Morals and ethics are often used interchangeably, but there are small differences.
- Ethics refers to rules provided by an external source, e.g., codes of conduct in workplaces or principles in religions.
- Morals refer to an individual’s own principles regarding right and wrong
There are two great arbitrators of morality devised by mankind, the State and Religion. Each has a power they use to enforce ethical standards.
Note; based on data collected by the State of Ohio up through 2017 and beyond, Ohio continues to revise its laws and regulations to make a distinction between opiate abuse and the legitimate use of opiates in treating chronic pain.
This makes Ohio a progressive leader in establishing balance and equity between these two issues. Protecting the rights of its citizens to unobstructed and equal access to medical care while fighting a continued blight on society through illicit drug abuse.
Actual law governing the prescribing of opiates for acute and chronic pain is both general and indirect, as it should be. They are limited to those actions which can be taken by a licensed physician. This fact indirectly acknowledges that as a legislative body, legislators are not qualified to diagnose and prescribe medical treatments requiring opiates.
The specific details for diagnosis and treatment are legislatively delegated to State Medical Boards as is common across all states and recognized under Title 21 (USC) Controlled Substance Act.
Specific recommendations and guidelines governing standards of care for chronic pain, how a primary care provider should treat and prescribe for chronic pain, are recent developments which have come about since 2016.
Prior that, few if any states had written standards of care for both primary care providers as well as pain specialist. Such guidelines were often left to non-government private interest groups representing medical specialties.
The entry of the Federal Government into this space through the CDC is both unprecedented and alarming, many calling it overstepping and government interference.
By implementing these recommended guidelines through the CDC and through State Medical Boards, government is now making unilateral decisions which affects hundreds of millions, avoiding the possibility of a hotly contested ethical debate and political fight, by keeping it from coming to a vote of the general public.
A person who knows the difference between right and wrong and chooses right is moral. A person whose morality is reflected in his willingness to do the right thing, even if it is hard or dangerous, is ethical. Ethics are moral values in action.
Since then there’s been mass confusion and a blatant disregard for the welfare of a minority group, resulting in suffering for tens of thousands, death for others and imprisonment for physicians sometimes irresponsibly so.
- A failure of law enforcement and government to enforce existing laws,
- an unchecked profit motive in healthcare,
- the unchecked growth of the illegal drug trade and
- unchecked political influence on our democratic process
has all come together like a perfect storm.
For some, the need to rapidly enact new laws which reflect their moral convictions resulted in unforeseen consequences to a silent minority.
20.4% of the population are chronic pain patients, many of which have taken opiates for decades.
While 80% of the non-opiate treated population rushed to curtail its use, little regard was given to the consequence it would have. Now that nearsightedness is reflected in a growing number of suicide deaths from individuals who have been forced to taper or terminate.
Ethics and morals relate to “right” and “wrong” conduct, so I ask these questions.
Is it right or wrong to deny chronic pain patients medication when most have used it without incident, simply for the possibility of curtailing illicit drug use and overdose deaths?
Or is it possible to do both, fight drug abuse while protecting individuals who use opiates as medication and do so without the tragic consequences we see in drug abuse?
Enacting laws without hearing from those substantively impacted by them, is nothing short of a moral and ethical failure of government.
What was done in error can be undone, but for those who have suffered needlessly and for those who have died, government has a responsibility to own this failure and take corrective action.
To date, these issues and questions have gone unacknowledged by our elected officials.