Legal and Ethical Issues Regarding the Clean Needle Exchange Program - Coursework Example

Legal and Ethical Issues Regarding the Clean Needle Exchange Program Discuss the ethical parameters of a clean needle exchange program and explore it from one or more of the following approaches: utilitarianism, deontologicalism, virtue ethics or feminine ethics. Introduction In the simplest of terms, the Clean Needle Exchange Program is a social policy which allows individuals to hand over used hypodermic syringes that may have contaminated needles and obtain clean syringes that have unused needles. Of course the hypodermic syringe is a medical instrument and the device itself is mostly used in hospitals and clinics. The primary users of the syringe and the clean needle in a non-hospital setting becomes drug users who need to use the needles in order to inject themselves with illegal drugs. This brings some very interesting ethical questions into play and depending on the ethical approach being taken with regard to the program; it can be shown that the program is debatable. To better understand that, we have to examine what ethical principles can be applied and how the application of these ethical principles can change how the program is viewed. Utilitarian Ethics As described by Wilson (2006), the principles of utilitarianism suggest that we should do things which bring the most pleasure and are most useful for society at large. It is a well founded philosophy which suggests that all of our collective and singular actions should be taken while keeping the good of the public in mind. The good of the people can be evaluated in terms of happiness, social pleasure or public satisfaction depending on the viewpoint taken concerning what is good for society (Thiroux and Krasemann, 2006). However, the basic idea is conform to actions which make life better for the people who a person is connected to directly or indirectly. The utilitarian ethics take pain and pleasure to be the most likely results for any actions taken by a society or even an individual. Thus, whatever brings pleasure to the greatest numbers of people and makes them closer to being happy is seen as utilitarian and is therefore a good thing for society (Thiroux and Krasemann, 2006). On the other hand, what brings misery; suffering or pain to the people should be avoided (Sweet, 2006). To evaluate the clean needle exchange program we would have to examine if it brings pain or pleasure and if both then which one is the greater good for the greatest number of people. Murphy and Knowles (2000) discuss the clean needle exchange program and cite a report by the Surgeon General regarding the effect of the clean needle exchange programs by saying that, “The report concluded that available research showed that needle exchange programs were effective in reducing transmission of HIV if they were part of a comprehensive HIV prevention strategy (Murphy and Knowles, 2000, Pg. 1)”. In essence, the clean needle exchange program does reduce the incidence of HIV therefore it can be seen as being good for the people at large. However, the idea of utilitarianism does have the concept of justice attached to it as per the guidelines and ethical theory given by Mill as he discussed it in his book titled Utilitarianism. Mill’s addition of the idea of justice along with doing what is good for everyone adds a new dimension to utilitarianism and makes the theory more complete (Wilson, 2006). We as a society have to be aware of the consequences of our decisions and perhaps a responsibility of the decisions made by an individual should also be borne by the individual. Therefore, an individual who chooses to engage in risky behavior has to bear the consequences of the resulting damage which can be experienced by him/her. To take the argument concerning clean needles a few steps further, we might start offering a sober driver program in which teenagers who drink and drive can call a government funded authority to give them a lift back home to wherever they want to go. However, the law demands that teenagers do not drink in the first place just as the law demands that people do not use drugs or share needles. A utilitarian argument which seeks to help society may even say that those who share unclean needles are likely to die from their use and even their deaths may be good for society since that would mean one less drug user. Even a patient who has acquired AIDS due to engaging in risky behavior may be seen as being responsible for their own condition much as a smoker could be seen responsible for his/her own condition if s/he develops lung cancer. Murphy and Knowles (2000) put a more colorful spin on it while discussing giving needles to drug users by saying, “Giving needles to IV drug addicts is like giving matches to a pyromaniac (Murphy and Knowles, 2000, Pg. 1)”. However, acknowledging the reality of the situation, Murphy and Knowles (2000) also note the failure of the American government to slow or stop the flow of drugs into the country. This failure means that there are going to be individuals who are going to use drugs intravenously and when scarce needles are shared between people, the likelihood of AIDS and other diseases spreading from one person to another is increased (AIDS Action Council, 2001). Being addicts or even casual user of drugs makes a person more likely to engage in risky behavior and thus puts them at a greater risk when it comes to getting preventable diseases. In absolute terms, even though it is not the responsibility of a social order to stop individuals from getting AIDS if they engage in activities that lead to AIDS, society bears a cost if such individuals do contract the disease. Logically, a society which wants to prevent a drain on its resources with regard to its hospitals being filled with AIDS patients would do all it can to prevent such individuals from developing the disease in the first place. Therefore, the clean needle exchange program can be said to be fitting the demands of utilitarianism. Even beyond AIDS, there are problems such as Hepatitis and other diseases which can be passed from person to person if they share needles. Further, needle exchange programs can help addicts by creating inroads into their lives where professional help can be given to them. The needle exchange program puts an addict in touch with doctors who might otherwise not even know about the existence of the addict. Murphy and Knowles (2000) note that: “An addict might visit a needle exchange just to get clean needles to use to inject drugs, but they might also pick up free condoms or talk to a drug counselor about treatment options. The governments refusal to fund needle exchange programs means that an opportunity to stop the spread of HIV has been lost (Murphy and Knowles, 2000, Pg. 1)”. In this manner, needle exchange programs not only create good for society, they also may lead to the creation of additional benefits of bringing addicts back to being productive members of the social order. Since both of these bring happiness to the addicts as well as those who are trying to help addicts kick their habits, under utilitarian ethics at least, the idea of needle exchange programs and the associated systems which govern such programs are not only ethical but also required for the good of society since the aim of society as well utilitarianism is to bring about good for the greatest number of people. Deontological Ethics However, the situation becomes quite different with deontological ethics since they are based on actions as well as decisions being wrong or right rather than the consequences of the decisions. With regard to the needle exchange program, an understanding of deontological ethics themselves needs to be completed before they can be applied to a social program. It must be understood that Deontological ethics are based on imperatives as defined by Kant who suggested that we should perform acts based on morality which helps us come to decisions regard what should and should not be done (Pojman, 1998). However, these obligations and imperatives which individuals are supposed to follow are to be free from any idea of personal desires or individual needs. Morality and the moral codes of society create imperatives for us which can be seen as universal laws that become acceptable to all those who live in a social order. Society is seen as an end rather than as means to get to an end and in fact, there is no real argument given by Kant why such imperatives should be followed expect that they are moral laws which are good to begin with and thus should produce good results (Pojman, 1998). When applied to the idea of the needle exchange program, the problem with deontological ethics becomes quite clear. The deontological approach suggests that it is morally wrong to help an addict with his/her habit and therefore it is morally wrong to give him/her clean needles. The resulting spread of AIDS or other diseases as a consequence is merely a moral result of the addict engaging in risky behavior therefore society is not responsible for this act. However, a doctor following deontological ethics would be placed in a dilemma since it would be a part of his/her duty to prevent disease which s/he could do by passing out clean needles. On the other hand, it would be morally wrong for him/her to help an addict. The situation is made even more complex when it comes to obeying laws which are unethical to begin with (Pojman 1998). For instance, under deontological ethics, a person would have a moral imperative to follow the law but if laws themselves are unethical then following unethical acts or committing unethical acts would be taken as perfectly moral behavior. That can be simplified from a situational example that took place in the previous century. For an individual living in Nazi era Germany, it would certainly be ethical in deontological terms if they willingly took part in the genocide against the Jews. Since the laws of the land asked them not to, harboring any Jews or providing them safety would be unethical since it would be against the law. In fact, helping the government would be quite ethical even if the government had made laws which led to active discrimination, torture and even murder. Even though basic human rights were being violated, deontological ethics might not have seen them as such since the government and the people were merely following the established laws of the land. Therefore, needle exchange programs might have to be stopped under deontological ethics where individuals are responsible for the choices they make, the moral decisions they make as well as the consequences of their actions. In a broader interpretation of deontological ethics, it can be said that the first duty of every individual is to do what is right even if it conflicts with the laws of the land. That is to say, if personal morality and the laws of the country are in conflict then personal morality would be followed (Pojman 1998). Conclusion The only manner in with deontological ethics can permit the clean needle exchange program is if the personal morality of the individual is different from the laws which have been imposed on them. Even if such a situation leads to a conflict between the individual and the community, the moral guidance of the individual is better than the laws which have been created to control individual. On the other hand, utilitarianism accepts the need for clean needle exchange programs simply because they are good for society as well as those parties that are directly involved with the issues. It is easy to see therefore that the clean needle exchange program is indeed beneficial for a social system and public policy should be made to include more funding for such programs. Works Cited AIDS Action Council. 2001. “” TheBody.com. 2001. AIDS Action Council http://www.thebody.com/content/art33776.html Murphy, J. and Knowles, B. “Are Needle Exchange Programs a Good Idea?” SpeakOut.com. 2000. Center for Disease Control. Pojman, L. 1998, Moral Philosophy, Hackett Publishing. Sweet, W. “Jeremy Bentham” The Internet Encyclopedia of Philosophy. 2006. University of Tennessee. Thiroux, J. and Krasemann, K. 2006, Ethics: Theory and Practice, Prentice Hall. Wilson, F. "John Stuart Mill" The Stanford Encyclopedia of Philosophy. 2006. Stanford University. Word Count: 2,068 Read More