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Overdоse Reаd the fоllоwing cаse аnd provide answers to each of the Eight Key Questions (provided below the case) to decide if the university should accept the Narcan donation. Note: The following scenario is fictional. It deals with a current issue that affects all of us. For those who have lost a friend or loved one, who know someone struggling with opioid addiction, or who are themselves dealing with addiction, please view this scenario as an effort to address a serious health problem with sensitivity and care. The opioid epidemic continues to be a major public health and economic issue. In this fictional scenario, Overdose, a university receives an offer of free emergency opioid overdose reversal medication, Narcan. Should the university accept the offer of the life-saving medication? Overdose According to the Centers for Disease Control and Prevention, America experienced a significant increase in fatal opioid overdoses. Between 1999 and 2017, the number of annual deaths by opioid overdose increased from approximately 8,000 to 48,000. Although disputed, many link the growth in opioid addiction to the widespread prescription of oxycodone for medical pain relief. The availability of the powerful synthetic opioid, Fentanyl, is another contributing factor. Currently, there is only one available remedy for opioid overdoses. Naloxone, marketed as Narcan, can be administered by injection or nasal spray. For some overdose victims treated quickly enough, Narcan can prevent brain injury and death. Forty plus states including Virginia have made legislative moves to make Narcan more available to the public. Despite the growing availability of Narcan, however, overdose fatalities continue to rise. Why? One explanation could be that an increased sense of safety can simultaneously bring about an increase in risky behavior—a phenomenon some have called a “moral hazard.” And indeed, some recent controversial studies suggest that higher rates of fatal opioid overdose can be found in areas with public Narcan accessibility. In response to the rising level of fatal opioid overdoses, a national foundation is donating thousands of Narcan kits to public and private universities. You serve in your university’s Student Government, and you must decide whether or not to accept Narcan on your campus. As you hear various perspectives, be curious about the ethical questions (8KQ) you will be address while deciding. Emergency Room Provider Overdoses of Fentanyl, the deadliest drug in America, happen fast and they are growing more powerful, so Narcan needs to be available where the opioid users are. If the university decides to provide Narcan, it is vital that the supply be readily available to the general population. It could be lifesaving. Statistics indicate that laypersons using Narcan have saved nearly 26,000 lives in the past 20 years. There are no known side-effects or risks to Narcan; you cannot harm someone by giving it to them by mistake. But you can save lives, so make it available! EMT/First Responder I have been on calls to overdose victims. Trying to revive someone is intense, and it is something that requires professional training and careful monitoring. If Narcan is available to students – say at a party – people might hesitate to call 911 because they think they can handle things themselves and they don’t want to get in trouble. They might not know that Narcan is metabolized faster than opioids, so there is a real danger of rebound overdose after being revived. And, if the brain goes without oxygen, even for just a short time, the damage can be permanent. Reviving overdose victims should be left to trained professionals. We should be called whenever a student faces a medical emergency and an overdose is an emergency! Waiting to call can be fatal. Parent of College Student I certainly didn’t send my son off to college with the idea that the university would have policies that “encourage” opioid use. I think making Narcan available is just that kind of encouragement. I worry about him living and working in a residence hall where he might be put in danger because of someone else’s addiction, or, that he might be put in the awful position of having to revive one of his friends or residents. That's unfair. He chose this college for a good education, but bringing Narcan to campus sends a totally different message about college life. Does the university really want to be known for this? College Student I run into misconceptions about opioid addiction all the time. I had a sports injury and I had an opioid prescribed by a medical doctor. I know what it is like to be addicted to pain medication. I’m in recovery now but unless you have been in that situation, I’m not sure you can understand. It may be that some students experiment – and I don’t think they have any idea how dangerous that is – but we live in a free country and people can do what they want, right? It shouldn’t stop us from offering help to those who really need it. Make the Narcan available to students—I know many of us will feel a lot safer with it around — and let us choose when and where to use it. College Professor Our university recently experienced an opioid overdose death. I had her in class and she was a good student. You would never know it, but she was addicted to medically-prescribed oxycodone following an accident. She tried but couldn’t kick the addiction. My fear is that if the university accepts Narcan it will unintentionally send the wrong message. Narcan could give false hope to those struggling with addiction. That is where all the resources and the support should go: to help those struggling. I know some medical professionals are in favor of Narcan because it saves lives, but my economist colleagues told me about research suggesting that Narcan availability might perversely increase the number of people who try opioids! I really care for these students so I say No Narcan. As harsh as it sounds, No Tolerance has the best chance of saving lives. Substance Abuse Coalition Representative My office looks at the opioid addiction crisis in the region. In terms of fairly distributing resources, there are areas in which people really need Narcan. Honestly, college campuses are already well served. If the foundation wanted to effectively save lives, and respond to the rights of those who may not be able to afford the quality of health care available to university students, then I would be happy to let them know where the Narcan kits would do the most good: the inner city and in rural areas. I guess I question the motives of the foundation and the university. Are they trying to do good or look good? Part A: Use the Eight Key Questions (8KQ) below, answer each of the Eight Key Questions separately based on the scenario you have read to answer the following question: Should the university accept the Narcan donation? James Madison University The Eight Key Questions (8KQ) Fairness - How can I (we) act justly, equitably, and balance legitimate interests? Outcomes - What possible actions achieve the best short- and long-term outcomes for me and all others? Responsibilities - What duties and/or obligations apply? Character - What actions help me (us) become my (our) ideal self (selves)? Liberty - How do I (we) show respect for personal freedom, autonomy, and consent? Empathy - How would I (we) act if I (we) cared about all involved? Authority - What do legitimate authorities (e.g. experts, law, my religion/god) expect? Rights - What rights, if any, (e.g. innate, legal, social) apply? Part B: Answer the following question: Should the university accept the Narcan donation? Make sure to justify your answer based on your responses to the 8KQ.
Cоntаgiоn Nоte: The following scenаrio is fictionаl. Please view this scenario as an effort to address a serious health problem with sensitivity and care. Contagion, a fictional ethical scenario about a Meningitis B (MenB)1 outbreak originating at a camp on the east coast of the U.S. that was host to several visitors including high school students from the New England area, doctors from all over the world, army reservists, inner-city children, and environmental researchers. As these groups of people left the camp, it became apparent they were ill and were potentially exposing others to MenB. There are a limited number of MenB vaccines available. Contagion No one saw it coming. But when it hit the East Coast, it hit hard. Twenty New England high school students spent three summer weeks volunteering with Serve Appalachia, repairing homes for low-income families, and staying at Camp Overlook. Before heading home, several students started feeling extremely sick. By the time they reached New England, at least half were seriously ill. Those who felt okay went home to their families. The symptoms suggest meningitis B (MenB)1: headaches, light sensitivity, and uncontrollable fever that can lead to death or disability. Medical treatment is only partially effective, namely due to increasing resistance to antibiotics. Vaccination is necessary to prevent a catastrophic outbreak. With the high schoolers at Camp Overlook was a group of at-risk youth from inner-city Baltimore attending a 10-day nature camp. Seven guest international doctors stayed at Camp Overlook while treating poor patients from surrounding counties. Several Army Reservists camped at Overlook while rebuilding a community destroyed by a tornado. A group of researchers considering the environmental effects on the health of rural populations were based at Camp Overlook. The MenB vaccine is limited; no more can be produced for months. You are part of Centers for Disease Control team summoned to Washington, D.C. to spearhead the response to the spreading contagion. When you arrive, you learn of five regional outbreaks: Army Bases. The Department of Defense reports that Virginia and New Jersey Army bases are on lockdown after a few temporarily housed reservists were diagnosed with MenB. The President sent an official request to dispatch vaccine to those bases. These military personnel are vital to maintaining national security if a crisis were to develop as a result of a MenB pandemic. Baltimore Youth. Nature camp proved to be an incredible experience for the group of at-risk children, but several returned home to the inner-city critically ill. Baltimore’s homeless shelters and food pantries shut down in fear. After making the MenB diagnoses public, health officials appealed to the mayor. With few vaccines available, hospitals in affluent neighborhoods are getting priority. Baltimore’s mayor pleads to your CDC group for vaccines to inoculate the poorest and most at-risk citizens in her city. International Doctors. Two international doctors based at Camp Overlook contracted MenB. Unfortunately, their symptoms did not surface until they were at an American Medical Association conference for international physicians in Louisville, KY. The head of the AMA contacts your team requesting vaccines to administer to doctors before they travel to other clinics in need. The AMA CEO stressed the critical role physicians play as first-responders, caring for the sick and administering inoculations, in medical crises. Environmental Researchers. Some environmental researchers and activists received vaccinations in preparation for their trip to Appalachia. However, two who are passionate about alternative medicine, refused the shot. They fell extremely ill upon returning home to Atlanta. Due to the epic nature of this crisis, the group offered the CDC director ten times the cost of existing inoculations thanks to one of its financial supporters. The overpayment could fund production of more vaccine. The existing supply would be used to protect Camp Overlook staff and others around the world researching environmental hazards to the health of rural populations. New England Parents. Parents of the high schoolers who got MenB on their service trip are terrified. In addition to their ill older children, schoolmates and younger siblings are getting sick. Many of the patients under the age of 20 have become disabled or died. One parent, who happens to be the official spokeswoman for the American Academy of Pediatrics, demands the vaccine for infants, toddlers, and school-aged children who may be in contact with the returning high schoolers. However, the CDC does not recommend MenB vaccines be administered to children under 10. 1 - Meningitis B (MenB), an infection of the membranes that protect the brain and spinal cord, is spread through exposure to salivary secretions, usually through close or prolonged contact. It typically affects children and young adults, those with weak immune systems, and people who live in close quarters. Having read the case, remember your responses to the Eight Key Questions (8KQ) based on the case and provide answers to the following questions. Read the following case, and answer the Eight Key Questions (8KQ) based on the case and then provide answers to the following 2 questions. Part A: Answer each of the following 8 questions based on the following question: Where should your CDC group send the vaccine? Fairness - How can I (we) act justly, equitably, and balance legitimate interests? Outcomes - What possible actions achieve the best short- and long-term outcomes for me and all others? Responsibilities - What duties and/or obligations apply? Character - What actions help me (us) become my (our) ideal self (selves)? Liberty - How do I (we) show respect for personal freedom, autonomy, and consent? Empathy - How would I (we) act if I (we) cared about all involved? Authority - What do legitimate authorities (e.g. experts, law, my religion/god) expect? Rights - What rights, if any, (e.g. innate, legal, social) apply? Part B: The vaccine available is enough for ONLY TWO requests. Assume the logistics for getting vaccine to each population are the same. Where should your CDC group send the vaccine? Why? Include justification for your decision using your answers to the 8KQ.
Accоrding tо а nаtiоnwide study, child welfаre agencies averaged 20–40 percent staff turnover in 2006.