When Empirical Science Meets Moral Panic

1. When Empirical Science Meets Moral Panic Crack Symposium March 10, 2005 Presented by Dr Perry Kendall

2. Acknowledgements David Buchanan, Susan Shaw, Amy Ford and Merrill Singer Journal of Public Health Policy, Volume 24, No. 3-4 (2003)

3. Moral Panic A moral panic is a mass movement based on the perception that some individual or group, frequently a minority group or subculture, is dangerously deviant and poses a menace to society. Source: Stanley Cohen, 1972 to describe Mods & Rockers in UK in the 60’s

4. Moral Panic in Action “Over the years the devastating effect of illegal drugs on individuals families and our society and civil institutions has forced us to enact laws that prohibit drug use and the paraphernalia that deliver drugs. It has been proved time and time again that the first step in curtailling drug use is to send a clear and unambiguous message that it is wrong and will not be tolerated…..whenever we allow compromise – we diminish our ethical resolve and moral authority.” Orsi, M. Needle Exchange Undermines Society. Atlantic City Press, October 17, 1998.

5. Policy Making Not (or Rarely)a Rational, Considered, Logical Process • How does evidence affect policy • Rational Process? • Role of Science • Other Factors and Strategies

6. NEX Bleach and Condoms in Jails SIS Rx Heroin Crack Pipe Distribution Consumption Rooms NEX in Jails Examples In Canadian Context

7. Approaches to (In)forming Policy • Define a problem • Quantity/Quality • Assemble Evidence • Science, Law, Opinion Polls, Ethical Review, Economic Analysis • Review Responses in Other Jurisdictions • Inform/Educate Significant Opinion Leaders • Forge Consensus • Implement Incrementally and Evaluate (Q.V. Tattoing in Fed Jails) • Caveat – look for unintended consequences

8. “Messianic Idealism” – Opposition from South of the Border We Americans are the peculiar, chosen people – the Israel of our time; we bear the ark of the liberties of the world. God has predestinated, mankind expects, great things from our race; and great things we feel in our souls. The rest of the nations must soon be in our rear. Long enough have we been skeptics with regards to ourselves, and doubted whether, indeed the political Messiah had come. But he has come in us. Herman Melville, 1850 White Jackett; or, The world in a man-of-war

9. Schematic Diagram of Different Sides of NEP Debate Proponents Opponents Problem Narrowly-defined: Broadly-defined: HIV transmission Moral degeneration Goal HIV prevention Human improvement Solution NEP Affirmation of the good/proscription of the bad behaviour Moral orientation Progressive Orthodox Legitimate authority Science God Type of argument Empirical, scientific Normative, ethical Ethical priorities Rights The Good Ethical motivation Pragmatic Utopian Symbolic meaning of Social Justice Moral degeneration NEP

10. Advice to Public Health Proponents • Go beyond the rational-scientific and • Go for the moral high ground • Point by point rebuttal of the moral claims of harm reduction opponents e.g. • NEP’s promote equity by preventing the most disadvantaged in society from suffering further preventable harm • NEP’s increase social and fiscal efficiency by immediately interrupting viral transmission at low cost – rather than waiting until an HIV infected IDU decides to change his/her life

11. NEP’s promote efficient use of taxpayer $ - it is fiscally, morally and ethically superior to prevent rather than treat a disease • NEP’s protect “innocent” women & children • NEP’s promote liberty because they increase the possibility for IDU’s to one day quit drugs, rejoin society and lead productive lives as they will not be dead/dying of HIV/AIDS, HCV, etc.

12. Suggestions • Never abandon scientific foundations • Recognise that science is not the highest value to which all other values must be subordinated • Change the interpretive framework • Good decent people do not ignore the pain suffered by our neighbours and fellow citizens

13. Thank you