First, do no harm: Medical ethicist says forcing people in addiction treatment has ‘huge problems’

If people need help because they aren’t able to help themselves, then we need to find a way to deal with that. There is definitely a better way of approaching it, I think, than this policy. If we adequately invested in the determinants of health, the problem that the Compassionate Intervention Act is trying to address, if it’s not eliminated, it would be radically and drastically reduced. I think that the probability of achieving those outcomes that the Compassion and Intervention Act claims to want to achieve are much better served by addressing the social determinants of health. And that’s where I think we would actually address this problem in a way that doesn’t violate the Charter in a way that doesn’t require using the notwithstanding clause. And that being said, even implementing such a policy is going to be very problematic. The idea of the policy is that we are going to mandate people that have a serious addiction, in extreme cases into treatment. We have a responsibility as a society to help those people and to try to get them into a treatment facility that seems to make an assumption that we have effective treatments for people. So if you think about addiction as a chronic relapsing condition for which there is no cure, some people can be struggling with this for the rest of their life. And chronic means it’s not going to go away necessarily. And relapsing means it comes and goes, it comes and goes. So there are some addictions for which we have effective treatments like Methadone, Suboxone and some of the other treatments are effective. But one of the studies we’re running on drug use here in New Brunswick shows that 90% of the people in our study use crystal meth. We don’t have effective treatments for crystal meth addiction. I think it would be ethically problematic to force those people into treatment when we don’t have any effective treatment for them. It’s just best for the community and best for the individual. Most importantly, best for the individual. It might actually cause more harm than good. So first, taking people’s rights away is a harm. You’re harming them. There’s no way you can get away from that. It is a harm in the program. How do we enforce compliance? So we tell someone you are required to go to this treatment and say they go and it’s not successful, or say they refuse to go. What do we do? Most approaches like this would have a punitive mechanism where the person that doesn’t comply with the rules of the program receive some type of punishment. So for instance, in some drug treatment courts, if a person doesn’t comply with the rule, there will be what’s called flash incarceration. The judge can say, OK, you go to jail for 48 hours, 48 hours or something like that. So if there’s a risk of using punishment in this program and we’re punishing people for not responding to treatment when we have no effective treatment for them, not only have we taken away from their rights, but we’ve also caused considerable amount of permit. So if it’s something that’s going to happen, notwithstanding the fact that it violates Charter rights, then we will have to tweak it. We will have to do things to make it as humane and ethical as we possibly can. However, if there’s an option to take another path, I would strongly encourage considering the social determinants of health and optimizing that in New Brunswick. And I think that would be an approach that really, really helps us address the problems that the Compassionate Intervention Act is proclaiming to be concerned with.