Ethical, Legal, & Regulatory Considerations in Addiction Medicine Flashcards

When a physician is asked to perform a forensic evaluation for legal proceedings involving a patient with substance use disorder, the most critical initial step is to:

Answer: Clarify the role distinction between treating clinician and forensic evaluator, and obtain appropriate consent

The treating clinician and forensic evaluator roles have fundamentally different obligations; conflating them creates ethical conflicts, and role clarity with appropriate consent is essential.

A patient discloses during addiction treatment that they are an airline pilot currently operating flights while using benzodiazepines without a prescription. The physician's duty to protect public safety most likely requires:

Answer: Documenting the disclosure and considering reporting to aviation authorities if imminent danger exists, consistent with applicable state and federal law

Public safety obligations may override confidentiality when there is an imminent, serious, and identifiable threat; the physician should consult legal counsel and applicable regulations before acting.

Which principle of medical ethics most directly supports the use of medication-assisted treatment (MAT) for opioid use disorder despite societal stigma against it?

Answer: Beneficence

Beneficence obligates physicians to act in patients' best interests by providing evidence-based treatments regardless of stigma or social pressure.

A recovering physician seeks treatment for opioid use disorder from a colleague. Regarding confidentiality, which statement is most accurate?

Answer: Physician-patients retain the same 42 CFR Part 2 and HIPAA protections as any other patient

Physician-patients retain full confidentiality protections; mandatory reporting only applies in specific circumstances such as imminent patient safety risks or board-mandated monitoring programs.

The Controlled Substances Act (CSA) Schedule II classification of oxycodone compared to Schedule III buprenorphine reflects which regulatory consideration?

Answer: Schedule II drugs have high abuse potential but accepted medical use with severe restrictions

Schedule II substances are defined by high abuse potential, accepted medical use, and risk of severe psychological or physical dependence, with stricter prescribing requirements than Schedule III.

A patient court-ordered to addiction treatment refuses to participate in group therapy. The treating physician's most appropriate response is to:

Answer: Explore the patient's reasons for refusal, offer alternatives where clinically appropriate, and document the interaction

Therapeutic exploration of treatment resistance, offering alternatives, and documentation reflect ethical care; automatic punitive reporting without clinical engagement is inappropriate.

Which of the following best characterizes the ethical concern of 'therapeutic privilege' in the context of addiction medicine?

Answer: Withholding information from a patient because disclosure might cause harm or worsen the condition

Therapeutic privilege refers to withholding information from patients on the grounds that disclosure would harm them, but it is considered a violation of the patient's right to informed consent in most circumstances.