Pubdate: Fri, 22 Aug 2008
Source: Regina Leader-Post (CN SN)
Copyright: 2008 The Leader-Post Ltd.
Contact: http://www.canada.com/reginaleaderpost/letters.html
Website: http://www.canada.com/regina/leaderpost/
Details: http://www.mapinc.org/media/361
Author: Murray Mandryk, The Leader-Post
Note: Mandryk is the political columnist for the Leader-Post.
Bookmark: http://www.mapinc.org/people/Tony+Clement
Bookmark: http://www.mapinc.org/people/Stephen+Harper
Bookmark: http://www.mapinc.org/topic/Insite (Insite)
Bookmark: http://www.mapinc.org/find?142 (Supervised Injection Sites)
Bookmark: http://www.mapinc.org/topic/Canadian+Medical+Association
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)

TORIES STUCK ON BLIND IDEOLOGY COULD LEARN FROM SASKATCHEWAN

Normally, the knock against government is its penchant to study things
to death.

But usually far smarter for politicians to engage in a thoughtful
examination of an issue rather than simply shoot off their mouths in
order to appease their political base.

In fact, Prime Minister Stephen Harper and his health minister, Tony
Clement -- who has been all too eager to condemn the morality of the
entire medical profession over the issue of safe intravenous drug-user
injection sites -- would be well advised to follow the lead of
Saskatchewan Health Minister Don McMorris.

When it comes to issues of health ethics, politicians need to step
back, put their own ethical beliefs aside and seek the input of
objective medical professionals.

This is exactly what McMorris did last month, when he launched an
independent review of Saskatchewan's own Needle Exchange Program "to
ensure the program is meeting its objectives of service delivery and
accountability".

Why McMorris's approach is admirable is that he has been under
considerable pressure from the political right to take far more
drastic measures to alter this program, started in 1999 to curtail the
deadly and costly spread of HIV and other blood-borne pathogens.

By all measures, Saskatchewan's needle exchange has been effective in
that goal and it's also important to note that nobody in Saskatchewan
has contacted HIV or hepatitis from a needle stick since the program
began.

That said, there also may be legitimate reasons to worry about the
potential dangers of unreturned needles.

The statistical rate of return of these needles by intravenous drug
users is actually rather remarkable. Of the 1.9 million needles handed
out in the Regina Qu'Appelle Health Region in fiscal year 2006-07, a
surprising 1,861,000 (or 98 per cent) was returned. Similarly, 873,000
of the one million needles handed out by Saskatoon Health Region that
year were returned.

Unfortunately, that still leaves tens of thousands of needles that
aren't returned. Police and firefighters raise the legitimate concern
that far too many of these needles show up in playgrounds where
children play.

Wisely, McMorris has opted to address these conflicting concerns by
launching an independent review of the needle-exchange program in
seven Saskatchewan health districts where the programs exist.

To do it, McMorris appointed Laurence Thompson -- a consultant with a
lengthy background in health services research who was CEO of the
Health Services Utilization and Research Commission. Thompson has
until December to fulfill a broad mandate that will compare the
province's needle exchange with programs elsewhere, examine additional
steps to enhance safety and confirm the program's objectives to
decrease both the transmission rates and high-risk behaviour itself.

By any measure, this is a thoughtful, objective approach to public
policy. It's also a startling contrast to the morality-preaching we're
hearing from Clement on safe drug-injection sites and the alleged
immorality of doctors who are currently working to stop the spread of
AIDS.

Clement recently called Vancouver's Insite safe injection site "a
profound moral issue" that Canadians will "reject on principle" and
even went so far as to question the medical ethics of doctors at a
medical conference in Montreal.

Sadly, it's hard to see where the Conservatives' moral and ethical
concerns extend much beyond crass, cynical politics. The party is now
distributing a political leaflet in a downtown east Vancouver
neighbourhood calling addicts "junkies" who should be in rehab or
behind bars -- and vowing that only a Conservative government would
clean this up.

It's a message that clearly plays to the Conservatives' base.
Clements' hard line on safe injection sites quickly won the approval
of already-supportive groups like the Canada Family Action Coalition,
which thanked the federal minister for ending "programs that aid
people to continue drug addictions".

But it also raised the ire of the Canadian Medical Association
(CMA).

It's one thing for one of the doctors working with Vancouver's addicts
to suggest that Clement's remarks are "repugnant" and "introduce an
element of ugliness into the discussion". But it's quite another when
Dr. Brian Day, outgoing president of the CMA (something less than a
bastion of left-wing activity) suggests the Conservatives are simply
being wrong-headed. "There is growing evidence that harm-reduction
efforts can have a positive effect on the poor health outcomes
associated with drug use," Day said.

Maybe it's time Harper and Clement figured out what McMorris evidently
has already learned -- that politicians need to at least attempt to
keep politics out of questions of health ethics.
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MAP posted-by: Richard Lake