Law and medicine share the same inversion of justice that one is guilty until proven innocent.
As far back as I can remember, especially in the Black community of Detroit, Mich., nearly every person of color was and is today presumed guilty of something and therefore treated as criminals, sometimes with brutal disregard for life and humanity.
Over the years, too, and more recently, the “opiate epidemic” has spawned the same mentality of presumptive guilt and medical criminality without due process of reason or benefit of doubt for the patient with chronic pain. Most patients are presumed guilty of drug-seeking, misuse or abuse.
The clashing reality and dilemma of opiate deaths and dismal pain management point to providers who are either burned out, pharmacologically ignorant, apathetic and, for some, racially, socially and culturally biased. The irony lies in the fact that most providers are resistant to patients’ pleas, even when there are established guidelines for safe administration and surveillance of these pain medications.
Too often, unreasonable fear of board sanctions push compassion and empathy aside, leaving the patient to bear the pain and stigma of a medical criminal.
Do I have an answer? No. But I do have a voice and a choice to be more understanding and compassionate as a physician.
I know my patients. I hear my patients. I care about my patients.
If there will be change, it must comes from the top. A return to humanity must start in the medical schools, flow unhindered through the clinics and specialty offices, and reshape the ways rules and decisions about point-of-care delivery are made.
Stop criminalizing those who are suffering beyond the imagination of you who have no pain.