CLEMENT RE-IGNITES NATIONAL DEBATE ON SAFE INJECTION

ALMAGUIN - The word count for Muskoka-Parry Sound MP and federal
health minister Tony Clement's annual speech to the Canadian Medical
Association on Aug.18 was just under 3,500.

Most of those words were used by the health minister to describe his
problems with Insite - Vancouver's safe injection site for drug users
- - from a public policy, scientific and ethical point of view.

In the week that has followed Clement's address at the CMA's annual
conference, numerous articles and opinion pieces have appeared in the
national media both supporting and opposing his message and tactics,
an outcome Clement is very happy with.

"It was my third speech to the CMA (and) . . . I get to choose what I
get to speak about and I thought this was an issue that was important
to help move the policy along about how we can help addicts," he told
this newspaper Monday from Denver, Colorado, where he is attending
the U.S. Democratic National Convention.

"The CMA took a position that I felt was wrong-headed and not in the
best interest of addicts and not in the best interests of our society
and I felt that it's part of my role to speak out when I think that
the public policy debate is going in the wrong direction."

According to a copy of Clement's speech provided to this newspaper,
the health minister was responding to a letter sent to him - with a
similar article later published in the Toronto Star - criticizing the
Conservatives for their dismissal of the "scientific evidence of the
positive role harm-reduction programs can play in society."

Clement countered in his speech that the science backing safe
injection sites provides a "lack of evidence" and that the value of
these sites remains questionable.

One of the most widely reported - and criticized - parts of Clement's
speech was his discussion on the ethical concerns behind safe injection sites.

"Is it ethical for health-care professionals to support the
administration of drugs that are of unknown substance, or purity, or
potency, drugs that cannot otherwise be legally prescribed? If this
were done in a doctor's office the provincial college would rightly
be investigating," Clement said in his speech.

He also claimed that while no overdose deaths have occurred at
Insite, there have been regular overdoses, which "undercuts the
ethics of medical practice and sets a debilitating example for all
physicians and nurses, both present and future, in Canada."

Clement told this newspaper that he was not calling anyone unethical,
rather asking a series of questions and asking the audience "to look
into their own hearts and minds."

However, he added that he believes safe injection sites are unethical.

"I think that part of a doctor's role in our society is to protect
people and I don't think injections sites protect people. I think
they harm people," he said.

When asked if questioning the ethics of those health care
professionals was the right way to go about the debate, Clement said,
"The CMA is not quiet or when it comes to making judgments about
political life and about politicians, so I think what's good for the
goose is good for the gander."

He later contacted this newspaper again to provide context for the
arena in which his speech was heard.

Clement said that he made the speech to the governing executive of
the CMA, about 250 people, and not a room full of thousands of doctors.

He added that both before and after the speech, he and the CMA have
had good communication on national health issues.

"I don't want it to appear that it was me against the CMA," he said.
"Part of my role is to advocate for what is the correct public policy
and if that offends someone along the way I find that regrettable but
you can't have a debate without someone obviously strenuously
disagreeing with you."

Clement also said that in the hundreds of e-mails he's received since
his speech was reported in the news, many have been from physicians
who support his point of view.

When asked if he would have changed his approach to the issue had he
been talking to a room of 5,000 doctors, Clement replied, "I'm not
very good with hypotheticals. I knew the room was 250 doctors (and
they) weren't a representation of every medical community."

Insite, which opened in Vancouver's Downtown Eastside in 2003, allows
addicts to inject their own narcotics while under medical supervision.

The centre was opened with an exemption from federal drug laws;
however, the Conservative government now wants to shut the site down.

Ottawa is now in the process of appealing a B.C. Supreme Court
decision that struck down portions of Canada's drug laws because they
prevent the site from operating.

The appeal is expected to be heard next April by the B.C. Court of Appeal.