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关怀患有阿片类药物使用障碍的被监禁孕妇:公平和司法影响。

Care for Incarcerated Pregnant People With Opioid Use Disorder: Equity and Justice Implications.

机构信息

University of California San Francisco School of Medicine, San Francisco, California; the Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, and the Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and the Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.

出版信息

Obstet Gynecol. 2020 Sep;136(3):576-581. doi: 10.1097/AOG.0000000000004002.

Abstract

With the simultaneous rise in maternal opioid use disorder (OUD) and the incarceration of pregnant people in the United States, we must ensure that prisons and jails adequately address the health and well-being of incarcerated pregnant people with OUD. Despite long-established, clear, and evidence-based recommendations regarding the treatment of OUD during pregnancy, incarcerated pregnant people with OUD do not consistently receive medication treatment and are instead forced into opioid withdrawal. This inadequate care raises multiple concerns, including issues of justice and equity, considerations regarding the legal and ethical obligations of the provision of health care, and violations of the medical and legal rights of incarcerated people. We offer recommendations for improving care for this often-ignored group.

摘要

随着美国产妇阿片类药物使用障碍(OUD)的同时上升和孕妇被监禁,我们必须确保监狱和拘留所充分解决患有 OUD 的被监禁孕妇的健康和福祉问题。尽管针对怀孕期间治疗 OUD 有长期确立的、明确的和基于证据的建议,但患有 OUD 的被监禁孕妇并未始终接受药物治疗,而是被迫戒断阿片类药物。这种不充分的护理引起了多个问题的关注,包括司法和公平问题、考虑医疗保健提供的法律和道德义务问题,以及侵犯被监禁者的医疗和法律权利问题。我们为改善对这个经常被忽视的群体的护理提出了建议。

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本文引用的文献

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Pregnancy Prevalence and Outcomes in U.S. Jails.美国监狱中的妊娠流行率与妊娠结局。
Obstet Gynecol. 2020 May;135(5):1177-1183. doi: 10.1097/AOG.0000000000003834.
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Buprenorphine Treatment Divide by Race/Ethnicity and Payment.美沙酮治疗按种族/民族和支付方式划分。
JAMA Psychiatry. 2019 Sep 1;76(9):979-981. doi: 10.1001/jamapsychiatry.2019.0876.
5
Pregnancy Outcomes in US Prisons, 2016-2017.美国监狱 2016-2017 年妊娠结局。
Am J Public Health. 2019 May;109(5):799-805. doi: 10.2105/AJPH.2019.305006. Epub 2019 Mar 21.
7
9
Do Pregnant Inmates have a Constitutional Right to Opioid Replacement Therapy?孕妇是否享有宪法规定的阿片类药物替代疗法的权利?
Am J Obstet Gynecol. 2018 Nov;219(5):455.e1-455.e4. doi: 10.1016/j.ajog.2018.07.004. Epub 2018 Jul 11.
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