NUR1 424 Class 11 2024 Harm Reduction - Nursing Ethics PDF

NUR1 424 Harm Reduction & Substance Use Public Health Ethics Part 2 – 2024 Copyright © 2024 Ingram School of Nursing @ Miller – Images...

NUR1 424 Harm Reduction & Substance Use Public Health Ethics Part 2 – 2024 Copyright © 2024 Ingram School of Nursing @ Miller – Images V.1 as cited or @ CC Class Objectives Discuss the application of harm reduction principles in nursing practice Explore how our personally held attitudes and beliefs influence our nursing practice when we care for people who use substances or are faced with an addiction Understand the legal, social, and ethical issues involving substance use and their impact on nursing practice NUR1 - 424 V.1  Equity-Oriented Health Care aknowlege structural inequity not only individuals levels but also structural level think bout system in place for equitable healthcare EQUIP Health Care. (2017). Promoting Health Equity - Harm Reduction: A Tool For Primary Health Care Organizations and Providers. Vancouver, BC. Retrieved from www.equiphealthcare.ca. NUR1 - 424 V.1 Story Time V.1 Image: Carré St-Louis. By Caribb, CC BY-NC-ND 2.0, https://www.flickr.com/photos/caribb/199152406  stigma and substance use can come into play into healtcare outcome Image: Carré St-Louis. By Caribb, CC BY-NC-ND 2.0, https://www.flickr.com/photos/caribb/199152406  carré saint Louis: stigma can limit access to healtcare Images: Emile Nelligan, CC0; Cover of 'Un ange cornu avec des ailes de tôle' by Michel Tremblay (2015); Carré Saint-Louis.By Chicoutimi, CC BY-SA 3.0, via Wikimedia Commons importance of adressing stigma: individual, interpersonal, systemic, institutional all have impact lots of different impact: final outcome Reports from the Chief Public Health Officer - Canada.ca  2023 Jan-Mar opioid crisis: average 21 death/ day Federal, provincial, and territorial Special Advisory Committee on the Epidemic of Opioid Overdoses. Opioid- and Stimulant-related Harms in Canada. Ottawa: Public Health Agency of Canada; September 2023. https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/ Reference: Government of Canada. (2017). Apparent opioid-related deaths in Canada in 2016 [Infographic]. Retrieved at: https://www.canada.ca/content/dam/hc- sc/documents/services/publications/healthy-living/opioids-infographic-eng.pdf  not just numbers; lived experiences https://www.lapresse.ca/actualites/2022-10-22/surdoses/l-epidemie-invisible.php When you think of harm reduction, what words come to mind? ⓘ Start presenting to display the poll results on this slide. Copyright © 2024 Ingram School of Nursing V.1 HARM REDUCTION - Defined A Public Health Approach ‘A philosophy and a set of programs & services Focusing on preventing the harms of substance use, not reducing substance use per se Viewing substance use as a health issue An evidence-based response’ Cited: EQUIP Health Care. (2017). Promoting Health Equity - Harm Reduction: A Tool For Primary Health Care Organizations and Providers. Vancouver, BC. Retrieved from www.equiphealthcare.ca.  Harm Reduction Defined public health approach; philosophy preventing harm of susbtance use not reducing susbstance use, susbance abuse: public health issue not moral ‘Harm reduction refers to policies, programs and practices that aim to minimize the negative health, social and legal impacts associated with drug use, drug policies and drug laws. Harm reduction is grounded in justice and human rights. It focuses on positive change and on working with people without judgement, coercion, discrimination, or requiring that people stop using drugs as a precondition of support.’ Harm Reduction International Harm Reduction International. What is harm reduction? London, United Kingdom: International Harm Reduction Association; 2020. Retrieved at: https://hri.global/what-is-harm-reduction/ Retrieved from: National Harm Reduction Coalition (2020). https://harmreduction.org/wp- content/uploads/2022/12/NHRC-PDF-Principles_Of_Harm_Reduction.pdf Principles of Harm Reduction – CATIE (2022) Practical and pragmatic what are the immediate needs of the user person in need Immediacy of needs Focus on the health and rights of people who use drugs, not reducing drug use Including challenging policies-programs that maximize harm Meaningful Participation of people who use drugs with (not for/againsy) involvement in decision making Promotion of human rights kEY Public health & evidence-based approach positive outcomes of harm reduction, lot of research, very evidence basesd Non-judgmental Adaptive and Innovative need to be adaptive and Adapted from https://www.catie.ca/harmreduction  Pragmatism Participation created by peple with substance use for people with susbtances use Nothing About Us Without Us Non-Judgment – Human Rights Retrieved from: National Harm Reduction Coalition (2020). https://harmreduction.org/wp- content/uploads/2022/12/NHRC-PDF-Principles_Of_Harm_Reduction.pdf  law: good samaritan law, if you witness overdose, possession you are protected harm reduction reinforcmenet Public Health is ‘inherently political’ https://www.canada.ca/en/health-canada/services/publications/healthy- living/pillars-canadian-drugs-substances-strategy.html https://www.canada.ca/en/health-canada/services/opioids/about-good- samaritan-drug-overdose-act.html#a2  Research with Communities - DTES first safe injection site, lot of access, research research there: getting research without good impact to the community, people do research than leve and publish with increase stigma even more to this area Boilevin, L., Chapman, J., Deane, L.... et al. (2019, March). Research 101 : A manifesto for ethical research in the Downtown Eastside. Retrieved at https://open.library.ubc.ca/cIRcle/collections/ubccommun ityandpartnerspublicati/52387/items/1.0377565 Gunay, A. E., Friesen, P., & Doerksen, E. M. (2023). Community research ethics oversight: Place, experience, and expertise. In Ethical Issues in Community and Patient Stakeholder–Engaged Health Research (pp. 275-297). Cham: Springer International Publishing.  Building on Indigenous Advocacy ’Harmful research practices have long been a source of betrayal, and disrespect in Indigenous communities. Research has long- functioned as a tool of colonialism, and colonial research practices continue in the ways that researchers exploit, exhaust, and extract from Indigenous and other marginalized communities. Finally, as Friesen and colleagues (2017) point out, much of the recent energy and innovation in the ethics of protecting marginalized communities from exploitative research emerged first in the resistance of Indigenous communities to colonial research practices. Thus, our work on empowering informed consent in the DTES is indebted to Indigenous peoples in several ways.’ p.2 Boilevin, L., Chapman, J., Deane, L.... et al. (2019, March). Research 101 : A manifesto for ethical research in the Downtown Eastside. Retrieved at https://open.library.ubc.ca/cIRcle/collections/ubccommunityandpartnerspub licati/52387/items/1.0377565  Pitfalls And Potentials Of Research in DTES* RISKS- PITFALLS POTENTIALS Perpetuate stigma Undermine community initiatives Lead to positive change Trigger trauma Help educate and empower the Devastate people when results never community shared Help challenge stigma Misrepresent communities and Help complexify the issues individuals Help create evidence to support Be an excuse for not taking action important community resources Sap resources from communities Be irrelevant to community members Create meaningful sources of if no action made after research income and new skills for people *Cited from: Boilevin, L., Chapman, J., Deane, L.... et al. (2019, March). Research 101 : A manifesto for ethical research in the Downtown Eastside. Retrieved at NUR1 - 424 https://open.library.ubc.ca/cIRcle/collections/ubccommunityandpartnerspublicati/52387/items/1.0377565  How does this relate to Harm Reduction Principles? What may be missing in an Academic REB? How does this relate to Josée Lavallée’s 6 R’s Indigenous Framework presented in Class 1? NUR1 - 424 Copyright © 2024 Ingram School of Nursing V.1 Taking Care of Each Other: Indigenizing Harm Reduction Note to self! 0- 3:11 6:30- end  CATIE – Online Harm Reduction Training https://www.catie.ca/harmreduc tion EQUIP HealthCare https://equiphealthcare.ca/ Indigenous Harm Reduction http://www.icad- cisd.com/pdf/Publications/I ndigenous-Harm- Reduction-Policy-Brief.pdf https://www.fnha.ca/Welln essSite/WellnessDocuments GET INVOLVED: /FNHA-Indigenous-Harm- HARM REDUCATION NURSES ASSOCIATION Reduction-Principles-and- https://www.hrna-aiirm.ca/ Practices-Fact-Sheet.pdf  Advocacy Come up 34 times in the CNA Code of Ethics Advocacy is defined by the CNA (2017) as “the act of supporting or recommending a cause or course of action, undertaken on behalf of persons or issues. It relates to the need to improve systems and societal structures to create greater equity and better health for all. Nurses endeavour, individually and collectively, to advocate for and work toward eliminating social inequities.” (p. 5) important at a collecive level -nurse advocacy HAs an impact on healthcare access, and changes NUR1 - 424 Copyright © 2022 Ingram School of Nursing V.1  Principles: Challenging Harming policies & Structures ongoing challenge to policy and structure effect of criminalization does not reflect gravity of the crime creates morebarreirs to healthcare NUR1 - 424  Changing the Script – Young Nurses Voices importance of safe supply https://globalnews.ca/news/865 5724/bc-safe-supply-not- https://www.youtube.com/watc meeting-need-advocates/ h?v=actW810oB98&t=1s NUR1 - 424 Copyright © 2022 Ingram School of Nursing V.1 Workshop Content Workshop Week Additional Resources HARM REDUCTION National Harm Reduction Coalition - Harm Reduction Truth https://www.youtube.com/watch?v=x9f5rz75swE WhatHarm Reduction Principles do you see played out and discussed? Harm Reduction Fundamentals - Harm reduction principles and practices How would you frame it through ethical principles discussed https://www.youtube.com/wat last week in the various ch?v=Zg1eUM9aLIU&t=363s frameworks in public health ethics? References Adams, A., Ferguson, M., Greer, A. M., Burmeister, C., Lock, K., McDougall, J.,... & Buxton, J. A. (2022). Guideline Development in Harm Reduction: Considerations around the Meaningful Involvement of People Who Access Services. Drug and Alcohol Dependence Reports, 100086. Boilevin, L., Chapman, J., Deane, L.... et al. (2019, March). Research 101: A manifesto for ethical research in the Downtown Eastside. Retrieved at https://open.library.ubc.ca/cIRcle/collections/ubccommunityandpartnerspublicati/52387/items/1.0377565. EQUIP Health Care. (2017). Promoting Health Equity - Harm Reduction: A Tool For Primary Health Care Organizations and Providers. Vancouver, BC. Retrieved from www.equiphealthcare.ca. Gunay, A. E., Friesen, P., & Doerksen, E. M. (2023). Community research ethics oversight: Place, experience, and expertise. In Ethical Issues in Community and Patient Stakeholder–Engaged Health Research (pp. 275-297). Cham: Springer International Publishing. Harm Reduction International. What is harm reduction? London, United Kingdom: International Harm Reduction Association; 2020. Retrieved at: https://hri.global/what-is-harm-reduction/. Levengood, T. W., Yoon, G. H., Davoust, M. J., Ogden, S. N., Marshall, B. D., Cahill, S. R., & Bazzi, A. R. (2021). Supervised injection facilities as harm reduction: a systematic review. American Journal of Preventive Medicine, 61(5), 738-749. Special Advisory Committee on the Epidemic of Opioid Overdoses. Opioid- and Stimulant-related Harms in Canada. Ottawa: Public Health Agency of Canada; September 2022. https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants. Tam, T. (2019). Addressing stigma: Towards a more inclusive health system. Public Health Agency of Canada. https://www.canada.ca/content/dam/phac-aspc/documents/corporate/publications/chief-public-health-officer-reports-state- public-health-canada/addressing-stigma-what-we-heard/stigma-eng.pdf. NUR1 - 424