https://padlet.com/pontusbjorkell/lw5l02rl0jyo en-us 2019-11-01 11:33:35 UTC 2025-11-24 09:38:02 UTC hello@padlet.com pontusbjorkell https://padlet.com/pontusbjorkell/lw5l02rl0jyo/wish/405389642 “When I put these questions to Cynthia, a recovering heroin addict at a local clinic, her reaction was disbelief and amazement. "That's crazy," she said, "if you are addicted to heroin, then by definition you can't say "No" to the stuff.”

So, either the examinee says "yes" to free heroin or does not qualify as an addict.

The Dilemma:
Premise 1: 
If one cannot say no to free heroin, then one cannot give voluntary consent.
Premise 2:
If one is mentally unstable (as heroin addicts are), then one cannot give voluntary consent.
Premise 3: Either one cannot say no to free heroin or one is mentally unstable (or both).
Conclusion: One cannot give voluntary consent. ]]> 2019-11-01 12:56:30 UTC https://padlet.com/pontusbjorkell/lw5l02rl0jyo/wish/405389642 pontusbjorkell https://padlet.com/pontusbjorkell/lw5l02rl0jyo/wish/405400182 Objective: To evaluate an experimental heroin maintenance programme.
Design: Randomised trial.
Setting: Outpatient clinic in Geneva, Switzerland.
Subjects: Heroin addicts recruited from the community who were socially marginalised and in poor health and had failed in at least two previous drug treatments.
Intervention: Patients in the experimental program received intravenous heroin and other health and psychosocial services. Control patients received any other conventional drug treatment.
Main outcome measures: Self reported drug use, health status, and social functioning.
Results: 25 experimental patients completed 6 months in the program, receiving a median of 480 mg of heroin daily.]]> 2019-11-01 13:19:44 UTC https://padlet.com/pontusbjorkell/lw5l02rl0jyo/wish/405400182 pontusbjorkell https://padlet.com/pontusbjorkell/lw5l02rl0jyo/wish/405415563 One experimental subject and 10 control subjects still used street heroin daily at follow up. Health status scores that improved significantly more in experimental subjects were mental health, role limitations due to emotional problems, and social functioning. Experimental subjects also significantly reduced their illegal income and drug expenses and committed fewer drug and property related offences. There were no benefits in terms of work, housing situation, somatic health status, and use of other drugs. Unexpectedly, only nine control subjects entered the heroin maintenance program at follow up.
Conclusions: A heroin maintenance programme is a feasible and clinically effective treatment for heroin users who fail in conventional drug treatment programmes. Even in this population, however, another attempt at methadone maintenance may be successful and help the patient to stop using injectable opioids.

https://www.northcarolinahealthnews.org/2019/01/28/switzerland-fights-heroin-with-heroin/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC28595/]]> 2019-11-01 13:46:10 UTC https://padlet.com/pontusbjorkell/lw5l02rl0jyo/wish/405415563 pontusbjorkell https://padlet.com/pontusbjorkell/lw5l02rl0jyo/wish/405427034 The philosopher Louis Charland's controversial view: "We should not presume that heroin-prescription subjects who are active in their addiction are capable of competent voluntary consent to heroin-prescription research. Quite the contrary, we should assume they are incompetent to consent unless proven otherwise."

Questions concerning the ethical implications of the dilemma:
1. Is it right to give heroin to heroin addicts?
2. What do you think is the motivation behind the study?
3. What are the ethical questions behind Cynthia's dilemma?

Key words:
addiction, heroin, voluntary consent, ethical dilemma, randomized trial, Louis Charland.]]> 2019-11-01 14:05:28 UTC https://padlet.com/pontusbjorkell/lw5l02rl0jyo/wish/405427034