The Ethical Controversy of a Nurse`s Role in Harm Reduction

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Harm reduction can be defined as an approach that aims to reduce the consequences of high risk behaviours such as injection drug use on the individual and on society as a whole. Harm reduction programs provide injection drug users with access to a clean injection environment, sterile injections, drug-preparation equipment and safe disposal of contaminated material at the time of injection. Staff members in harm reduction facilities provide health teaching, anonymous HIV testing, information on addiction treatment, condoms and assist in connecting clients to social and health services (Semaan et al., 2011; Ball, 2007). Although, the benefits of harm reduction are evident through reduction of accidental drug overdose and prevention of disease spread, some argue that a more conservative approach such as abstinence based approaches should be enforced. In this paper, I will discuss the controversy surrounding harm reduction clinics and its adherence to the Canadian Nurses Code of Ethics. In my opinion harm reduction programs provide an effective and ethical solution to the immense harm that result from the engagement in high risk behaviours.

Accidental drug overdose is one of the many extremely detrimental risks associated with injection drug use. According to a study by Marshall (2003) that analyzed death rates of injection drug users before and after the opening of a safe injection facility in Vancouver demonstrated the facility`s effectiveness through a comparison of the rates of fatal overdose before and after in the area of the clinic to rates before and after in another part of the city that the facility was not accessible. This study revealed that the fatal overdose rate in the area of the facility decreased by 35% after the...

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...n overdose mortality after the opening of North America'ss first medically supervised safer injecting facility: a retrospective population-based study. Lancet, 377(9775), 1429-1437.

Pauly, B. B. (2008). Shifting moral values to enhance access to health care: Harm reduction as a context for nursing ethical practice. International Journal of Drug Policy, 19(3), 195-204.

Quan, V. M., Go, V. F., Nam, L. V., Bergenstrom, A., Thuoc, N. P., Zenilman, J., ...Celentano, D.D. (2009). Risks for HIV, HBV, and HCV infections among male injection drug users in northern Vietnam: a case-control study. AIDS Care, 21(1), 7-16.

Semaan, S., Fleming, P., Worrell, C., Stolp, H., Baack, B., & Miller, M. (2011). Potential role of safer injection facilities in reducing HIV and Hepatitis C infections and overdose mortality in the United States. Drug and Alcohol Dependence, 118, 100-110.

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