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Julie M Aultman, Michael Firstenberg, Dianne McCallister and Emanuela Peshel
Northeast Ohio Medical University, USA
HealthONE, USA
Posters & Accepted Abstracts: J Clin Psychiatr Neurosci
The treatment of patients with Intravenous Drug Use (IVDU) has evolved to include a wide range of medications, psychiatric rehabilitation, and surgical interventions, especially for life-threatening complications such as Infective Endocarditis (IE). Such interventions remain at the discretion of physicians, particularly surgeons, whose treatment decisions are not merely influenced by medical factors, but also social justice issues ranging from physician bias to bedside rationing. These social justice issues become heightened when IVDU patients require repeat valve replacement surgeries for IE due to relapse or continued drug use. Patients who receive a valve replacement and continue to abuse illicit drugs intravenously, often return to their medical providers months to a few years later with a re-infection of their bio prosthetic valve; such patients require additional surgeries which are at the center of many ethical discussions due to high mortality rates associated with continuous chemical dependency after surgical interventions. The following presentation details our study findings collected from 220 U.S. and international surgeons, who are involved either medically or surgically with the care of their IVDU-IE patients, and their identified practices, attitudes, and ethical perspectives surrounding repetitive heart valve transplantations. Furthermore, we describe the importance of integrative addiction care for this patient population and propose guidelines and best practices for preventing relapse and subsequent patient harm. Our proposed guidelines and best practices are informed by comprehensive care programs, interprofessional health care teams, and administrative support.
Julie M Aultman, PhD, is a clinical ethicist and Professor of Family and Community Medicine, College of Medicine, NEOMED, where she teaches and researches a variety of topics in bioethics and medical humanities and serves four clinical institutions as a clinical ethics consultant. She is the Director for the Medical Ethics and Humanities Program, College of Graduate Studies. She holds leadership positions within and external to NEOMED, including Chair of the IRB, Diversity Council, and Council on Academic Performance and Professionalism for the College of Graduate Studies. Her research interests extend to psychiatric ethics, healthcare justice, international studies in healthcare systems and community based rehabilitation programs, and moral and professional development in medical education. Recent reseach areas have focused on the ethics of heart valve replacements for patients struggling with addiction, as well as, justice issues surrouding access of care for refugee and undocumented patients.
E-mail: jmaultma@neomed.edu
+447723598358
