Harm Reduction and Moral Desert in the Context of Drug Policy
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Harm Reduction and Moral Desert in the Context of Drug Policy Lindsey Brooke Porter1 Accepted: 12 October 2020 © The Author(s) 2020
Abstract The target of my discussion is intuitions lay people have about justice in the context of drug policy—intuitions that take on a more or less moral-desert-based shape. I argue that even if we think desert is the right measure of how we ought to treat people, we ought still be in favour of Harm Reduction measures for people who use drugs. Harm Reduction measures are controversial with members of the public, and much of the opposition seems to come from something like an appeal to a desert conception of justice—the notion that a just state of affairs is one in which everybody gets what they deserve, no more, no less. A recent study, for example, found that ‘moral outrage’ predicts a preference for prevalence reduction (criminal sanction, etc.) over Harm Reduction. The thinking seems to be that, since drug use is wrong, letting people who use drugs suffer and/or die as a consequence of their use is just. Aiding their health and safety, while perhaps compassionate, is unjust. I argue that there is a bad desert fit between using drugs and suffering avoidable harm even if using drugs is morally wrong. Many of the possible harms of drug use are socially/policy driven, and much problematic drug use is context dependent, not cleanly attributable to the decisions of the person who uses drugs. This means that even if drug use is wrong, people who use drugs deserve Harm Reduction policies, at minimum. Keywords Drug policy · Harm reduction · Moral desert · Avoidable harm
Introduction Much of the opposition to Harm Reduction approaches to drug policy seems to come from something like an appeal to a particular conception of justice: what’s usually called ‘justice as desert’. On this account of the nature of justice, as Rawls * Lindsey Brooke Porter [email protected] 1
Centre for Health, Law and Society, University of Bristol Law School, 8‑10 Berkeley Square, Bristol BS8 1HH, UK
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put it, justice is happiness according to virtue [10]. What is just is that people get what they deserve: happiness and wellbeing if they or their own actions are morally virtuous, or unhappiness if they/their actions are vicious.1 With respect to the apparent vice of drug use, justice as desert might have it that people who use drugs (PWUD) don’t deserve for public funds to be spent on—or policy to be altered towards the end of—reducing the harms they suffer as a result of drug use because they were (morally) wrong to use drugs in the first place. The thinking, then, is that since PWUD create and maintain the circumstances that put them in harm’s way via their own bad actions, we (we society, we taxpayers, we health professionals and other service providers) are under no obligation to aid them in avoiding harm. More so, justice demands that we not do so. Even many advocates of Harm Reduction approaches to drug policy (dHR) tacitly assume that in order to su
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