Bioethics case study, need you ideas and opinions

[jayjaya29]

Got this to work on in my Bioethics class.

Jean comes from a family that is usually characterized as dysfunctional. She has been addicted to drugs since she was 15, to support her habit, she turned to prostitution when she was 17. She dropped out of school in the tenth grade, so she has little education and few marketable skills. Today she is a single mother with two young children and continues to support them and herself by prostitution. She still is addicted to drugs.
However, recently she began feeling a determination to turn her life around. If not for her sake, then for her children's. She now wants to overcome her addiction to drugs and then try to get an education so that she can get a decent job to support herself and her children. She has no money to par for a drug rehabilitation program, so she goes to the nearest publicly supported program.
She is told there is a waiting list, so that she can not be admitted for six to twelve months, and that all other drug rehabilitation programs in the city have similarly long waiting lists. Jean pleads with the intake counselor because she is afraid that her resolve to turn her life around will not survive the six to twelve months she must wait. The intake counselor says she is sorry, but a shortage of funds makes it impossible for public clinics and programs to meet the demand for services. Jean asks why not, and the counselor tells her that these programs are funded entirely but tax dollars and that taxpayers complain of high taxes and clamor for tax relief. Consequently, there is simply not enough money to meet the needs for drug rehabilitation. Politicians don't dare increase taxes to fund drug rehabilitation programs and are reluctant to take money earmarked for other purposes, such as police and fire protection, education, garbage removal, highway repair, and medical car. Jean leaves feeling hopeless and depressed.
What should society do about cases such as Jean's? Does society have a duty to provide adequate services for drug rehabilitation so that people such as Jean will not be put on waiting lists? What about competing needs that are also inadequately funded? What duties do politicians have? What duties do citizens/taxpayers/voters have?

Post your ideas and opinions on this. I'd really like to know how you feel about this situation and what you would do about it.

[Jacobfox]

I say that the taxes should be raised to cover stuff like this. I am a supporter of big government and I believe that this is a worthy reason to boost taxes.
I think that the duty of the politician is to create programs that serve their constituents and do the greatest good for the most people. Drug addiction is a serious problem and this is a worthy outlet for tax money. The citizens have a duty to help those less fortunate than themselves and help elevate our society. Progressives like to say that a person should pull themselves up by their bootstraps, but that they need boots first.

[FATMOUSE]

Problem: Shortage of Funds
Solution: Acquire more funds
How: The hard part, clearly. Loans + repayment on the part of the person undergoing rehab would be the obvious thing to do, but this would likely not work out financially since a good amount of people would relapse and be unable to pay back.

Alternatively, higher taxes. Or reorganize tax distribution.

[Firecat]

Just a little history on the "war on drugs"...

Under Nixon a majority of funding was geared towards treatment and prevention, but Reagan changed that and focused on law enforcement.

There is a chart in this pdf that shows the breakdown of funds (healing, stopping, and disruption)
http://www.whitehousedrugpolicy.gov/...t/06budget.pdf

So it isn't really a matter of raising taxes, but rather re-appropriating the funds that are already allocated. It's also necessary to point out that these programs are effective.

[ioynerien]

Just a thought...
Can't they start some sort of "work for your rehab" kind of thing? Basic jobs such as inmates have. The addicts learn a job, get experience, earn some money, are in a monitored environment, get controlled access to drugs and they provide services for the community.

[Blind_Io]

The question is not so much "do the politicians have the duty" but "should the people be expected to fund it."

Yes, in an ideal world everyone would have a bed at a rehab facility as soon as they show up. But this is not an ideal world, the government does what it can by providing grants to programs but that can only go so far. So she got turned down at one facility - keep looking. There are private programs that are funded by donations and government grants, there are even prostitution outreach programs. The services are there if she bothered to look, if she is that dedicated then she should also look in the surrounding area out of the city where services might not be in such high demand.

To be honest, if this woman came in for treatment the first thing I would do is assess the children for risk. A drug using prostitute mom with two kids is hardly a good mother - these kids may be in serious danger. What does her pimp think about this, has he threatened her or her kids? What violence is in her past?

Ok, I am getting off into treatment planning and away from social issues.

As a clinician I would like to see more funding for such programs, however we will never be able to meet the demand. The problem is too widespread for us to even come close. The vignette you have described is incomplete, as the woman is portrayed as being the total victim - the product of her environment. If someone came in to treatment with that attitude I would not give them a good prognosis for recovery because they had not taken any personal responsibility for their actions. The same is true here, while society does have some responsibility it can hardly be expected to dedicate such a significant part of the public coffers to treating this population. Do they deserve treatment? Certainly, if they are serious - but in my experience many members of this population abuse the system simply to have a warm place to sleep, a hot meal, or to hide from dealers or gang members.

[zenkidori]

if she is a known drug addict then why are her kids still with her?

[AnGuRuSO]

Jean sounds like a really hopeless person. She has no faith in herself and is so pathetic she tries to place the blame on the government for her problems.

Child abuse is terrible, but that doesn't mean she isn't at fault. I don't understand why her being a prostitute is relevant at all.

Fuck Jean, there are so many non-government support groups, the church, the synagogue I don't fucking know doesn't she have any friends that can help her out?

Also I don't like the quoted section, if you wrote that I suggest you shorten it to whats relevant and maybe make it less boring (sorry for being so vague but I don't know what it is that made the quoted section so hard to read.)

Penn and Teller bullshit is a little bit one sided but I think it might help if you took a look at their War on Drugs episode

[jayjaya29]

I'll make this clear, I did not write that, its a group assignment in my bioethics class. What is written is pretty much set in stone, so as far as I know, if we present a solution to raise taxes, we won't get credited for it because it says in the writing that raising taxes cannot be done. The story of "Jean" is to personalize and individualize the problem. Think of the reading as your substrate, you must work off what you have, you cannot change the parameters of the substrate.

This is what we are to do with this case study:
1. What is the problem? The issue?
2. What is our response? Position?
3. What is our justification? Warranting? Complete argument with sound logic must be formed
4. How did you arrive at your final conclusion?

Thats is what we have to do with that short paragraph. I just posted it on here to see what you guys response would be to it. But as we do in class, we never change what the case study tells us, we act off what it tells us. As one of you said, "Jean sounds like a really hopeless person." We have to assume that Jean's feeling and determination to act and become sober is a true feeling.

Thanks for your responses, gave me 1 or 2 good ideas which can be put in with the other ideas my group and I have thought out so far.

If you want, I can put up some more case studies, which put you between a rock and a hard place and really makes you make a moral decision about the situation.

[AnGuRuSO]

Originally Posted by jayjaya29

If you want, I can put up some more case studies, which put you between a rock and a hard place and really makes you make a moral decision about the situation.

Yea go ahead, I like this kind of stuff.

[jayjaya29]

What kinda of case study would you like next?

One that involves Patient Doctor Confidentiality or a new Dad killing his own son?