Heroin injecting room in Catholic health centre?

Heroin injecting room in Catholic health centre?

Dr Joseph Santamaria

Editor: Sydney's 'Catholic Weekly' reported (8 August 1999) that the move by the Sisters of Charity Health Service to set up a drug injecting facility at King's Cross has drawn support from prominent Catholic spokesmen. Sydney Archdiocesan Secretary, Fr Paul Lucas, was quoted as saying, "This decision is not inconsistent with Catholic moral teaching." Fr Gerry Gleeson of the Plunkett Centre for Ethics in Health Care said, "This is a program aimed at keeping people alive and getting them off drugs. Most people should see that it is worth trying something new." Sr Margaret Cassidy CSB, President of the Australian Conference of Leaders of Religious Institutes, said that the Sisters of Charity were taking positive action to redress the suffering of broken lives, while Dr Simon Longstaff, executive director of the St James Ethics Centre, said the move was in complete accordance with the Catholic Church's theological teachings.

In the following article, Dr Joseph Santamaria, who is the former Director of the Alcohol and Drug Services at St Vincent's Hospital, Melbourne, and Foundation Director of the St Vincent's Bioethics Centre, questions these views and the move by the Sisters of Charity.

In July, 1999, the medical director of St. Vincent's Hospital in Sydney announced that the Sisters of Charity had agreed to establish an injection room for heroin addicts as it was consistent with their philosophy of care and with Catholic teaching. Despite criticisms, many leading Catholic spokesmen have sprung to the defence of this decision, claiming that it is not inconsistent with Catholic moral teaching and that, in the existing circumstances, it is a prudential Catholic response.

In the statement given to the media, the medical director claimed that there had been wide consultation on the issue and that the decision was carefully considered before it was announced. However, on the weight of evidence, it is difficult to believe that the consultation was wide enough.

The responsible authority in the Catholic Church for the ethical underpinning of the Catholic Health Services is the Pontifical Council for Pastoral Assistance to Health Care Workers. In 1995, that Council issued its Charter for Health Care Workers. The question of addictive narcotics is covered in sections 93-96. Section 94 states: "From the moral viewpoint, using drugs is always illicit, because it implies an unjustified and irrational refusal to think, will, and act as free persons."

The section then talks about not condemning the addicted drug user and sets out principles for rehabilitation. It concludes by saying that "using drugs is anti-life." There is no freedom or right to use such drugs "and even less do they have the right to make others pay for their choice."

On the basis of this official teaching, it is apparent that the taking of mind-altering drugs for non- therapeutic reasons is intrinsically evil. This is separate from the question of culpability of the addicted person. The Catholic hospital is prepared to establish a room with all the injecting paraphernalia, exclusively for use by injecting drug users, with the intention of preventing their possible death and hopefully to move them towards further rehabilitation.

The act of the Catholic hospital, however, is to co-operate, in an immediate material way, in an intrinsically evil act, similar in kind to providing abortion facilities for an abortionist in the hope that they may deter a woman from having the abortion or of having further abortions in the future. I do not see that the hospital's decision conforms with Catholic moral teaching on immediate material co-operation in an intrinsically evil act.

It may be argued that the decision is the lesser of two evils. But is it? The principle of the lesser of two evils implies that there is no other alternative and the outcome is proportionate to the evil consequences. The scientific evidence reveals that injecting drugs is a very dangerous practice, quite apart from the danger of acute death. The incidence of Hepatitis C in injecting drug users is now so high that many of such people will die in the next 15- 20 years, even if they become abstinent in the meantime.


Moreover, there is prima facie evidence to suggest that the rising death rate in injecting drug users is closely related to the wider availability of free needles and syringes, even given the many other factors that contribute to drug taking. And are there really no other alternatives for the Catholic Church in the field of drug abuse, in the field of intervention? I suggest that the Church authorities should read the book Community Encounter as a more appropriate response. (A review of this book will appear in the next AD2000 - Editor).

Then there is the matter of the role of the police. Heroin use is illegal. The police have the obligation and the responsibility to enforce the law. The establishment of an injecting room at St Vincent's Hospital, located where it is, requires the police not to intervene if a suspect is heading for the Room or even in the purchase of the heroin which the addict must have in his possession to enter the facility.

This is a corruption of the duty of the police force and the hospital has not only co-operated but has negotiated for this to happen, for it would be impossible to launch the project without an agreement to that effect. Does this run counter to the principle of the common good? Does this type of activity compromise the national drug strategy? Does it diminish the level of motivation to enter other programs, more in keeping with the role of the Catholic Church?

I believe that a wider consultation with the Bishops Conference is necessary for I would be surprised if they all accept the present decision. Moreover I am not sure that they know all the scientific evidence that must be considered in reaching a prudential judgment on a very complex issue.

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