Healthcare Ethics at the Intersection of Substance Use Disorders, Correctional Health and Guardianship
9:00 – 10:20 am Ethical Dilemmas in Caring for Patients with Substance Use Disorders
Julie Childers, MD, FAAHPM, FASAM
Professor of Medicine
Program Director, UPMC ME Addiction Medicine Fellowship
Section of Palliative Care and Medical Ethics
Section of Treatment, Research, and Education in Addiction Medicine
University of Pittsburgh
Abstract: Substance use disorders (SUDs) present clinicians with complex ethical challenges that extend beyond traditional medical decision-making. This presentation explores the ethical dilemmas that arise when caring for individuals with SUDs, using real-world clinical cases to highlight tensions between patient autonomy, beneficence, nonmaleficence, and justice. Participants will examine how stigma, legal frameworks, and prevailing views of addiction as a moral failing shape patient care and influence institutional policies. The session also introduces harm-reduction principles—humanism, pragmatism, incrementalism, and accountability without termination—as a framework for respectful, patient-centered care.
10:20 - 10:30 Break
10:30 – 12:00 pm The Landscape is Changing: Ethics of Substance Use Disorder Across the Lifespan
Adele Flaherty, PhD
End of Life Resource Specialist, CCAC
Program Coordinator at LiveLung
Abstract: This presentation will look at substance use disorders from a public health ethics perspective, focusing on harm reduction and how substance use affects people throughout their lives. We will explore how healthcare systems, communities, and policymakers can work together to reduce stigma, improve access to treatment, and support recovery in meaningful ways. Using the socioecological model, we will consider how individual experiences and social influences shape both challenges and opportunities for change. The discussion will include examples from early life and maternal health, mid-life experiences such as participation in research, and end-of-life care for individuals living with substance use disorders.
12:00 – 12:30 PM LUNCH
12:30 – 2:00 PM Ethical and Policy Considerations for Medication-Assisted Treatment in Correctional Settings
Greg Dober, MA
Healthcare Ethics Advocate
Private Practice
Abstract: Opioid use disorder (OUD) is highly prevalent in correctional settings, yet access to medication-assisted treatment (MAT) in jails and prisons is often limited. This presentation explores the ethical challenges of MAT through the lens of the four principles of biomedical ethics: autonomy, beneficence, non-maleficence, and justice. Central concerns include coercion and barriers to informed consent, interruption of treatment continuity, harms from forced withdrawal and overdose risk after release, and inequitable access across facilities. These issues raise not only ethical but also legal and human rights concerns, particularly regarding incarcerated individuals’ right to adequate healthcare. The presentation will highlight reforms—such as guaranteeing treatment parity with community standards, ensuring continuation of care during incarceration, and supporting overdose prevention at reentry—that can guide correctional systems toward more ethical, effective, and humane responses to OUD.
2:15 – 3:30 PM Ethical Challenges in Guardianship for Individuals with Substance Use Histories and Prior Incarceration
Libby Moore, PhD
Federated Guardians
Abstract: Guardianship for individuals with a history of substance use and prior incarceration presents unique and often complex ethical challenges. This session explores the responsibilities of court-appointed guardians and the ethical dilemmas that may arise when supporting individuals navigating recovery and reintegration. Participants will examine real-world scenarios, apply core ethical principles, and discuss strategies for balancing autonomy, beneficence, and justice in guardianship decision-making.