The Good Samaritan Framework for Caring for Pregnant Patients with Opioid Use Disorder
Ellery Sarosi, Theology, Medicine and Culture Fellow, Duke Divinity School
Casey is a 33-year-old pregnant female with a history of heroin overdose. While speaking with her doctor, she shares she has used heroin throughout the pregnancy. How can her care team support her?
Opioid Use Disorder (OUD) is a stigmatized diagnosis that is often viewed as a moral failure rather than an illness. Stigma is one of many barriers pregnant patients with OUD face in accessing addiction treatment and prenatal care. Given the increasing prevalence of OUD in pregnancy,1 healthcare practitioners must explore ways to support, rather than marginalize, these patients. Exploration must lead to action given the increased risk of maternal death associated with OUD in pregnancy.2
In this presentation, I will consider how the Good Samaritan (Luke 10:25-37, NRSV) should reframe how we, as medical practitioners, care for pregnant patients with OUD. In envisioning ourselves as travelers on the Jericho Road and patients like Casey as the injured traveler, the question becomes: How can we respond like the Good Samaritan rather than pass by like the priest or Levite?
I will begin answering this question by examining factors that limit our ability to see pregnant patients with OUD as our neighbors. Just as the Samaritan overcame inherited cultural hostility to demonstrate mercy to a presumably Jewish traveler, one who strives to respond like the Good Samaritan must work against societal pressures that isolate patients like Casey, caring for them in a way that actualizes human solidarity.3 I will propose ways our care should facilitate solidarity: recognizing OUD’s oppressive character and responding with compassion rather than judgment, addressing racial disparities influencing treatment of OUD in pregnancy, working against criminalization of addiction, caring for the high levels of trauma in this population as was likely necessary in the beaten traveler’s recovery, and partaking in the Samaritan’s willingness to help the traveler through expanding the pool of practitioners caring for these patients.
Next, I will explore health care models that incorporate Good Samaritan Values into caring for pregnant patients with OUD. I will identify practices that embody the Samaritan’s self-sacrificial care, long-term commitment to the traveler’s healing, willingness to rely on others to support the traveler, and foundational compassion and mercy.
I will conclude as Jesus concluded his proclamation of the parable, with a call to, “Go and do likewise” (Luke 10:37). In responding to this call, the care provided and relationships developed become sacred. Adopting this perspective will help us respond to Casey and others like her in ways that affirm. their dignity.
1 Hirai et al. (2021). Neonatal Abstinence Syndrome and Maternal Opioid-Related Diagnoses in the US, 2010-2017. JAMA, 325, 146-155.
2 Maeda et al. (2014). Opioid Abuse and Dependence during Pregnancy: Temporal Trends and Obstetrical Outcomes. Anesthesiology, Vol. 121, 1158–1165.
3 Catholic Church, and John Paul. 1984. Apostolic letter Salvifici doloris of the Supreme Pontiff John Paul II to the bishops, to the priests, to the religious families and to the faithful of the Catholic Church on the Christian meaning of human suffering. Ottawa: Canadian Conference of Catholic Bishops.
Opioid Use Disorder (OUD) is a stigmatized diagnosis that is often viewed as a moral failure rather than an illness. Stigma is one of many barriers pregnant patients with OUD face in accessing addiction treatment and prenatal care. Given the increasing prevalence of OUD in pregnancy,1 healthcare practitioners must explore ways to support, rather than marginalize, these patients. Exploration must lead to action given the increased risk of maternal death associated with OUD in pregnancy.2
In this presentation, I will consider how the Good Samaritan (Luke 10:25-37, NRSV) should reframe how we, as medical practitioners, care for pregnant patients with OUD. In envisioning ourselves as travelers on the Jericho Road and patients like Casey as the injured traveler, the question becomes: How can we respond like the Good Samaritan rather than pass by like the priest or Levite?
I will begin answering this question by examining factors that limit our ability to see pregnant patients with OUD as our neighbors. Just as the Samaritan overcame inherited cultural hostility to demonstrate mercy to a presumably Jewish traveler, one who strives to respond like the Good Samaritan must work against societal pressures that isolate patients like Casey, caring for them in a way that actualizes human solidarity.3 I will propose ways our care should facilitate solidarity: recognizing OUD’s oppressive character and responding with compassion rather than judgment, addressing racial disparities influencing treatment of OUD in pregnancy, working against criminalization of addiction, caring for the high levels of trauma in this population as was likely necessary in the beaten traveler’s recovery, and partaking in the Samaritan’s willingness to help the traveler through expanding the pool of practitioners caring for these patients.
Next, I will explore health care models that incorporate Good Samaritan Values into caring for pregnant patients with OUD. I will identify practices that embody the Samaritan’s self-sacrificial care, long-term commitment to the traveler’s healing, willingness to rely on others to support the traveler, and foundational compassion and mercy.
I will conclude as Jesus concluded his proclamation of the parable, with a call to, “Go and do likewise” (Luke 10:37). In responding to this call, the care provided and relationships developed become sacred. Adopting this perspective will help us respond to Casey and others like her in ways that affirm. their dignity.
1 Hirai et al. (2021). Neonatal Abstinence Syndrome and Maternal Opioid-Related Diagnoses in the US, 2010-2017. JAMA, 325, 146-155.
2 Maeda et al. (2014). Opioid Abuse and Dependence during Pregnancy: Temporal Trends and Obstetrical Outcomes. Anesthesiology, Vol. 121, 1158–1165.
3 Catholic Church, and John Paul. 1984. Apostolic letter Salvifici doloris of the Supreme Pontiff John Paul II to the bishops, to the priests, to the religious families and to the faithful of the Catholic Church on the Christian meaning of human suffering. Ottawa: Canadian Conference of Catholic Bishops.