ARGUE IDEAS, DON'T ATTACK MD ETHICS

The Harper Conservatives have now turned on the country's doctors,
lowering what should be a respectful and legitimate discussion about
the wisdom of safe-injection sites for drug addicts into the gutter
of personal attacks and name-calling. Is this really how the
government imagines it will convince Canadians to grant it
untrammeled majority power?

Speaking at the Canadian Medical Association's general council
meeting in Montreal on Monday, Health Minister Tony Clement
effectively told physicians they are acting unethically if they see
merit in the controversial Vancouver "Insite" clinic -- which is
operates on the principle that addicts should have access to sterile
equipment because their addiction will drive them to self-administer
drugs whether they have safe needles or not.

Unbelievably, Clement admitted such sites might "slow the death
spiral" of an intravenous drug user, but argued he didn't see this as
a "positive health outcome" because it doesn't reverse the downward
trend. This suggests that it would be ethical, in his view, for the
public health system to cease medical intervention in any case in
which a downward trend cannot be halted -- which would be startling
news indeed to doctors and patients alike in situations without long-term hope.

Almost as surprisingly, Clement's desire to turn the subject into a
Republican-style culture-wars battleground -- note the loaded
description of it as a "profound moral issue" -- led him to directly
confront the CMA's current president Dr. Brian Day. Day is a man who
might otherwise tend to sympathize with the Harper crowd, given his
call for more openness to choice and private alternatives in the health system.

Make no mistake here: the foregoing is not intended either to reject
all of Clement's arguments on drug policy, or even to accept in their
entirety claims that the safe-injection clinic is an unqualified
success. He says the clinic is not a satisfactory alternative to more
and better treatment for addiction -- and he's absolutely right.
Further, the implication is valid that past governments have tended
to pretend that stopgap measures are sufficient.

Beyond our borders, we have finally begun to understand that
humanitarian aid programs for refugees are no answer to the thugs who
forced them to flee their homes. When it comes to domestic social
threats, however, we are still too easily seduced by the (far
cheaper) appearance of action.

But Clement seems to say that the safe-injection clinic was somehow
preventing the Harper government from doing more treatment of
"junkies" and jailing more "pushers," to use the charming language
with which the Conservatives seek to drive wedges between good
Canadians and their enemies.

Clearly, the political goal here is to win favour in large urban
centres, such as Toronto and Vancouver, that are currently political
deserts for Conservatives. The government seems to think that the
communities with the most first-hand experience with the drug problem
haven't noticed that the American "war on drugs" approach doesn't
actually work. In the election that now seems certain this fall, it
will be interesting to see whether a largely rural and suburban party
understands the urban majority as well as it thinks it does. But in
the meantime, all Canadians have to ask themselves why Canada's
medical community is wrong to want to have "a positive effect on the
poor health incomes associated with drug use," as Day put it in a
letter to Clement.

If Clement could prove that providing sterile injection tools don't
have such a effect, the question would be different. But until that
happens, you have to suspect he's really only playing a variant of
previous governments' game of using the clinic to give the illusion
they are getting to the bottom of the underlying problem.

The Liberals made themselves look like they were on the case in 2003
by opening it. The Conservatives hope the electorate will buy the
same snake oil in 2008 -- by closing it again.