Disgust or Dignity? The Moral Basis of Harm Reduction

Health Care Analysis 28 (4):343-351 (2020)
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Abstract

Harm reduction has been advocated to address a diverse range of public health concerns. The moral justification of harm reduction is usually presumed to be consequentialist because the goal of harm reduction is to reduce the harmful health consequences of risky behaviors, such as substance use. Harm reduction is contrasted with an abstinence model whose goal is to eradicate or reduce the prevalence of such behaviors. The abstinence model is often thought to be justified by ‘deontological’ considerations: it is claimed that many risky behaviors are morally unacceptable, and therefore that we have a moral obligation to recommend abstinence. Because harm reduction is associated with a consequentialist justification and the abstinence model is associated with a deontological justification, the potential for a deontological justification of harm reduction has been overlooked. This paper addresses this gap. It argues that the moral duty to protect autonomy and dignity that has been advocated in other areas of medical ethics also justifies the public health policy of harm reduction. It offers two examples—the provision of supervised injection sites and the Housing First policy to address homelessness—to illustrate the argument.

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Natalie Stoljar
McGill University

References found in this work

The Theory and Practice of Autonomy.Gerald Dworkin - 1988 - New York: Cambridge University Press.
The Morality of Freedom.Joseph Raz - 1986 - Philosophy 63 (243):119-122.
The morality of freedom.J. Raz - 1986 - Revue Philosophique de la France Et de l'Etranger 178 (1):108-109.
The Theory and Practice of Autonomy.Gerald Dworkin - 1988 - Philosophy 64 (250):571-572.

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