title: Prescription Drug Monitoring Programs: Ethical Issues in the Emergency Department.
abstract: Prescription drug monitoring programs are statewide databases available to clinicians to track prescriptions of controlled medications. These programs may provide valuable information to assess the history and use of controlled substances and contribute to clinical decisionmaking in the emergency department (ED). The widespread availability of the programs raises important ethical issues about beneficence, nonmaleficence, respect for persons, justice, confidentiality, veracity, and physician autonomy. In this article, we review the ethical issues surrounding prescription drug monitoring programs and how those issues might be addressed to ensure the proper application of this tool in the ED. Clinical decisionmaking in regard to the appropriate use of opioids and other controlled substances is complex and should take into account all relevant clinical factors, including age, sex, clinical condition, medical history, medication history and potential drug-drug interactions, history of addiction or diversion, and disease state.
authors.affiliation: Department of Emergency Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH. Electronic address: cmarco2@aol.com.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Marco
authors.affiliation: Department of Emergency Medicine, Allegheny Health Network, Pittsburgh, PA.
authors.forename: Arvind
authors.initials: A
authors.lastname: Venkat
authors.affiliation: Riverwood Emergency Services, Inc., Perrysburg, OH, and the University of Toledo College of Medicine and Life Sciences, Toledo, OH.
authors.forename: Eileen F
authors.initials: EF
authors.lastname: Baker
authors.affiliation: Department of Emergency Medicine, Augusta Medical Center, Fishersville, VA.
authors.forename: John E
authors.initials: JE
authors.lastname: Jesus
authors.affiliation: Ruth and Harry Roman Emergency Department, Department of Emergency Medicine, and the Center for Healthcare Ethics, Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Geiderman
mesh_terms: D017723:Drug Utilization Review / Q000941:ethics*; D004636:Emergency Service, Hospital / Q000941:ethics*; D006801:Humans; D063487:Prescription Drug Misuse / Q000517:prevention & control; D055553:Prescription Drugs / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D055553:Prescription Drugs