Ethical and Legal Considerations

  • María Luisa MittalEmail author
  • Leo Beletsky
  • Peter J. Davidson


In this chapter, the four basic principles of biomedical ethics are discussed in relation to clinical decision-making for patients with SUDs and their families: (1) beneficence, (2) non-maleficence, (3) respect for autonomy and (4) justice. Examples focusing on decisions particular to medication treatment for OUD are presented. Stigma is considered. Additionally, some of the regulatory frameworks that affect substance use are reviewed, including current laws to expand access and availability of naloxone for opioid overdose reversal, the Harrison Narcotics Tax Act of 1914 and the Controlled Substances Act of 1970. The Narcotic Addict Treatment Act of 1974 and the Drug Addiction Treatment Act of 2000 (DATA 2000), under which opioid agonist treatments have been delivered in the United States are explored. Patient confidentiality laws such as 42 CFR Part 2 are also examined.


Beneficence Non-maleficence Respect for autonomy Justice Harrison Narcotic Act of 1914 Drug Addiction Treatment Act (DATA) 2000 CFR 42 Part 2 Stigma 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • María Luisa Mittal
    • 1
    Email author
  • Leo Beletsky
    • 1
    • 2
  • Peter J. Davidson
    • 1
  1. 1.Department of MedicineUniversity of California San DiegoLa JollaUSA
  2. 2.School of Law & Bouvé College of Health SciencesNortheastern UniversityBostonUSA

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