure into this somehow.

    “… don’t you think it’s time we revisit that federal law that mandates lifesaving care at hospitals?”

    No. And … listen to yourself, will you ?!?!?!?!?!?!?

    • Post Scripts says:

      Yeah, I was listening and it sounds harsh, well, maybe it is harsh. But, for a person who became addicted to illegal drugs all on their own, who is costing society huge sums of money that would be better served saving the life of someone who is not self destructive… then I say go with the tough love approach. Give them just enough care to sustain life, but no frills and kick them. No more wasting time and money on them, if they will not do one things to correct their situation. They are a free person and if they OD somewhere where the ambulance can’t get there in time, too bad, so sad.

  2. Joe says:

    If your mail showed up late last Fall this might explain it….

    Postal Service broke law in pushing time off for workers to campaign for Clinton, investigation finds


  3. Tina says:

    Pharmaceutical companies produce products to aid and assist in the healing process. Unless it can be proven that they pay their sales people extra under the table or something of that nature they can’t be held responsible for drugs being taken or administered incorrectly.

    Some abusers are people with chronic pain who become desperate for relief once their original Rx runs out. There are people who’ve gotten caught up in this nightmare that manage to make different choices and do what needs to be done to clean up and put their lives back together so we know it’s possible. Choice matters.

    One of the problems has been doctors who are over prescribing, sometimes in violation of current law. See here and here. More information here and here.

    Those who abuse substances are not all addicts in the sense of the true alcoholic who can never again touch the stuff once he manages to get off it. Hundreds of thousands of (recovering) alcoholics have been helped through AA. Let’s not pretend there aren’t plenty of programs and people ready to support addicted people. Yes Libby…it’s a personal choice.

    Those who become addicted have done so through a series of personal choices that take them down a very dark path to dependency. The recovered are the first to tell us that they do it to themselves. Until the addict takes responsibility for the state of his life, and owns it, he has no prayer of making better choices. Those who refuse help are lost…there is nothing that anyone, other than themselves, can do for them. But there are things we can do ABOUT them. There is no reason society should have to tolerate the attending bad behaviors and trash.

    I would have to consult a constitutional lawyer before saying absolutely that a law or policy could be written forcing or allowing hospitals to refuse care. However, the thing I would like to know is why it wouldn’t be acceptable for a hospital to treat people three times (as Jack suggested) and then call the authorities,especially if it’s discovered or known that the person has been a public nuisance, trespassed, or have damaged property. At that point they face a judge and instead of regular jail time he faces forced rehab. Give them treatment, in jail, for a specific amount of time. Make it clear they have the opportunity to make better choices and if they still refuse, or repeat offend, the next step is a mental ward. Something has to be done to protect the people who are victimized by these people and create a safe environment for them. Until we stop tolerating the behavior and stand up for our own rights there will be little incentive for this to stop.

    The crisis we face is a crisis of culture. Anyone that knows what life was like in America before the sixties generation raged against authority and made drug use a recreational activity, knows we don’t have to live like this. The level of civil decline that exists in the wake of this madness is excessive and intolerable.

    One more thing. Jail in America is too much of a cake walk. Decent treatment is one thing, special treatment is not acceptable. Remember the old saying, ‘treat them like animals and they’ll act like animals. Well by the time they get to prison they’ve already decided to live like animals…worse! Every con is a con artist. (Libby types fall for the con every time) They deserve three squares, a cot and a bit of sunshine each day. If we spent less on making them comfortable we could afford the mental institutions and rehab without spending another dime.

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