John Dossetor Health Ethics Centre, University of Alberta, Edmonton, Alberta, Canada
John Dossetor Health Ethics Centre, University of Alberta, Edmonton, Alberta, Canada.
J Med Ethics. 2023 Jun;49(6):377-382. doi: 10.1136/jme-2021-108087. Epub 2022 Aug 19.
The COVID-19 pandemic has exacerbated the drug poisoning epidemic in a number of ways: individuals use alone more often, there is decreased access to harm reduction services and there has been an increase in the toxicity of the unregulated drug supply. In response to the crisis, clinicians, policy makers and people who use drugs have been seeking ways to prevent the worst harms of unregulated opioid use. One prominent idea is safe supply. One form of safe supply enlists clinicians to prescribe opioids so that people have access to drugs of known composition and strength. In this paper, we assess the ethical case for clinicians providing this service. As we describe, there is much that is unknown about safe supply. However, given the seriousness of the overdose death epidemic and the current limited evidence for safe supply's efficacy, we argue that it is ethically permissible for clinicians to begin prescribing opioids for some select patients.
人们独自用药的情况更为常见，获得减少伤害服务的机会减少，无管制药物供应的毒性增加。为应对这场危机，临床医生、政策制定者和吸毒者一直在寻找预防无管制阿片类药物使用最严重危害的方法。一个突出的想法是安全供应。安全供应的一种形式是聘请临床医生开阿片类药物处方，以便人们能够获得成分和效力已知的药物。在本文中，我们评估了临床医生提供这项服务的伦理案例。正如我们所描述的，安全供应有很多未知之处。然而，鉴于过量死亡的流行和目前安全供应效果的有限证据，我们认为，临床医生为一些特定患者开阿片类药物处方在伦理上是可以接受的。
