Clement questions MDs who favour safe injection sites

Federal Health Minister Tony Clement says ethical concerns raised by supervised injection sites for drug addicts are "profoundly disturbing," and he questions doctors who support the practice.

"Is it ethical for health-care professionals to support the administration of drugs that are of unknown substance, or purity or potency — drugs that cannot otherwise be legally prescribed?" Clement said Monday in a speech at the Canadian Medical Association's annual meeting in Montreal.

In any other medical setting, supervised overdoses would be considered "highly unprofessional," he said.

"In this way, supervised injection sites undercut the ethics of medical practice, and set a debilitating example for all physicians and nurses, both present and future in Canada, who might begin to question whether it's OK to let someone overdose in their care."

Vancouver's Insite safe-injection centre has not noticeably reduced drug overdose deaths, because narcotics use in "back alleys and seedy motels" is still high, he said.

Clement also questioned the validity of calling supervised injection sites palliative care for addiction, a concept put forward by the B.C. medical association in the late 1990s.

"Imagine for a moment a doctor that has a patient with a serious but treatable case of cancer. Would it be ethical for that doctor to automatically give that woman morphine and otherwise make her comfortable until she died of her disease, rather than offering the patient an attempt at treatment, and a chance at recovery?

"Why do we limit ourselves to palliative care?" he continued. "There is a better alternative for injection drug users, and that is treatment. Even if they fail treatment the first time, we can help them to get up and try again."

CMA president Brian Day has said nearly 80 per cent of association members support harm reduction through supervised injection sites.

The sites — which allow addicts to inject their own narcotics under the supervision of medical staff — have successfully curbed illegal drug use.

"The minister was off base in calling into question the ethics of physicians involved in harm reduction," Day told reporters.

"It's clear that this was being used as a political issue."

Robert Ouellet, a radiologist in Montreal, said safe injection sites are an important point of entry for addicts into the health care system. He said the goal is harm reduction — by lowering the risk of disease transmission through dirty needles — as well as by providing education about drug addiction.

"We doctors think that we need to take care of patients and this is quite different. He's doing politics, we're doing health care," he said.

Insite has operated in Vancouver since 2003, under an exemption from federal drug laws.

The federal government is appealing a B.C. Supreme Court decision that struck down sections of Canada's drug laws as unconstitutional, because they prevent Insite from operating.