Wednesday, 12 September 2012

Harm reduction: Relativism in action?

Many of our healthcare strategies are based on harm reduction. We use methadone to treat drug addiction, substituting long-acting methadone for short-acting heroin. Many people live stable lives on methadone, but very few of them manage to get off the methadone. We have simply substituted one addiction for another, but we accept this because it reduces crime and anti-social behaviour. It does have some benefit for the individual as well, they are not committing crime or anti-social behaviour, but the benefit to society as a whole is much greater than the benefit to the person in question. They are still an addict; their dealer is now the government.

Pharmacies provide needle exchange services. Clean needles and sharps bins are given to drug users and dirty needles can be exposed of. Users do not need to share or reuse needles and therefore they have a reduced risk of contracting blood-borne diseases and other infections, using drugs is made safer. The NHS spends less money treating them and there is a clear public health benefit. But the individual is still an addict.

These strategies are not a total waste of time, and do bring some other benefits to users in terms of physical health. They are brought into contact with a health care professional whom they see regularly and/or frequently, and thus are enabled them to access other medical services. The problem is that that both these strategies are based on the premise that people will always take drugs (being intrinsically bad), an assumption that the person will not and is not able to change, and the reduction of the person to their body. We think we are choosing a lesser evil, but actually we are settling for a lesser good.

We were created good, and whilst are capable of misusing our freedom and choosing the bad, we are also capable of exercising that freedom in the way that it was intended and choosing the good. Choosing between good and bad is not the best use of our freedom: even a lab rat is capable of doing the same. The proper use of our freedom is choosing between good and better. Obviously our ability to exercise our freedom is serverely impaired by behaviour such as drug misuse and abuse, but it is not gone.

Reduction of the person to the physical is also seen in the way we attempt to address the epidemic of sexually transmitted diseases and teenage pregnancy: again, on the basis of harm reduction we throw contraceptives at the problem. Once again it fails to address the root of the problem which is a lack of understanding of what a person really is. Made in the image and likeness of God, we have an inherent dignity, a dignity further raised by the incarnation: God became man. The Lord Jesus worked with human hands, thought with a human mind, acted by human choice and loved with a human heart (GS 22)

We have a body but we are not our bodies. We also have a soul and a spirit, and in the hierarchy of body, soul and spirit, the body is the least. We are capable of entering into relationships on more than a merely physical level. Understanding of this dignity leads to respect of self and others, a better basis for decision making and surely a change in the way we choose to behave. Quick-fix solutions of short-term harm-reduction are not the answer to problems which come from a disordered desire for instant gratification on a physical (and psychological) level and a wrong undestanding of the human person. They are much easier to measure which is good for government statisticians, but that is a topic for another day.

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