Disagreement, Unenforceability, and Harm Reduction
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Disagreement, Unenforceability, and Harm Reduction Daniel M. Weinstock1 Accepted: 10 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Talk of harm reduction has expanded horizontally, to apply to an ever-widening range of policy domains, and vertically, becoming part of official legal and political discourse. This expansion calls for philosophical theorization. What is the best way in which to characterize harm reduction? Does it represent a distinctive ethical position? How is it best morally justified, and what are its moral limits? I distinguish two varieties of harm reduction. One of them, technocratic harm reduction, is premised on the fact of non-enforceability of prohibitionist policies. The second, deliberative harm reduction, is premised on the fact of reasonable disagreement, grounded in the fact that reasonable persons disagree about a range of controversial behaviours. I argue that deliberative harm reduction better accounts for some of harm reduction’s most attractive features, and provides a plausible way of accounting for harm reductions’s justificatory grounds and limits. Keywords Harm reduction · Consequentialism · Disagreement · Enforcement · Policy
Introduction Harm Reduction is having a moment. Initially thought of as a practice aimed at meeting the needs of drug users without resorting to the punitive, prohibitive approach taken by states [1, 18, 19], it is now being invoked in a wide range of different contexts. More specifically, it is undergoing both vertical and horizontal expansion. The vertical expansion consists in the fact that harm reduction has now migrated up the policy ladder and has entered into the lexicon of officialdom. It is no longer solely the preserve of street-level practitioners directly with street involved This paper was originally presented at a workshop on harm reduction that I co-organized with Shannon Dea. Thanks are due to the participants at the workshop. Thanks are also due to two anonymous referees for this Journal, whose comments improved the paper immeasurably. * Daniel M. Weinstock [email protected] 1
Institute for Health and Social Policy, Faculty of Law, McGill University, Montreal, Canada
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drug users. In Canada, for example, it became a term commonly used by Jane Philpott, Justin Trudeau’s first Health Minister,1 and it is arguably operative in a trio of decisions of the Supreme Court of Canada, to do with safe injection sites, sex work, and medical assistance in dying.2 The horizontal expansion has had to do with the range of practices to which talk of harm reduction has been seen by some to be appropriate. No longer confined solely to drug use, harm reduction has been seen by some as an appropriate approach to adopt across a wide range of practices, including sex work [3], female genital cutting [20], domestic violence [7], medical assistance in dying [9, 15], abortion [4], and even risky behaviour in the context of the COVID-19 pandemic [13]. This e
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