Narrative Inquiry in Bioethics

This issue completes the eighth volume of Narrative Inquiry in Bioethics. The narrative symposium in this issue is edited by Kelly K. Dineen and Daniel S. Goldberg, and is titled, "Living with Chronic Pain in the Midst of the Opioid Crisis." The symposium presents a collection of stories by individuals who have struggled with or been a witness to a loved one's chronic pain at a time when the US is experiencing an opioid-addiction crisis. Prescription opioids can be effective medications for treating pain, but they are also drugs of abuse and misuse. Long term use can lead patients to develop tolerance and physical dependence. The authors describe a range of experiences. Some describe how because of opioids they are able to work, take care of their children, and live a "normal" life, while others have been under-treated or abandoned by their physicians who, due to heightened scrutiny of opioid prescribing practices or concerns about addiction, are hesitant to prescribe opioids. Many authors describe non-pharmacological approaches to treating their pain with varying success. The three commentary articles by Caroline Huang, Travis N. Rieder, and Maia Szalavitz offer insights into the authors' stories from the perspective of their personal experiences or expertise related to opioids, substance abuse, and chronic pain.

Eline M. Bunnik, Frans Meulenberg, and Inez D. de Beaufort contributed a research article to the issue titled Ethical Issues in the Beauty Salon: The Development of National Ethics Guidelines for Aestheticians in the Netherlands. The article describes a novel and significant concern about beauty salons from a bioethics perspective. Aestheticians' services increasingly overlap with medical care. The demand for risky and sometimes irreversible treatments (e.g., laser hair removal, Botox injections, chemical peels) is growing. The authors conducted a study in the Netherlands to explore 17 domains of ethical issues that apply to the beauty salon environment, including age limits, vulnerable groups, informed consent, and confidentiality. The authors' work led to the development of the first national guidelines for aestheticians in the world.

"Weight is the last admissible prejudice, and obese people are the targets of all kind of cruel behavior because of their size," write Lori A. Roscoe and Daniel P. Schenck in their case study, Victim of Abuse, or Bully? The Case of the 800-Pound Man. This case describes a morbidly obese patient who was taken to the hospital when he experienced difficulty breathing. His wife, son, and daughter-in-law had been taking care of him at home and continued to bring him whatever food he asked for in the hospital. The family reported giving in to his requests despite knowing the patient's weight was causing his underlying health problems because they feared his tantrums and were frightened of him due to his large size. The authors question if this patient bullied his family into getting what he wanted or whether their compliance with his requests, jeopardizing for his health and survival, made him a victim of abuse. [End Page v]