Safe injection sites may fall to ideology

By 
  • August 29, 2007
{mosimage}An Evangelical Christian scientist, with the support of 134 scientists and public health officials, has challenged the federal government to either continue funding a safe injection site for drug addicts in Vancouver or admit ideology and not science is behind its decision to close down the three-year old InSite safe injection facility .

In "Science and Ideology ," published in the online scientific journal www.openmedicine.ca , Dr. Stephen Hwang claims statements from Health Minister Tony Clement that scientific studies on safe injection sites are so far inconclusive "suggests that scientific evidence is about to be trumped by ideology." Without a decision to continue funding by Sept. 12, InSite will close in December.

Among the signatories supporting Hwang's letter are British Columbia's chief medical officer of health, the head of the British Columbia Centre for Disease Control and Montreal's director of public health. Hwang is a doctor and researcher at St. Michael's Hospital and a professor of medicine at the University of Toronto.

The idea of tax dollars going to help addicts do something which is illegal and immoral may sound wrong to many Christians, but science tells Hwang that it is in fact the Christian thing to do.

"I feel very strongly about this issue. This issue is one in which not only does the science show that it's effective, the scientific evidence strongly suggests that the fears that people raise about the approach are not true," Hwang told The Catholic Register. "It's a case in which even if one were to make the moral argument that we're concerned that this harm reduction intervention will encourage people to use more drugs, the evidence suggests that's not true."

Studies show the crime rate has fallen in Vancouver's downtown east side since the safe injection site opened, that addicts seek rehabilitation sooner because of the safe injection site and that the clean needles distributed at the site help control the spread of HIV, hepatitis and other diseases. Science is a better basis for deciding how to treat addicts than a gut reaction of moral repugnance for what addicts do, Hwang said.

"The discussion around addicts and addiction will often degenerate into a discussion of how do we good people avoid being harmed by these bad people," Hwang said. "It is very much a kind of blaming, and positioning oneself as being morally superior to these people."

Hwang's Evangelical faith tells him that isolating and punishing addicts is wrong.

"Our Christian faith tells us that we're all equally sinful, and we stand equally before God, and none of us is righteous or good in the Christian sense," he said. "Therefore, we shouldn't be creating classes of what people now call bad people but which Christians call sinners. It's essentially saying, "I'm not so bad a sinner and you're a really bad one.' "

The Catholic case for harm reduction in public health care is just as strong, said clinical ethicist Brendan Leier.

"The tradition that speaks to me on this is really the social justice tradition," said the St. Joseph's College, University of Alberta professor of moral theology and ethicist at the John Dossetor Health Centre in Edmonton.

Public policy which marginalizes and demonizes addicts has proven itself to be harmful to the common good in the "war on drugs" approach in the United States, Leier said. High standards of personal morality don't constitute a public policy which cares for the whole community, he said.

"For individuals, it's fine to say "I'm not going to raise my children with a harm reduction strategy; I'm going to say you should abstain from premarital sex and you should abstain from drugs and alcohol,' " said Leier. "That's fine. That's an individual choice, and one that I would certainly never argue with anyone about. But when we're talking about public policy, public policy demands the allocation of scarce resources — tax dollars and what have you. That demands a fair and equitable rationale for their distribution. Unfortunately, dogma and individual conscience decisions to abstain and any sort of moralistic judgment doesn't weigh into the just allocation of scarce resources."

While some Catholics might at first worry that the government is materially or formally co-operating in evil by providing addicts with the tools of their own destruction, that doesn't stand up to scrutiny, said Redemptorist ethicist Fr. Mark Miller.

Traditional Catholic moral theology prohibits formal co-operation in the sin of another, meaning to assist someone in committing an evil act while having in mind the same purpose or goal as the person committing the act. If the purpose of the safe injection site is to provide a safe environment, clean needles, medical supervision and generally to preserve the life of the addict then it's not formally co-operating in the addict's self destructive act.

"Some people would say you're giving them the OK. I disagree with that because I think the implication is that we're dealing with people who can make choices," said Miller, who works as clinical ethicist at St. Paul's Hospital in Regina. "When they're addicted that's a whole different kettle of fish. My argument would be that we're providing material co-operation because it does reduce harm."

A Catholic understanding of the natural law concept found in the writing of St. Thomas Aquinas would strongly favour following scientific evidence in setting public policy, said Miller.

"The truth of science is something that will complement the truth of morality, and vice versa," he said.

Catholic support for harm reduction isn't just a matter of ethical theory and philosophy in Miller's eyes. He also turns to Scripture.

"This is a social justice issue. It's almost like the situation of lepers in the time of Jesus," he said. "What Jesus did was say, "No, you embrace them; you bring them in, you make them part of the community.' That becomes part of the healing. It doesn't work for everybody, but it's going to work for the community. It also becomes part of the healing of the community, because otherwise you become elitist and moralistic."


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