A Feminist Approach to the Opioid Epidemic - page 3

Nonmedical prescription opioid abuse (NPOA) is an ongoing problem in America, with data showing an increase in this phenomenon in every state (Paulozzi & Xi, 2008). This phenomenon found its genesis... Read More

  1. by   Issaiah1332
    Quote from JKL33
    And women can and do care in ways that are not "feminine" in the traditional sense.

    This piece is essentially asking people to choose a positive "female" ethic over a negative "male" ethic as if each of those don't have a respective opposite, if you will.

    Or maybe I'm just bound to disagree because I haven't noticed people fitting into boxes quite this neatly such that we could choose a philosophy of care that we agree with and simply label it masculine or feminine - and I wouldn't see the benefit of doing so.
    Fair, but just to be clear I am not advocating for any patient to be pigeonholed into a certain treatment. I am also not blaming men. I was simply arguing that the more paternal role that we see throughout the system, may be one that isn't beneficial in many cases. Certainly, I've had patients that require a more paternal approach.
  2. by   Issaiah1332
    Quote from MunoRN
    I think you mean 'maternal' and 'paternal' rather than masculine and feminine, although the patient treatment philosophies you're referring to aren't really as specific to gender as you're making them out to be.
    "Maternal/Paternal" is likely better wording.
  3. by   Issaiah1332
    Quote from klone
    I did wonder if he meant "paternalistic" rather than "masculine." Although paternalism in healthcare is a well-known and documented phenomenon, is there such a thing as "maternalism"? I do not believe so, which causes his theory to sort of fall apart.
    Paternalism is well-documented. As to the "fall apart" bit, there isn't likely a mountain of documentation that uses "maternalism" as its label. The lack of intervention or existence of its study is precisely what I argue for. Philosophically, there are social lenses we view things through to observe and evaluate the dynamics of a system.
  4. by   Issaiah1332
    Quote from klone
    Why is the graphic for this article a woman snorting a rail of coke?
    HAHA...No idea, they put the same one on another article I wrote. I imagine stock photos for substance abuse are lacking.
  5. by   Emergent
    Just because you are a man doesn't give your essay more veracity. If I am a Jew and say the Holocaust never occurred, that does no make it true. Your gender is irrelevant.

    I argue that, perhaps my response may very well have a ring of truth. Society, in the last 50 years, has become emasculated. Strong male role models are increasingly rare, with the breakdown of families, feminization of the educational system, lack of discipline of our youth, loss of religious values and delineated moral codes.

    And what is the result? What I observe is rampant drug abuse, mental illness and violence. I see a decrease in civility. There are regular mass shootings of innocent people. The societal decay is self-evident.
  6. by   Issaiah1332
    Quote from Emergent
    Just because you are a man doesn't give your essay more veracity. If I am a Jew and say the Holocaust never occurred, that does no make it true. Your gender is irrelevant.

    I argue that, perhaps my response may very well have a ring of truth. Society, in the last 50 years, has become emasculated. Strong male role models are increasingly rare, with the breakdown of families, feminization of the educational system, lack of discipline of our youth, loss of religious values and delineated moral codes.

    And what is the result? What I observe is rampant drug abuse, mental illness and violence. I see a decrease in civility. There are regular mass shootings of innocent people. The societal decay is self-evident.
    I didn't claim it gave more validity. I was simply stating this fact, because people seemed to assume a female must've written this.

    Drug abuse has been rampant and in no way is correlated with the vague claim that male role models are less "strong" or that education has been "feminized" (something I'd like you expand on). Trying to find causation in the opioid epidemic isn't going to be traced to something like you're claiming nor would it be possible even if it were true.

    I wasn't commenting on causality. I was simply saying that the paternalistic, masculine view of Society and the healthcare system likely contributes to resistance. Like I've stressed, it's not a claim that employs blame toward me. It's a social lens to examine the dynamics in a patient-provider relationship and the way it may shape treatment.

    It seems my error, which I'd correct if I could, was to use the words "masculine/feminine" rather than "maternal/paternal." I thought I elaborated in that, but I can see and admit I didn't in an adequate way.

    Another way to put it, is to compare the nursing model and the medical model. The medical model is frequently regarded as paternal, while the nursing model is seen as maternal. The results? Nursing is the most trusted profession, nurse practitioners see higher satisfaction rates and their patients often modify maladaptive lifestyle choices.
  7. by   Simonesays
    Interesting read! The premise of your article isn't inflammatory. And yet lots of people seem to be responding as if you are saying something egregious. We are in the middle of a documented opioid crises. Traditional approaches to NPOA have not been working and it is time to do something different. These are well-documented points.

    I have to conclude that it's your phrasing (masculine/paternalistic and feminine/maternalistic) that's been rubbing people the wrong way. Admittedly, I'm not sure if I love it myself. Although interesting in theory, I think it draws attention away from your actual thesis (which seems to be a holistic model of compassionate care, something that most people could probably support). Instead, the focus turns towards stereotypical gender roles and how we might fit in as male and female HCPs within a binary system (maybe why some of the responses have been defensive?).

    Anyways, I really enjoyed reading your article and hearing your perspective about this topic. Although not an academic article, the New Yorker published a pretty interesting piece recently about the opioid crisis. If you haven't already, it's well worth a read! And thanks for taking the time to write out such a well-researched piece.
    Last edit by Simonesays on Nov 25 : Reason: spelling
  8. by   SummitRN
    The OP has used a bunch of supposition to split care along poorly defined labels. The OP didn't cite where it would actually be relevant to the claims. Only because OP's professor agrees with the virtue signalling is the OP able to get away with failing to cite anything to back up actual thrust of the paper. Presumed and moralistic labeling has little to do with real thrust of patient centered care, which is nothing new.

    If this is what passes for scholarly writing in NP programs these days, it does not bode well for the future of the NP profession.

    If nursing academia continues to act like client-centered-care is a rare phenomena with nursing piercing the night of paternalism, they will continue to reinforce the idea that they are in a self-affirming ivory tower, oblivious to the last 2+ decades of change in healthcare. Then again, they are the same academics who insist on wasting NP students' time with the same plethora of (non-NP) nursing theorists from undergrad. Why should we be surprised these same academics would pose a paternalistic/patient centered care dilemma as a masculine/feminine dichotomy to their students?
    Last edit by SummitRN on Nov 25
  9. by   Issaiah1332
    Quote from SummitRN
    The OP has used a bunch of supposition to split care along poorly defined labels. The OP didn't cite where it would actually be relevant to the claims. Only because OP's professor agrees with the virtue signalling is the OP able to get away with failing to cite anything to back up actual thrust of the paper. Presumed and moralistic labeling has little to do with real thrust of patient centered care, which is nothing new.

    If this is what passes for scholarly writing in NP programs these days, it does not bode well for the future of the NP profession.

    If nursing academia continues to act like client-centered-care is a rare phenomena with nursing piercing the night of paternalism, they will continue to reinforce the idea that they are in a self-affirming ivory tower, oblivious to the last 2+ decades of change in healthcare. Then again, they are the same academics who insist on wasting NP students' time with the same plethora of (non-NP) nursing theorists from undergrad. Why should we be surprised these same academics would pose a paternalistic/patient centered care dilemma as a masculine/feminine dichotomy to their students?
    Actually, as I said above, the nursing model isn't the problem. The medical problem, the domineering force in healthcare, largely is. There is a host of research into the paternal nature of the medical model.

    Secondly, I'm not an undergrad student. I am, however, a graduate student.

    I cited a paper by Green who builds off of Gilligan, theoretically.

    This isn't a study nor something that is meant to be published in a nursing journal, something I haven't claimed. It's philosophic in nature.

    Paternal/maternal is presumed dichotomous, unless you have a word for the in-between. Can it be a spectrum? Surely, most things are. By and large, however, the medical model emphasizes a relationship between the provider and patient that puts emphasizes the patient to be a passive-receiver of care and not an equal partner in the care, treatment planning, etc.
  10. by   Lil Nel
    The current opioid crisis was brought about the marketing of OxyContin by it's manufacturer. That is the
    plain, and simple truth.

    This article just left me thinking: Huh?

    How did the author overlook the obvious: The role of Capitalism in Modern Medicine.

    It is amazingly gender neutral.

    If you want to understand the opioid crisis, investigate and learn about the pharmaceutical company that makes OxyContin. It is all the education you will need on the topic.
  11. by   AJJKRN
    Quote from Issaiah1332
    Thanks! I'm a guy by the way, haha. Yeah, it was never meant to incite a war between the sexes.
    The guys/girl comment was more of a play on words in my own special way because, well, I tend to be a bit "special" sometimes ;-). It really had nothing to do with genders but more so about the approaches of responding posts if that makes any more sense.
  12. by   JKL33
    Issaiah1332,

    Thank you for taking the time to reply to everyone (although I bristle slightly at your passing comment that those who complimented you or agree are looking at this more philosophically than the rest of us).


    1) How does feminist theory reconcile the idea that "pain is whatever the patient says it is" (and we should treat it according to what patients say it is) with this: "the masculine approach is one that tends to generate blame, without empathy, and 'tough love' whether that is through the judicial system or evident in the care received?" I'm afraid it does matter, whether you wanted it to or not, because part of your opening statement was that the opioid crisis found it's "genesis and growth within the masculine context of care."

    2) My view, in part, is that the opioid crisis is a direct result of missteps in attempt to quash "paternalistic" control and judgment with regard to the assessment of pain and the prescribing of pain medication. In other words, if you want to talk about this in terms of paternalism, many of us believe this crisis is the result of a sort of paternalism back-lash, if you will. If we must talk in such terms, I would argue that the idea to label a subjective report as a vital sign did not evolve from a masculine or paternalistic mode of thinking.

    You want to say it doesn't matter how this got started but it certainly does, because if your theories are sloppy you risk doubling down on wrong ideas.

    3) I'm sincerely curious why, even if we all agree that "paternalism" has no place in patient care, we must label our theory of care with anything remotely "gendered" (for lack of a better term). Why must we do that? You haven't told us that. You also appear not to have considered whether there is a potential "outcropping" of this feminist theory that would be more akin to "paternalism" - what would that be? Maternalism? Feministic care? Is this really a "care theory experiment" that we need to experience? We already know paternalism didn't work out too well. Is there a particular reason we can never aim for equilibrium rather than wide swings of the pendulum?

    4) Lastly, you have presented an idea that may be helpful, and because you see it as decidedly not "paternalistic" you have said that it is a feminist theory. But just being different than a negative manifestation of "paternal" doesn't make something feminist. The opposite of "paternalistic" is positive manifestations of 'paternal'; I certainly hope you agree that there are positives to paternal, just as there are to maternal. Now we are back to square one, where not all things that have to do with "this" are bad, and all things that have to do with "that" are good.
  13. by   Ruby Vee
    Quote from Daisy Joyce
    I'm not entirely certain the opioid epidemic is the result of obedient and powerless patients.
    I more get the sense that these patients were not taking their meds as prescribed, and HCPs sorta shot themselves in the foot when they decided that pain is whatever the patient says it is.
    The "Pain is whatever the patient says it is" theory of patient care was a nice idea in theory, but once it was exposed to real patients kind of fell apart. There is that group of patients who believe they should experience NO pain EVER, and a generation of physicians who will tell them what they want to hear. "The nurses will make sure you don't have any pain." Once they've heard that, they don't believe me when I tell them that if I ensured that they had no pain ever, they wouldn't be breathing.

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