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Tuesday, August 19, 2008

Tony Clement takes flak for calling doctors’ support of harm reduction “unethical”

Federal Health Minister Tony Clement yesterday angered many physicians at the Canadian Medical Association (CMA) annual meeting in Montreal by not just expressing his doubts about the effectiveness of supervised injection as an element of harm reduction for drug addicts, but by going even farther and accusing Canada’s physicians of acting unethically by supporting such programs.

“I find the ethical considerations of supervised injections to be profoundly disturbing,” said Mr Clement in an address to hundreds of the nation’s most influential doctors. “Is it ethical for healthcare professionals to support the distribution of drugs that are of unknown substance, or purity, or potency -- drugs that cannot otherwise be legally prescribed?”

In a Q&A following Mr Clement’s speech, CMA ethics chair Dr Bonnie Cham firmly told the Minister of Health his interpretation of medical ethics was deeply flawed. “Supporting harm reduction is not a breach of medical ethics,” she said. Her comments elicited a great deal of applause, as did comments from a public health physician, former CMA president Albert Schumacher and others.

As the session came to an end, a small group of opposition Members of Parliament assembled in the hallway.

“This guy is insulting the physicians and nurses on the frontlines,” said Carolyn Bennett, a Liberal MP and former physician. “Yet another disgusting example of ideology over science. It’s disgusting. He only talked one thing for the whole frickin’ speech!” she said. “There is a refusal to acknowledge the CMA knows more about this than he does.”

“As a physician I find Mr Clement’s remarks with regard to Insite extremely dangerous,” said fellow Liberal Hedy Fry, who’s also a former physicians. “What is most appalling to me, however, is that Mr Clement didn’t just say that his government has a moral issue with this, he then went on to lecture physicians on what is the ethical practice of medicine. Is this government going to decide to tell physicians how to practise medicine soon?”

“Sort of an irony today,” interjected Ms Wasylycia-Leis. “A lawyer chastising doctors today on ethics. Remarkable... That was a shameful performance.”

As Drs Fry and Bennett left the media scrum, Ms Wasylycia-Leis said the Liberal Party’s criticisms, though admirable, were undermined by the fact that when they were in power they didn’t increase the number of safe-injection facilities as they are now calling on the Conservative government to do.

“I think it is a bit hypocritical but at this point we need all the allies we can get,” Ms Wasylycia-Leis said. “We need to work together to stop an almost neanderthal position on the part of Tony Clement. Liberals may not be prepared to enact something and put public money towards it but at least they understand the importance of it. Tony Clement doesn’t seem to understand either, neither the importance of harm nor the importance of investing public money into it,” she said, adding that Mr Clement should feel “humiliated” and “embarrassed.”

At a press conference held by the CMA’s leadership afterwards, outgoing president Dr Brian Day said, “In rejecting harm reduction as one tool of addiction treatment, the minister is abandoning the most vulnerable members of society.”

“It is contrary to the interests of both scientific inquiry and informed public debate to categorically reject supervised injection sites,” wrote the Centre for Addiction and Mental Health’s president Dr Paul Garfinkel in an op/ed in today’s Toronto Star. “I regret that the Government of Canada has adopted this position.”

In addition, The Globe and Mail’s André Picard reported:

His comments come as the Conservatives have bombarded urban ridings in Vancouver and Toronto with ads, sent free using MPs' mailing privileges, that depict a discarded syringe and a headline that states: “Junkies and pushers don't belong near children and families. They should be in rehab or behind bars.”
The Conservative government is appealing a BC judge’s ruling that Vancouver’s safe-injection site, Insite, cannot be shuttered by the federal government.

Mr Clement has been on a roll lately when it comes to inciting anger in medical professionals. Just two weeks, at the International AIDS Conference in Mexico City, he was criticized for 'embarrassing Canada' after he spoke out against harm reduction -- during an event sponsoring a new World Health Organization document that endorses harm reduction.

Photo: Ashley Fraser, NRM


  1. ...this is worth a "read" to fully understand how a " harm reduction" perspective is gaining ground ( equal to prevention and treatment).....

    top this off with pressure from the United Nations that Canada is in contravention of two treaties for (a) distributing crack kits (b) participating in the illegal drug market

    The big questions are:

    Why are physicians " up in arms" about possible closure of Insite?

    Does this " harm reduction" perspective open the door to promoting ( or at least facilitating ) any " patient-led" perspective on drug treatments?

    Does this facilitate the development of " drive-through" style clinics where the patient writes the prescription and the valuable input from the physician is his/her signature?

    Considering that... what happens if the " prescription-led" distribution of drugs is changed....and the physician is no longer the gatekeeper?

    Yes.... this " harm reduction" perspective could eventually have an impact on "iatrogenic" illness itself..............yes............ the mind boggles ....

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