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How do you deal with patients who request parenteral opioids for exacerbation of chronic pain and then want refills of their potent analgesics on discharge? If you are like me, painfully, often with frustration and hostility; this issue should therefore be of interest.
J. Stephan Stapczynski, MD, Editor
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New drugs are constantly added to the market, many of them legal. Many new drugs with abuse potential are often called “legal highs,” as they are not banned by the federal government or states. Also, products may be labeled “not for human consumption” to avoid the label of illegal. The European Monitoring Center for Drugs and Addiction Europol says 41 new drugs entered the market in 2010. The legal status of the more familiar recreational substances has encouraged users to seek newer options that offer the advantages of being legal, less expensive, less contaminated with adulterants, more readily available, or with more desirable pharmacological effects.
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The fact that an expert witness recently prevailed after suing a specialty society for suspending him for allegedly giving improper testimony in a medical negligence case wont affect the ability of the American College of Emergency Physicians (ACEP) to discipline unethical expert witnesses, according to Louise B. Andrew, MD, litigation stress counselor, founder and principal of www.MDMentor.com, and former chair of ACEPs Professional Liability Task Force Expert Witness subcommittee.
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An expert witness for the plaintiff takes the stand and proceeds to tell the jury patently false statements regarding the standard of care. While this problem is certainly not unique to emergency medicine, it is exacerbated by the number of experts allowed by judges to testify based on limited exposure to emergency medicine, who are not themselves emergency physicians, says Hugh F. Hill III, MD, JD, FACEP, an assistant professor in the School of Medicine at Johns Hopkins University in Baltimore, MD.
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If an ED claims to have certain services available, that creates a duty to provide them, according to Douglas S. Diekema, MD, MPH, an attending physician in the ED at Seattle Childrens Hospital and director of education for the Treuman Katz Center for Pediatric Bioethics at Seattle (WA) Childrens Research Institute.
