INSITE

"There are facts in two things, science and opinion; the former
begets knowledge, the latter ignorance." Hippocrates, Law

Whether Nobel Laureate or first year university student, any
scientist worth their salt knows that objectivity is the foundation
of their work. With that in mind, I read this week's article on the
Insite facility in Vancouver's Downtown Eastside with great concern.

In a nutshell, Insite operates under an exemption from the Criminal
Code that allows them to deliver a safe-injection and needle exchange
service without fear of prosecution or police intervention. It is
consistent with the Government of British Columbia's "Four Pillar
Approach" to combating the scourge of drug addiction through
prevention, treatment, harm-reduction, and enforcement. Furthermore,
it is entirely funded by the Portland Health Authority of British Columbia.

However, the exemption that Insite was granted from prosecution under
the Criminal Code is set to expire and the Conservative Government of
Canada has been less than forthcoming in offering to renew it. In
fact, they've gone so far as to question the facility's
effectiveness. On Oct. 4, 2007, Prime Minister Stephen Harper claimed
that Insite was "a second-best strategy at best because if you remain
a drug addict, I don't care how much harm you reduce, you're going to
have a short and miserable life." Health Minister Tony Clement went
on to say that, "There has been more research done, and some of it
has been questioning of the research that has already taken place and
questioning of the methodology of those associated with Insite" When
asked which study he was referring to, Minister Clement was unable to
provide an answer. Call me cynical, but I question whether it's care
and sincerity for drug addicts that is driving Mr. Harper and Mr.
Clement's agenda.

The fact is Insite and its effectiveness are things to be judged by
science and science alone. If Mr. Harper truly had the welfare and
health of drug addicts in mind, he would consider the twenty-five
different, independent studies supporting the positive work the
facility has done or consult the doctors, nurses, and front line
social workers who dedicate their lives to solving the problem of
drug addiction. He didn't. Thankfully, these front-line professionals
took it upon themselves to make their position known.

On August 16, 2007, in an open letter to the Prime Minister, 130
scientists, doctors, and public health professionals wrote that "the
health of the nation is placed in peril if our leaders ignore crucial
research findings simply because they run contrary to a rigid policy
agenda driven by ideology or fixed beliefs." Strong words;
particularly if you consider that the letter's signatories included
Dr. Robert Brunham, head of the B.C. Centre for Disease Control; Dr.
Richard Lessard, Montreal's director of public health; Dr. Perry
Kendall, British Columbia's chief medical officer of health; and
leading HIV-AIDS researcher Dr. Mark Wainberg of McGill University.

For Mr. Harper and his government to ignore the prompting of so many
respected and experienced scientists means one of two things; either
Mr. Harper considers his knowledge of the situation to be superior to
the 130-odd signatories of the letter or he's basing his judgement on
something other than science. If it's the former, I anxiously await
his publication in a respected scientific journal so that he can
defend his skepticism. If it's the latter, I worry for the safety and
decency of our country. Society has long acknowledged science's
primacy in answering factual questions; there is simply no better
standard to date. For Canada's elected representatives to use
ideology and moral grandstanding instead of fact is both dangerous
and irresponsible.

For the record, I'd like to make clear that I'm claiming that science
is the sole authority to judge factual questions. Normative
questions--questions of what should be or what ought to be--are the
realm of ethics and the social sciences. Science does itself a great
disservice when it tries to answer these types of moral issues.

Ultimately, the decision our Government takes on Insite will have
profound implications, both for the addicts whose lives will be worse
for the lack of this service, and for Canada as a whole. If our
government chooses to ignore the promptings of science on this
question, I shudder to think what it has in mind for something like
the Kyoto Protocol and the proof behind anthropogenic climate change.