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When is coercive methadone therapy justified?

Heroin use poses a significant health and economic burden to society, and individuals with heroin dependence are responsible for a significant amount of crime. Owing to its efficacy and cost‐effectiveness, methadone maintenance therapy (MMT) is offered as an optional alternative to imprisonment for...

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Detalles Bibliográficos
Autores principales: D'Hotman, Daniel, Pugh, Jonathan, Douglas, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174954/
https://www.ncbi.nlm.nih.gov/pubmed/29883516
http://dx.doi.org/10.1111/bioe.12451
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author D'Hotman, Daniel
Pugh, Jonathan
Douglas, Thomas
author_facet D'Hotman, Daniel
Pugh, Jonathan
Douglas, Thomas
author_sort D'Hotman, Daniel
collection PubMed
description Heroin use poses a significant health and economic burden to society, and individuals with heroin dependence are responsible for a significant amount of crime. Owing to its efficacy and cost‐effectiveness, methadone maintenance therapy (MMT) is offered as an optional alternative to imprisonment for drug offenders in several jurisdictions. Some object to such ‘MMT offers’ on the basis that they involve coercion and thus invalidate the offender's consent to MMT. While we find these arguments unpersuasive, we do not attempt to build a case against them here. Instead, we explore whether administration of MMT following acceptance of an MMT offer might be permissible even on the assumption that MMT offers are coercive, and in such a way that the resulting MMT is non‐consensual. We argue that non‐consensual MMT following an MMT offer is typically permissible. We first offer empirical evidence to demonstrate the substantial benefits to the offender and society of implementing non‐consensual MMT in the criminal justice system. We then explore and respond to potential objections to such uses of MMT. These appeal respectively to harm, autonomy, bodily and mental interference, and penal theoretic considerations. Finally, we introduce and dismiss a potential response to our argument that takes a revisionist position, rejecting prevailing incarceration practices.
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spelling pubmed-61749542018-10-15 When is coercive methadone therapy justified? D'Hotman, Daniel Pugh, Jonathan Douglas, Thomas Bioethics Original Articles Heroin use poses a significant health and economic burden to society, and individuals with heroin dependence are responsible for a significant amount of crime. Owing to its efficacy and cost‐effectiveness, methadone maintenance therapy (MMT) is offered as an optional alternative to imprisonment for drug offenders in several jurisdictions. Some object to such ‘MMT offers’ on the basis that they involve coercion and thus invalidate the offender's consent to MMT. While we find these arguments unpersuasive, we do not attempt to build a case against them here. Instead, we explore whether administration of MMT following acceptance of an MMT offer might be permissible even on the assumption that MMT offers are coercive, and in such a way that the resulting MMT is non‐consensual. We argue that non‐consensual MMT following an MMT offer is typically permissible. We first offer empirical evidence to demonstrate the substantial benefits to the offender and society of implementing non‐consensual MMT in the criminal justice system. We then explore and respond to potential objections to such uses of MMT. These appeal respectively to harm, autonomy, bodily and mental interference, and penal theoretic considerations. Finally, we introduce and dismiss a potential response to our argument that takes a revisionist position, rejecting prevailing incarceration practices. John Wiley and Sons Inc. 2018-06-08 2018-09 /pmc/articles/PMC6174954/ /pubmed/29883516 http://dx.doi.org/10.1111/bioe.12451 Text en © 2018 The Authors Bioethics Published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
D'Hotman, Daniel
Pugh, Jonathan
Douglas, Thomas
When is coercive methadone therapy justified?
title When is coercive methadone therapy justified?
title_full When is coercive methadone therapy justified?
title_fullStr When is coercive methadone therapy justified?
title_full_unstemmed When is coercive methadone therapy justified?
title_short When is coercive methadone therapy justified?
title_sort when is coercive methadone therapy justified?
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174954/
https://www.ncbi.nlm.nih.gov/pubmed/29883516
http://dx.doi.org/10.1111/bioe.12451
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