Pubdate: Wed, 27 Aug 2008 Source: Huntsville Forester, The (CN ON) Copyright: 2008 The Huntsville Forester Contact: http://www.huntsvilleforester.com/ Details: http://www.mapinc.org/media/2430 Bookmark: http://www.mapinc.org/find?142 (Supervised Injection Sites) Bookmark: http://www.mapinc.org/topic/InSite Author: Carlye Malchuk Dash CLEMENT REIGNITES INJECTION SITE DEBATE 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. - --- MAP posted-by: Jay Bergstrom