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A Care and Justice Ethics Approach to Opioid Use Disorder in Pregnancy

Wu, Katherine C
http://rave.ohiolink.edu/etdc/view?acc_num=ne2gs1620579941339304

Abstract Details

2021, Master of Arts in Medical Ethics and Humanities, Northeast Ohio Medical University, College of Graduate Studies.
Despite the Anti-Drug Abuse Act of 1986 that declared a “war on drugs”, criminalized substance abuse, and opened up treatment programs specific to pregnant women, the number of pregnant women using opioids increased five-fold from 2000 to 2009, skyrocketing the related costs for state Medicaid programs (Patrick et al., 2012). Unfortunately, this law has had a pervasive effect on the public’s attitudes and clinicians’ treatment toward opioid use disorder (OUD) in pregnancy. My analysis according to the principles of biomedical ethics has outlined several ethical dilemmas that have been created by criminalization of substance abuse, mandatory reporting laws, stigma toward OUD and its treatments, and little understanding of the social determinants of health. This ethical framework alone does not emphasize the relational aspect of pregnancy, support patient-centered care, or address the intersectionality of this patient population. I will argue how using a care and justice ethics approach to treatment of women with OUD who would like to carry a fetus to birth is the preferable ethical approach to guide physician and public health treatment of this issue. I will discuss how this framework revives the idea of using Ulysses contracts for this patient population and how Ohio has successfully implemented caring structures already. Finally, I will envision how Ohio can continue to expand its wraparound services and fight stigma against OUD in pregnancy, which stymies clinicians’ potential to form caring relationships.
Rebecca Fischbein (Advisor)
Julie Aultman (Committee Member)
Ethics; Medicine; Neurosciences; Psychobiology; Public Health; Public Policy; Womens Studies
opioid use disorder; OUD; pregnancy; maternal health; social determinants of health

Recommended Citations

Citations

  • Wu, K. C. (2021). A Care and Justice Ethics Approach to Opioid Use Disorder in Pregnancy [Master's thesis, Northeast Ohio Medical University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ne2gs1620579941339304

    APA Style (7th edition)

  • Wu, Katherine. A Care and Justice Ethics Approach to Opioid Use Disorder in Pregnancy. 2021. Northeast Ohio Medical University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ne2gs1620579941339304.

    MLA Style (8th edition)

  • Wu, Katherine. "A Care and Justice Ethics Approach to Opioid Use Disorder in Pregnancy." Master's thesis, Northeast Ohio Medical University, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ne2gs1620579941339304

    Chicago Manual of Style (17th edition)

ne2gs1620579941339304
303
© 2021, all rights reserved.
This open access ETD is published by NEOMED College of Graduate Studies and OhioLINK.