Friday, September 19, 2008

Ethics


Today in my Health Promotion Methods class we had a discussion on ethics. We talked about a lot of different experiments people did that went wrong. We talked about how the Nazi's documented everything in great detail and how that information is used today and is it ethical? We talked about the German women swimmers who won all the gold medals during an Olympics in the 60's because they were being injected with large amounts of steroids and did not even know. How that messed up their lives, some died from it. Others had children but they were so severely deformed that they just tossed the babies aside (I know.. shudder). What interested me was something I knew nothing about. The Needle Exchange.

Anyone ever heard of it? I can't believe I did not know what it was because it was going on in Spokane, Washington. I grew up 2 hours south of there. For those of you who don't know; The Needle Exchange is a program where any drug user can come with a dirty needle and get a brand new clean shiny one. For free. No questions asked. Now, you have to come with a needle to get a new needle. They also give you a pamphlet and that's that. The police have agreed (much to their angst) to not arrest anyone coming to The Needle Exchange. My first reaction was, Isn't this condoning drug use? Isn't this helping a bad behavior? Isn't this saying that the Government supports it? (by the way, I don't know if isn't is a real word or not, I'm not an English major, so I really don't care :)

But then we started to talk more in depth about it. This is preventing the spread of disease. The spread of AIDS and anything else transmittable out there. Suprisingly, since this has been going on (started in the mid 90's) there has been a 20% increase in the amount of drug users coming in for help. I thought, now why is this?

Because it's showing these drug users that people care. That even though we acknowledge their drug use is wrong and illegal, we still care that someone does not get sick. Now, my teach said that we would all be surprised at how many BMW's, Audi's, Range Rovers and Lexus's come to exchange needles. So... I got to thinking.. maybe this isn't such a bad thing. I guess if you think of it in the helping people perspective. I'm still so undecided on exactly where I stand.

I want to know what you all think of this, but first, this is what my teach said before we left. That if we look at these people like they are our brothers and sisters are we not happy that they are getting help in some way? Are we not happy that these children of Heavenly Father are being taken care of?

The people that are drug users are obviously pretty far gone to be having to inject the stuff into their bodies. But they are never far gone enough for help not to actually help. It was so crazy to talk about and discuss this in an optimistic sort of way. You just have to take one, or two, or thirty steps back and look at it from every perspective.

What do you think?

23 comments:

Jillene said...

I am addicted to watching Intervention on A&E. It breaks my heart every time I watch it. Addiction is such a scary thing and so unpredictable. I guess I have mixed feelings about this. I think that decreasing the spreading of AIDS is worth the needle exchange but on the other hand it is kind of inableing them. I need to thing about this some more--I will comment agian later!

Kristina P. said...

This kind of program is called "Harm Reduction." There are many organizations who will go around to the homeless populations giving clean needles, condomns, etc.

I've been working in the substance abuse field for 10 years, and this is always a controversial subject. I work at a substance abuse counseling center for adolescents and we practice harm reduction on a very small scale. We don't give needles out or anything, but we will give information out about places they can go.

I think this is like passing out comdomns to people. People are having sex anyway, and many kids are not being taught proper sex education, so this keeps the risk of pregnancy and STIs down.

I think it can be effective with people who are hard core addicts who are not seeking treatment.

Off my soapbox now. :)

Victoria Elder said...

To me this is a no brainer... they obviously had a needle to use in the first place anyways. so whats the big deal? The program is just helping the spread of disease, that's a good thing...I dunno I may be biased due to having family that are/have been addicts

Kristina P. said...

Ummm, I do know how to spell "condom." Need I remind you that my head hurts?

*MARY* said...

I don't like it, I don't like it one bit. Yes, everyone is a child of God and we are all brothers and sisters but do you think God would go around handing out clean needles or try and help them kick the habit completely?
It's also like the whole letting little girls have birth control when they're nine thing. Because well they're gonna do it anyway might as well keep them from getting pregnant.
Or teaching your kids abstinence and then throwing them a pack of condoms.
Or giving a gun to a murderer who usually stabs his victims to death. "Here, use this gun to kill, it's easier and won't make the victim suffer as much." You know? It's like well, he's going to go kill people anyway we might as well let him get the job done faster and with less suffering.
okay that last one was a bit of a stretch but both drugs and murder are against the law so why would the government give them the tools to break it?
Well, as you can see I'm way too self-conscious to voice my opinion on this, I'm scared of what people might think of me so I better shut up.

Kristina P. said...

Mary, I completely understand where you are coming from, but unfortunately, I don't think it's an entirely realistic situation.

I am very frustrated that we live in an abstinence only State. I fully believe that it IS the responsibility of parents to teach sex ed, or about drugs and alcohol, but unfortunately, many parents do a HORRIBLE job.

I have 12 year-old clients who come into my office, pregnant, all the time, because they thought Coke was a birth control method. Or that you can't get an STI from oral sex, etc.

And honestly, I think that Jesus/God would do both. Addiction is a terrible disease, and most people have relapse after relapse. Get them help AND help them to be safe and stop spreading disease to others.

I don't think harm reduction is perfect, by any means, and I don't think I would work for a company whose mission was to do this, but I do think that these type of things have to be looked at realistically.

There's a metaphor that I like about teaching our kids to be able to drive out of a skid. Is teaching them how to get out of a skid likely to encourage reckless driving? Most likely not. But do we want our kids to be able to know what to do once they get there? Yes. I feel the same way about sex and other risky behavior.

Let's continue this conversation over breadsticks and salad at the OG. I'll bring some amazing syphilis slides.

OK, off to watch a Lifetime movie now! Thanks for the conversation, Whitney.

Whitney said...

Jillene - It's a tough call, huh?

Kristina - I completely agree with you that it's the parents job to teach about everything. I honestly don't remember my parents teaching me, I learned through friends, school and church. I knew that what everyone was doing was wrong, but I was just never tempted. Drugs, alcohol and promiscuous behavior wasn't my forbidden fruit. I know it's not the case with a lot of people. But, it's hard because this program is having a positive effect. Even if it's a little bit at a time, but really, if any one person comes in to get helped and is treated and better forever because of it, then wasn't it worth it? But, again, giving users the idea that we think it's okay to use and here, have this clean needle to do your job can't be the best thing. I see the positive and the negative.

Vic - having family does give you a different perspective. Especially if this program can potentially help them. Needles aren't the easiest to come by, so giving out free clean ones may even be stopping other crimes from happening. It's all so confusing! ;)

Mary - Didn't realize you were such a fire cracker. :) It's good to have an opinion and feel strongly about it. I can see where your coming from. But we had this discussion, too and talked about the positives and it makes it a little harder to argue when people are really getting help. I'm still very undecided on what I think.

Kristina again - I'm glad you have experience with this sort of thing to give a different perspective. Makes for some interesting conversation.

Miss Lovely's Musings said...

Uh-oh, Aunt Susan is on her soap-box again....

This certainly is a tough call, and one that calls for less idealism and more realism. When a person is in the throes of addiction, a different part of the brain takes over, and their usual judgement is co-opted by the addiction. Check out this article from Time

http://www.time.com/time/2007/addiction/

That said, supplying clean needles is not condoning drug use, but is trying to stop the spread of disease which is often acquired by innocent people through the IV drug user. Supplying clean needles is kind of like keeping water out of a leaky boat long enough to reach the other shore so you can fix the problem. In fact, the people picking up the clean needles are, in a fashion, being responsible.

I've never had a serious addiction, so I don't understand the desperation, but I do know that people don't usually wake up one morning and decide to destroy their lives and the lives of their loved ones. Something bigger takes over.

Less judgement, more compassion, tough laws and treatment are what is needed.

There is a saying "There but for the grace of god go I."

*MARY* said...

So scared to come back to this post.
I honestly didn't even know there was a program like this out there. I just learned about it now through Whitney so I didn't have long to form an opinion, this was just the first thing that popped into my head after reading it. Kristina gave me a new perspective, she has way more experience with drugs than I do (not saying she does drugs, you know what I mean) So, hmm... I have a lot more to think about and bring to the table, the OG table.
And I totally agree with the whole parents teaching kids about sex thing. My parents DIDN'T! One time in elementary school we were playing tag and I was running around waving my arms and my finger touched a boys mouth and I got a bit of his saliva on my finger. Later that night after a big dinner I looked at my rounder than usual tummy and thought I was pregnant. I freaked out for a week.
The whole controversy a while back about the tween girls getting birth control pills from the school nurse just had me baffled. These girls were PRE-TEEN! And you're passing out birth control like it's candy and you're not even required to tell the parents. I know all parents aren't as responsible as I will be when the sex talk time comes. So sex ed is a necessity. But if you're talking to your kid about sex and throwing in religion and waiting for marriage into the discussion like I plan to do, don't then go and give them a pack of condoms.

Kristina P. said...

Mary, don't be scared! You have an extremely valid and well spoken opinion.

The condom thing is tough. Honestly, I don't know what I would do in that situation. I fully intend to teach abstinence to my children, because I waited until marriage to have sex, so I know it can be done, but I also intend to teach consequences and let my kids make their own decision. That's the great thing about agency, is that people can make their own choices.

I would hope my children would not have sex before marriage, but if I found out they were anyway, I would want them to be safe. My sister got pregnant when she was 16, and she loves her son more than anything, but she will fully admit that decision caused hardship upon hardship upon hardship. I would rather give my child a condom, than a baby at a young age, if they are going to make a decision to have sex.

In fact, I had a young man in my office a couple weeks ago, who was 12, 13, and when I inventoried his items, he had a condom with him. It sort of took me back, since he was so young, but I was glad that at least he was being somewhat smart and safe.

Another thing with drug treatment is that it's extremely expensive, and most of the addicts that are being given needles would need long term residential care, which just isn't readily available.

Sorry to hog up a ton of comments! I fully admit that I am biased about this subject, but it's one I have a lot of experience with.

Rychelle said...

whitney - great conversation starter.

kristina - i couldn't agree more.

Alexis and Casey Treese said...

I'm a 'for the people' person. I think most people are intrinsically good and deserve the benefit of the doubt. I also am obsessed with addiction and learning all about it. I definitely have the ability and the inclination to 'suffer fools'. So obviously I think the needle exchange is a fantastic idea and those German woman should keep their medals. Great post. Now I am going to watch the Simpsons because that was too much education for a Saturday.

Jillene said...

This is a really great subject. I am all about finding out all I can about addiction. I have a 9 year old and a lot of 9 year old kids are taking their first drink of alcohol. The world is scary these days!! I want to be as educated as possible on sex and addiction so that I can in turn teach my children. I want our communication to be open and honest. I want them to be able to talk to me about anything. My husband and I are going to have the 'sex" talk with Zachary soon. So sad but it is everywhere! He came home from school the first week and told us that on part of the play equipment someone spray painted--"If you want to have sex call----" I just hope and pray that we can teach our children right from wrong and if they make mistakes we won't judge them but help them through it.

I will have to say that I have been really impressed with you Kristina! I agree with all you have said. You are extremely passionate about your work and I truely admire that! The kids you work with are really lucky!

Miss Lovely's Musings said...

I remember when Misti was 6 and Ashely and Nick were 4, I decided to be progressive about sex education, so I went to the library and got a book which explained the act using chickens as models.

Sometimes Ashely will say, "Hey mom, remember that book you got us with the chickens doing it?"

LOL

Whitney said...

Aunt Susan - I just love your soap box! That's so funny, you showed a 4 year old chickens procreating?! Somehow.. I'm not surprised :)

Mary - I hoped that for futurs sake, your parents explained that your tummy getting a little bigger was bloating. Because.. well, we know that could have caused some panic later before you had learned the rest about sex. I'm glad you came back and voiced your new opinion. It's nice to have someone "on the inside" ;) to help us better grasp these situations.

Kristina - I think we can all agree that we don't mind your super long (the longest I've ever seen!) comments. They actually help shed some light that none of us can explain.

Rychelle - Thanks! I love comment conversations.

Alexis - I agree, I think most people are genuinely good and should be given every opportunity to be so. I hope it was a really funny Simpsons with absolutely no thinking involved on your part to get the jokes.

Jillene - I really don't envy your position in having to have "the talk" with Zach. But I know you will do a very good job on helping him to understand, your a great mom.

Aunt Susan again - Chickens??? My mom let me pick up the Chicken stuff off the streets. And TV.

Danger Cat said...

LOL, Whit, I have to go with Auntie Sue on this one, Having worked in addiction recovery (12 step) programs for the past year we can see that in making the choice to use substances to do risky behavior the person is giving up their agency to the substance or behavior. If they are not in a place where they can or will get help to "kick it" at least keep them and others safe with an exchange program.

b. said...

I think I have an opinion on this, but my head hurts after spending 4 days with hundreds of kids...

I think isn't is a real word.

But does your spell check underline it? Mine does. It underlines pretty much anything with an apostrophe!

Ash and Jeff said...

Hi! I'm new to your blog, and this topic made me want to comment. My blog is private, but I'll send you an invite momentarily...

Anyway...I too have enjoyed Kristina's perspective on this subject. I think she does a very good job at eloquently getting her point across. I think that when you are touched/understand addiction (ha! I accidentally typed addition...corrected now), it completely changes your view on such an exchange program.

My younger brother is a drug addict and has been for years. He has been in intesive treatment, sober living, etc. My mother taught us both the dangers of drugs, sex, etc. I turned out one way, and my brother turned out the complete other. Even with all the help he has been given (and the successes he has seen), he still turns back to the drugs. You reach a point with an addict that you realize you are not going to change them. You can only hope that you they will have the desire (and willpower--most important) to change themselves. You also hope that while you cannot stop their self-destruction, in the process they won't hurt someone else.

Offering clean needles to drug users isn't enabling them. The fact of the matter is, they are going to use the drug, clean needle or not. They cannot control it. The drug controls them.

I also don't think that the needle exchange and handing out of condoms is an apples for apples comparison. I could see situations where having a condom handy might allow a young teen to make the decision to engage in sex a little more readily than if they didn't have it. However, I do not think that someone would pick up a drug habit just because there are free needles available. I also don't think that a recovering addict would be more likely to relapse just because they knew they could get a clean needle. Trust me. They are clever, they are conniving, and they will do whatever they have to do to get their high.

Off my soap box now. Is my post longer than Kristina's? :)

P.S. Isn't IS a word. It's the contraction of is not. Kudos.

Rowboat said...

i don't really have a strong opinion yet. this is something i don't know a lot about. at first i was tempted to be completely horrified that they would hand out clean needles, thinking that just perpetuates the problem. but after reading everyone's comments, especially the girl right above (ash and jeff) i realize there's a lot more to it than i know. i like posts like this whitney, keep it up!

Christa said...

I'm not sure if I've ever left a comment here before, but here it goes. I hope you don't mind. Especially since it's a little late in the game on this post and it will probably be kind of long.

First off, I have to say that I wasn't appalled by this idea at all. I can only see this being a beneficial thing. Also, I thank Kristina for her opinions and her concise way of expressing them. To me, they all seem very rational and logical. I totally agree with everything she had to say.

I have a cousin who is now just about 30 years old. She began rebelling and acting out when she was around 11. At first, she did all of the stupid teenage things. Skipping school, sneaking out of the house, totally disobeying her parents at every turn, making out with every boy she met, etc. Then she graduated to harder stuff. She became involved with gangs, drugs, sex, other crime, you name it.

Her parents are divorced, she was adopted by them and she loved using the break-up of their marriage and the fact that she was adopted, as an excuse for all of her behavior. I wonder why all adopted children and children of divorce don't act out in the same way? :0) Her parents coddled her for the longest time because they obviously felt that they had failed her in some way. Eventually the coddling turned to anger and they became fed up. Unfortunately, they tried to take control when it was already too late. They didn't know what to do with her. She started bouncing back and forth between the 2 homes because neither household could put up with her and then running away from each when she was there.

When she was 15, her father took her to the doctor to get on the pill. Everyone knew she was sexually active, duh, but I remember that my grandma was outraged that he would do it. She felt that he had just given her a license to have sex. No, he in fact had not and he wasn't condoning her behavior. He was simply trying to slow down the inevitable. I remember asking my grandma if she would rather see her sexually active, but not pregnant, or, pregnant. Because it was going to happen soon if someone didn't do something. She refused to believe that she would get pregnant and was apalled that I was being so frank and would suggest that. Well, she was pregant about 2 months later. She thought that she would be able to trap the father into a long term commitment and having a cute little baby around would just be so much fun. She thought he was fun until she discovered that by keeping him, it meant that she was actully going to have to raise and care for him. She neglected him and used him when he was convenient. He shuffled between her house and her mother's. She had another baby within about 2 years and all told has had 4 children. All of them with different fathers. The youngest is now 2. She has had her parental rights to the first 3 terminated. The main reason for all of this behavior is the fact that she was addicted to heroin. This in no way excuses her behavior, but it partly explains it. The addiction was ruling her. All logic and reason left and the drug was king. Now, I could throw in here that her parents could have been more pro-active in the beginning, and by that I mean they could have done something period, but that's another story. My point of my ridiculously long dissertaion is this:

I so wish that a program like this would have existed at that time because through the use of dirty needles, she contracted HIV and I believe now has full blown AIDS. I don't keep in contact with her because too be in contact with her is dangerous. She has always been manipulative and still is. She has been in and out of prison for identity theft and bank fraud, both of which she started doing to support her habit. Maybe, just maybe, if she could have had a resource like this that could have provided her with an opportunity and a desire to get clean, she wouldn't be where she is today. She will not be Magic Johnson and survive indefinitely from this. If she lives another 5 years it will be a miracle. She is currently drug free, but doesn't live a healthy lifestyle. It's sad to know that her life will end because of this disease.

I can see all sides and opinions on this subject, but I tend to lean to the Free Agency slant of things. The plan was that we came here and we made our own decisions. Good or bad and then we deal with the consequences. I can sometimes take the tough love thing a bit far, I know, but I'm a firm beleiver that our decisions are ours to make. The consequences are also ours to deal with, but that doesn't mean that we don't deserve a little help. My cousin made her choices and they didn't lead her to a good end. Now she has to deal with that. Offering a clean needle is not enabling a person who is already gone. It's showing them a different way to live and then hopefully, showing them that someone cares and is willing to help. I guess I could simply have said that I didn't think it was such a bad idea in the beginning. I didn't have to be so long winded. Sorry to all about that. :0)

Christa said...
This comment has been removed by the author.
Christa said...

I thought that I should clarify that I don't feel it's dangerous to be around my cousin because of her disease. It's dangerous to be around her because she's a criminal. She would have no qualms whatsoever stealing mine or my husband's or my children's identity. There. I should finally be done.

I don't mind at all if you follow my blog.

Whitney said...

Don't worry, I didn't think you meant that you couldn't be around her because of her disease. I figured it was more because of her lifestyle. I don't judge :)