Certified Cannabis Patient Ethics & Privacy 💬 | Green CulturED

Ethics a n d patient privacy along with their legal rights are a growing concern for the expanding medical cannabis industry, but too frequently, organizations fail to treat it as a significant risk a n d management priority.

Profession al perso ns in health care delivery fields have legal a n d ethical responsibilities to safeguard the co nfidentia lity of information regarding the patients in their care.

It is helpful to thin k of privacy as having two (2) ma jor dimensions – legal requirements that arise specific ally from #0excludeGlossary cannabis regulations concerning its medical use, a n d then requirements that are more generally applicable but include cannabis organizations that are operating.

#1excludeGlossary regulations differ between various legal jurisdictions, a n d even within communities, such as requirements applicable to medical cannabis patients a n d #2excludeGlossary consumers.

Ma ny take a n approach to medical user privacy that is inspire d by the fairly robust set of standards aroun d health information a n d laws that govern medical records.

It’s been long established that the mere fact of receipt of medical care is itself treated as Protected Health Information (PHI), a n d so similarly cannabis operators are frequently required to maintain the co nfidentia lity of medical users.

Medical Cannabis Certification Programs

Medical cannabis is becoming widely available a n d its medicinal use for patients is likely to expand. Despite the increase d accessibility a n d use of medical cannabis, physicians have significant knowledge gaps regarding evidence of clinical benefits and potential harms.

Primary care providers have a n ethical obligation to develop competency to provide cannabis to appropriate patients. Furthermore, specific ethical co n side rations should guide the recommend ation of a patient’s medical cannabis certification.

In ma ny cases, these ethical co n side rations are extensions of #3excludeGlossary principles of benefice nce a n d nonm alef ice nce, which indicate that providers should recommend cannabis only for conditions that have the strongest evidence base.

A d dition ally, the co n tested status of cannabis in cultures aroun d the world raises specific issues rel ated to share d #4excludeGlossary a n d patient education, as well as co ntinuing clinic al education.

Despite these rapid changes, aspects of the political debate over medicinal cannabis remain en trenched in a discourse that reflects anachronistic moral and political sentiments, rather tha n #5excludeGlossary co n side rations of how to balance the benefits of medicinal cannabis a gainst potential in dividual a n d public health risks.

Recent surveys indicate significant k nowledge gaps about the effectiveness of medical cannabis among practicing physicia ns, a n d although ma ny providers believe medical cannabis ca n be helpful for patients, a minority feel sufficiently in formed to make recommendations.1,2

Their training offers little promise of improvement: a recent survey of reside nts demonstrates that nearly #6excludeGlossary percent (85%) receive no education in medical school or reside ncy on medicinal cannabis.3

Given the rea lity of medical cannabis, primary care providers now have a n ethical obligation to develop a level of clinic al a n d ethical competency to enable them to recommend cannabis to their patients when it is indicated.

This is particularly so because cannabis industry regulators typically establish a list of qualifying medical conditions, typically including termin al illnesses a n d illnesses presenting severe chronic pain.

This is sometimes a closed list created by statute or regulation, or sometimes a more open list subject to the opinions of license d medical profession als. Thus, the mere fact of particip ating in a medical cannabis program implicates significant privacy concerns.

On the #7excludeGlossary side, privacy regulation is more varied but ca n be exacting, as some regulators impose extensive requirements on the gathering, use, a n d retention of medical user personal information.

Outside of #8excludeGlossary regulation, cannabis organizations are also subject to generally applicable privacy laws if they gather significant information about patients.

The identity verification a n d #9excludeGlossary practices of most cannabis businesses necessarily involve gathering a n d holding personal information that is subject to local regulations.

Due Diligence Practices

As with a ny organization in a highly regulated industry, cannabis companies must co n tend with the key risks surrounding regulatory compliance rel ating to their tra nsactions.

Such regulatory issues include obtaining a n d determining the validity of a n organization’s licenses a n d permits to co n duct operations un der the legal framework, particularly because government licensing regimes change frequently a n d typically issue licenses that must be regularly renewed.

But beyon d the import a nt question of whether a n organization is legally able to operate in a given jurisdiction, the organization’s compliance with privacy laws should be a salient part of due diligence. Compliance diligence is necessary to un dersta n d a n d identify a ny potential liabilities that may arise from past or current operations.

Cannabis professionals should regularly ask questions a n d request materials rel ated to data privacy on the following matters: #10excludeGlossary privacy policies that establish the rights of patients, paying particular attention to the specific laws in the jurisdiction that you’re operating will dictate the co n tents a n d implementation of privacy policies.

#1 1excludeGlossary policies that govern the treatment of co nfidential information, including policies on training a n d a d ministrative, organization al, a n d technical safeguards for co nfidential information.

Allegations of noncompliance with data privacy laws. Records of patients’ requests to opt out of receiving marketing materials (ex. where the law permits such marketing in the first place, etc.). Just as #1 2excludeGlossary regulation continues to evolve at the government regulator level, data privacy is one of the most active areas of legislation.

Significant new privacy legislation is either working its way through the legislature or has been recently en acted in ma ny jurisdictions in which medical or #1 3excludeGlossary cannabis as the regulatory la n dscape continues to shift.

Medical Cannabis vs Mental Risks

Medical patients a n d their cannabis certification carry certain risks. As a psychoactive drug, its effects on behavioral health are especially import a nt to recognize. In particular, cannabis use is associated with increase d incidence of psychosis in a #14excludeGlossary manner, ma jor depressive disorder, bipolar disorder, a n d anxiety disorders.4

For children a n d a dolescents, the clinic al a n d ethical #15excludeGlossary are more complex; the younger the in dividual, the higher the risk for cannabis dependence or a dverse outcomes.4

Individuals with mental health disorders disproportion ately use drugs like cannabis, a n d it is common for people with drug abuse or dependency disorders to have #1 6excludeGlossary mental health disorders.6

People with psychosis spectrum disorders frequently #1 7excludeGlossary with cannabis,7,8 a practice linked to a greater risk of drug dependence, making its use both a #18excludeGlossary treatment a n d a potential cause of psychosis.9

The causal relationship between cannabis a n d mental illness remains un clear, likely multidirection al, a n d subject to co n founding.10 There are several possible a n d likely interconnected causes of these associations: Substance abuse may be a risk factor for developing mental illness.

Mental illness may be a risk factor for developing substance abuse disorder. There may be a n overlap of predisposing risk factors to both conditions, like genetic vulnerability a n d environment al stress.1 1

These are not mutually exclusive causal relationships, a n d the multiple associations found between patient medical cannabis certification a n d severe mental health disorders require prudence when certifying cannabis for patients, especially for young a dults a n d patients with other risk factors.

Let us k now what you thin k.

Patient Medical Cannabis Certification References