Fighting addiction's death row: British Columbia Supreme Court Justice Ian Pitfield shows a measure of legal courage
Tóm tắt
The art in law, like medicine, is in its humanity. Nowhere is the humanity in law more poignant than in BC Supreme Court Justice Ian Pitfield's recent judgment in the legal case aimed at protecting North America's only supervised injection facility (SIF) as a healthcare program: PHS Community Services Society versus the Attorney General of Canada. In order to protect the SIF from politicization, the PHS Community Services Society, the community organization that established and operates the program, along with two people living with addiction and three lawyers working for free, pro bono publico, took the federal government of Canada to court. The courtroom struggle that ensued was akin to a battle between David and Goliath. The judge in the case, Justice Pitfield, ruled in favour of the PHS and gave the Government of Canada one year to bring the Controlled Drugs and Substances Act (CDSA) into compliance with the country's Charter of Rights and Freedoms. If parliament fails to do so, then the CDSA will evaporate from enforceability and law in June of 2009. Despite the fact that there are roughly twelve million intravenous drug addiction users in the world today, politics andprejudice oards harm reduction are still a barrier to the widespread application of the "best medicine" available for serious addicts. Nowhere is this clearer than in the opposition by conservative Prime Minister Stephen Harper and his faithful servant, federal health minister Tony Clement, towards Vancouver's SIF ("Insite"). The continued angry politicization of addiction will only lead to the tragic loss of life, as addicts are condemned to death from infectious diseases (HIV & hepatitis) and preventable overdoses. In light of the established facts in science, medicine and now law, political opposition to life-saving population health programs (including SIFs) to address the effects of addiction is a kind of implicit capital punishment for the addicted. This commentary examines the socio-political context of the legal case and the major figures that contributed to it. It reviews Justice Pitfield's ruling, a judgment that has brought Canada one step closer to putting a stop to addiction's death row where intravenous drug users are needlessly, for political and ideological reasons alone, forced to face increased risks of death due to AIDS, hepatitis and overdose.
Tài liệu tham khảo
Closing Argument in The State of Illinois v. Nathan Leopold & Richard Loeb Delivered by Clarence Darrow 22 April. [http://www.law.umkc.edu/faculty/projects/ftrials/leoploeb/darrowclosing.html]
Jensen RJ: Clarence Darrow: The Creation of an American Myth. 1992, New York: Greenwood Press
Pitfield THMJ: PHS Community Services Society v. Attorney General of Canada, 2008 BCSC 661. 2008, The Supreme Court of British Columbia
Small D: Amazing grace: Vancouver's supervised injection facility granted six-month lease on life. Harm Reduction Journal. 2008, 5: 1-6. 10.1186/1477-7517-5-1.
Milloy M-JS, Kerr T, Tyndall M, Montaner J, Wood E: Estimated Drug Overdose Deaths Averted by North America's First Medically-Supervised Safer Injection Facility. PLoS ONE. 2008, 3: e3351-e3351. 10.1371/journal.pone.0003351.
The Constitution Act, 1982. Canada. 1982
Wong S: On the front cover: John J.L. Hunter, Q.C. (Law Society of British Columbia president (Testimonial). The Advocate. 2008, Law Society of British Columbia, 66: 13-18.
John J.L. Hunter, Q.C.: Representative Cases. [http://www.litigationchambers.com/lawyers/john_hunter.htm]
Gusfield JR: The Culture of Public Problems: Drinking-Driving and the Symbolic Order. 1981, Chicago: University of Chicago Press
Csete J, Wolfe D: Closed to Reason: The International Narcotics Control Board and HIV/AIDS. 2007, Canadian HIV/AIDS Legal Network International Harm Reduction Development Program (IHRD) Open Society Institute (OSI), 1-32.
Agreement V: Vancouver Agreement: 2000–2005 progress and highlights. 2008, Vancouver: Vancouver Agreement
Cain JV: Report of the Task Force into Illicit Narcotic Overdose Deaths in British Columbia. 1994, Office of the Chief Coroner: Ministry of the Attorney General
Whynot E: Health Impact of Injection Drug Use and HIV in Vancouver. 1996
Millar JS: HIV, Hepatitis, and Injection Drug Use in British Columbia: Pay Now or Pay Later?. 1998, Victoria: Office of the Provincial Health Officer
Benoit C, Carroll D, Lawr L, Chaudhry M: Marginalized Voices in the Downtwon Eastside: Aboriginal Women Speak About Their Experiences. 2001, York University
MacPherson D: A Framework for Action: A Four-Pillar Approach to Drug Problems in Vancouver. 2001, Vancouver: City of Vancouver, 1-90.
Vancouver Police Department Policy 11.04 Guidelines for Police Attending Illicity Drug Overdoses.
Victorial Police Drug and Alcohol Strategy Unit: What is Harm Minimisation. [http://www.police.vic.gov.au/content.asp?Document_ID=5059]
Fowler G, Allsop S, Melville D, Wilkinson C: Drug harm minimization education for police in Australia. A collaborative report by the National Centre for Education and Training on Addiction. 1999, Queensland: Queensland Police Service Edith Cowan University
Small D: Two cultures passing in the night. International Journal of Drug Policy. 2005, 16: 221-222. 10.1016/j.drugpo.2004.11.002.
Safety NMDoP: State Police Officers Trained in use of Narcan. 2004, Safety NMDoP ed. Santa Fe: New Mexico Department of Public Safety
Education Programs. [http://www.youthco.org/cms/page1113.cfm]
Howell M: RCMP question safe injection site research. Vancouver Courier. 2006, Vancouver: CanWest MediaWorks Publications Inc
Mason G: Insite revelation proves RCMP needs watching. Globe and Mail. 2008, Toronto: CTV globe media
Picard A: Hatred for safe-injection sites is irrational: The facilities will not cure drug abuse but they're integral to strategies for prevention and rehabilitation. Globe and Mail. 2008, Toronto: CTV globe media
RCMP secretly funded anti-Insite research. [http://www.pivotlegal.org/pdfs/RCMPsecretlyfundedreserch-documents.pdf]
RCMP Letter to the BC Centre of Excellence in HIV/AIDS. [http://bc.rcmp.ca/ViewPage.action?siteNodeId=39&contentId=6672&languageId=1]
DeBeck K, Wood E, Zhang R, Tyndall M, Montaner J, Kerr T: Police and public health partnerships: Evidence from the evaluation of Vancouver's supervised injection facility. Substance Abuse Treatent, Prevention and Policy. 2008, 3: 1-5. 10.1186/1747-597X-3-1.
Fairburn N, Small W, Shannon K, Wood E, Kerr T: Women's Experiences in North America's First Medically Supervised Safer Injection Facility. Social Science and Medicine Forthcoming.
Kerr T, Kimber J, DeBeck K, Wood E: The Role of Safer Injection Facilities in the Response to HIV/AIDS Among Injection Drug Users. Current HIV/AIDS Reports. 2007, 4: 158-164. 10.1007/s11904-007-0023-8.
Kerr T, Small W, Moore D, Wood E: A Micro-Environmental Intervention to Reduce Harms Associated with Drug-Related Overdose: Evidence from the Evaluation of Vancouver's Safer Injection Facility. International Journal of Drug Policy. 2007, 18: 37-45. 10.1016/j.drugpo.2006.12.008.
Kerr T, Stoltz J, Tyndall M, Li K, Zhang R, Montaner J, Wood E: Impact of a Medically Supervised Safer Injection Facility on Community Drug Use Patterns: A Before and After Study. British Medical Journal. 2006, 332: 220-222. 10.1136/bmj.332.7535.220.
Kerr T, Tyndall MW, Lai C, Montaner JSG, Wood E: Drug-Related Overdoses Within A Medically Supervised Safer Injection Facility. International Journal of Drug Policy. 2006, 17: 436-441. 10.1016/j.drugpo.2006.05.008.
Kerr T, Tyndall MW, Lai C, Montaner JSG, Wood E: Circumstances of First Injection Among Illicit Drug Users Accessing a Medically Supervised Safer Injecting Facility. American Journal of Public Health. 2007, 97: 1228-1220. 10.2105/AJPH.2006.086256.
Kerr T, Tyndall MW, Li K, Montaner JS, Wood E: Safer Injecting Facility Use and Syringe Sharing Among Injection Drug Users. Lancet. 2005, 366: 316-318. 10.1016/S0140-6736(05)66475-6.
Kerr T, Wood E, Small D, Palepu A, Tyndall MW: Potential Use of Safer Injecting Facilities Among Injection Drug Users in Vancouver's Downtown Eastside. CMAJ. 2003, 169 (8): 759-763.
McKnight I, Maas B, Wood E, Tyndall MW, Small W, Lai C, Montaner JSG, Kerr T: Factors Associated with Public Injecting Among Users of Vancouver's Supervised Injection Facility. American Journal of Drug and Alcohol Abuse. 2007, 33: 319-325. 10.1080/00952990601175102.
Milloy MJ, Wood E, Small W, Tyndall M, Lai C, Montaner J, Kerr T: Incarceration experiences in a cohort of active injection drug users. Drug and Alcohol Review. 2008, 1-7. 10.1080/09595230801956157.
Petrar S, Kerr T, Tyndall MW, Zhang R, McKnight B, Montaner JSG, Wood E: Injection Drug Users' Perceptions Regarding Use of a Medically Supervised Safer Injecting Facility. Addictive Behaviors. 2007, 32: 1088-1093. 10.1016/j.addbeh.2006.07.013.
Stoltz JA, Wood E, Small W: Changes in Injecting Practices Associated with the Use of a Medically Supervised Injection Facility. J Public Health (Oxf). 2007, 29 (1): 35-39. 10.1093/pubmed/fdl090.
Tyndall MW, Kerr T, Zhang R, King E, Montaner JG, Wood E: Attendance, Drug Use Patterns, and Referrals Made From North America's First Supervised Injection Facility. Drug Alcohol Depend. 2006, 83 (3): 193-198. 10.1016/j.drugalcdep.2005.11.011.
Tyndall MW, Wood E, Zhang R, Lai C, Montaner JS, Kerr T: HIV Sero-prevalence Among Participants at a Supervised Injection Facility in Vancouver, Canada: Implications for Prevention, Care and Treatment. Harm Reduction Journal. 2006, 3:
Wood E, Kerr T, Buchner C, Marsh D, Montaner JS, Tyndall MW: Methodology for Evaluating Insite: Canada's First Medically Supervised Safer Injection Facility for Injection Drug Users. Harm Reduction Journal. 2004, 1: 1-5. 10.1186/1477-7517-1-9.
Wood E, Kerr T, Montaner JS, Strathdee S, Kerr T, Wodak A, Spittal P, Hankins C, Schechter MT, Tyndall M: Rationale For Evaluating North America's First Medically Supervised Injecting Facility. Lancet Infectious Diseases. 2004, 4: 301-306. 10.1016/S1473-3099(04)01006-0.
Wood E, Kerr T, Small W, Li K, Marsh D, Montaner JS, Tyndall MW: Changes In Public Order After The Opening of a Medically Supervised Safer Injection Facility for Injection Drug Users. Canadian Medical Association Journal. 2004, 171: 731-734. 10.1503/cmaj.1040774.
Wood E, Kerr T, Stoltz J, Qui Z, Zhang R, Montaner JSG, Tyndall MW: Prevalence and correlates of hepatitis C among users of North America's first medically supervised safer injection facility. Public Health. 2005, 119: 1111-1115. 10.1016/j.puhe.2005.05.006.
Wood E, Kerr T, Tyndall MW, Montaner JSG: The Canadian government's treatment of scientific process and evidence: Inside the evaluation of North America's first supervised injecting facility. Int J Drug Policy. 2008, 19 (3): 220-225. 10.1016/j.drugpo.2007.11.001.
Wood E, Montaner JS, Kerr T: Reflection and Reaction: Illicit drug addiction, infection disease spread, and the need for an evidence-based response. Lancet. 2008, 8: 142-143.
Wood E, Tyndall MW, Lai C, Montaner JSG, Kerr T: Impact of a Medically Supervised Safer Injecting Facility on Drug Dealing and Other Drug-Related Crime. Substance Abuse Treatment, Prevention and Policy. 2006, 1: 1-4. 10.1186/1747-597X-1-13.
Wood E, Tyndall MW, Li K, Lloyd-Smith E, Small W, Montaner JSG, Kerr T: Do Supervised Injecting Facilities Attract Higher-Risk Injection Drug Users?. American Journal of Preventive Medicine. 2005, 29: 126-130. 10.1016/j.amepre.2005.04.011.
Wood E, Tyndall MW, Montaner JS, Kerr T: Summary of findings from the evaluation of a pilot medically supervised injecting facility. Canadian Medical Association Journal. 2006, 175: 1399-1404. 10.1503/cmaj.060863.
Wood E, Tyndall MW, Qui Z, Zhang R, Montaner JS, Kerr T: Service Uptake and Characteristics of Injection Drug Users Utilizing North America's First Medically Supervised Safer Injection Facility. American Journal of Public Health. 2006, 96: 770-773. 10.2105/AJPH.2004.057828.
Wood E, Tyndall MW, Stoltz J, Small W, Lloyd-Smith E, Zhang R, Montaner JSG, Kerr T: Factors Associated with Syringe Sharing Among Users of a Medically Supervised Injecting Facility. American Journal of Infectious Diseases. 2005, 1: 50-54.
Wood E, Tyndall MW, Stoltz J, Small W, Zhang R, O'Connell J, Montaner JSG, Kerr T: Safer Injecting Education for HIV Prevention Within a Medically Supervised Safer Injecting Facility. International Journal of Drug Policy. 2005, 16: 281-284. 10.1016/j.drugpo.2005.07.004.
Wood E, Tyndall MW, Zhang R, Stoltz J, Lai C, Montaner JSG, Kerr T: Attendance at Supervised Injecting Facilities and Use of Detoxification Services. New England Journal of Medicine. 2006, 354: 2512-2514. 10.1056/NEJMc052939.
Wood E, Tyndall MW, Zhang R, Montaner JS, Kerr T: Rate of detoxification service use and its impact among a cohort of supervised injection facility users. Addiction. 2007, 102: 916-919. 10.1111/j.1360-0443.2007.01818.x.
Wood RA, Wood E, Lai C, Tyndall MW, Montaner JSG, Kerr T: Nurse-delivered safer injection education among a cohort of injection drug users: Evidence from the evaluation of Vancouver's supervised injection facility. Int J Drug Policy. 2008, 19 (3): 183-188. 10.1016/j.drugpo.2008.01.003.
Hwang SW: Science and ideology. Open Medicine. 2007, 1: E99-101.
Day B: Ottawa's bad prescription on addiction. The Toronto Star. 2008, Toronto: Toronto Star Press Centre
Small D, Drucker E: Policy makers ignoring science and scientists ignoring policy: the medical ethical challenges of heroin treatment. Harm Reduction Journal. 2006, 3: 1-14. 10.1186/1477-7517-3-1.
Small D: Fools rush in where angels fear to tread: Playing God with Vancouver's Supervised Injection Facility in the political borderland. International Journal of Drug Policy. 2007, 18: 18-26. 10.1016/j.drugpo.2006.12.013.
Vancouver Co: 2007 Survey of Low-Income Housing in the Downtown Core. 2007, Group HCCS ed.: City of Vancouver
Dispute Resolution Award in LawStudies. [http://cfcj-fcjc.org/clearinghouse/drpapers-en.php]
Lupick T: Olympics on way means workers need to know their rights. Georgia Straight. 2007, Vancouver: Georgia Straight
Mason B: Law Worth Losing Sleep Over: The finer points of law are no longer moot to Monique Pongracic-Speier. UBC Reports, May 10 edition. 2001, Vancouver: University of British Columbia, 47:
Mexico: Patterns in Human Rights Abuses. [http://www.lrwc.org/pub1.php]
Anonymous: Drew Schroeder Rhodes Scholar. The Martlet. 1969, Victoria: University of Victoria, 9: 5-
McManus T: 20,000 people could be impacted by decision: Schroeder estimates about 20,000 people could be affected by the court's decision and the funds to be paid out for interest could range from $15 to $20 million. Burnaby Now. 2007, Burnaby: Vannet Newspapers
Doukhobor children suing B.C. for settlement. [http://www.cbc.ca/canada/story/2002/02/25/doukhobor_bc020225.html]
Post N: Best lawyers: labour and employment. Financial Post. 2006, Canwest Publishing, 2008:
Joseph Arvay, Q.C., Receives CBA'S SOGIC Ally Award. [http://www.cba.org/CBA/news/2000_releases/00-08-21_ally_award.aspx]
Joseph Arvay, Q.C. Wins Tarnopolsky Human Rights Award. [http://www.cba.org/CBA/news/2000_releases/00-08-21_tarnopolsky_award.aspx]
News Archive. [http://www.arvayfinlay.com/news.htm]
Galloway G: Clement seeks appeal of Insite decision. Globe and Mail. 2008, Toronto: CTV globe media
Canada Go: Standing Committee on Health: Transcript of Meeting Thursday, May 29, 2008. 2008, Health SCo ed. Ottawa: Government of Canada
Clement T: Do no harm, right?. Globe and Mail. 2008, Globe and Mail: CTV Globe Media Publishing
Shore R: MPs launch formal complaint over Conservative flyers: Rules forbid using free postage to send out campaign material. Vancouver Sun. 2008, Vancouver: Canwest Global, A-19-