Beyond Professional Licensure: A Statement of Principle on Culturally-Responsive Healthcare

This work calls on healthcare institutions and organizations to move toward inclusive recognition and representation of healthcare practitioners whose credibility is established both inside and outside of professional licensure mechanisms. Despite professional licensure’s advantages, this credentialing mechanism has in many cases served to reinforce unjust sociocultural power relations in relation to ethnicity and race, class and gender. To foster health equity and the delivery of culturally-responsive care, it is essential that mechanisms other than licensure be recognized as legitimate pathways for community accountability, safety and quality assurance. Such mechanisms include certification with non-statutory occupational bodies, as well as community-based recognition pathways such as those engaged for Community Health Workers (including Promotores de Salud) and Indigenous healing practitioners. Implementation of this vision will require interdisciplinary dialogue and reconciliation, constructive collaboration, and shared decision making between healthcare institutions and organizations, practitioners and the communities they serve.

Alzheimer's disease biomarkers: another tool for FAA pilot screening?

Research advancements to improve the accuracy of diagnosing Alzheimer's disease (AD) have altered clinicians and researchers’ understanding of the disease process. The discovery of amyloid and tau biomarkers as measures of disease pathology supports early identification of disease risk that precedes symptom onset. As a result, AD is now understood to be an underlying pathology that causes a spectrum of clinical syndromes, beginning with preclinical AD. Future clinical implementation of biomarkers will raise novel employment and professional licensure discrimination risks based on AD biomarker status. This article evaluates the potential consequences of biomarker status for commercial pilots within Federal Aviation Administration pilot licensing procedures. The article argues for a careful implementation of AD biomarker status in licensing procedures to emphasize public safety, integrate accurate scientific knowledge, and limit unjustified and adverse consequences for individual pilots.

Legal Regulation of Prescription Opioids and Prescribers

Prescribing opioids and other controlled substances is challenging on myriad levels. Beyond the complexities and uncertainties of evaluating and treating patients in pain, the legal landscape is increasingly complicated. Even within the already highly regulated health care environment, opioid prescribing involves additional legal and regulatory constraints. This chapter provides an overview of the legal frameworks for opioid prescribing, including a brief history of opioid regulation in general and for addiction treatment. The federal Controlled Substances Act, Food Drug and Cosmetic Act, and the federal agencies charged with enforcement are reviewed. The chapter also outlines the function, scope, and authority of state professional licensure boards. Clarified definitions of misprescribing are offered and a framework for classifying misprescribers is suggested. Finally, the penalties providers may face for misprescribing in civil court, licensure and discipline actions, and federal and state criminal legal actions are explained.