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

Moreover, NEPs will provide sterile needle and syringes to avoid exchanges of used injections between drug users. Since NEPs are implemented, the number of HIV cases and other diseases are declined. In Saskatchewan, distributing needles reduces the total costs for health care because needle exchange programs reduce the transmission of HIV by one-third and accommodate a return of four thousand dollars investment in health care costs. (Thompson) Needle exchange program provide safety not only in drug addicts but also provide safety in the community. Many of needle exchange programs perform a one-for-one basis to decrease the exposure of contaminated needles in streets and playgrounds so that children and other people are away from needle sticks accident. (Franciscus)

Nurses rely on personal knowledge and their professional skills to provide ethical care (Creasia & Friberg, 2011). In everyday practice, nurses must balance the needs of their patients against those of the organization, society and themselves. They strive to deliver the highest level of care for patients, but adjusting for limited organizational and personal resources often requires difficult decisions. This paper explores the following scenario suggested by Maville and Huerta: “You are a nurse providing home care to a mother, and you suspect child abuse after observing the mother’s reaction to her child” (as cited by Arizona State University, 2014). When faced with a moral dilemma, a competent nurse incorporates ethical, bioethical and legal considerations. In the proposed story, incorporating the nursing ethics of advocacy, beneficence, nonmaleficence and collaboration will guide the nurse towards an appropriate and legal course of action.

Several studies have shown that injection drug users lower their risk of transmitting infectious diseases when there is a needle exchange program available. There has not been a valid study of whether or not the amounts of time needles are returned to the exchange programs are harmful to communities. The Journal of Public Health, conducted surveys, evidence from needle exchange sites, jails, and institutions that needle exchange programs are effective in reducing illnesses such as HIV and AIDS (Burt & Theide, 2016). Furthermore, Reepalu, Blome, Bjork, Widell, & Bjorkman (2012), researched the same individuals for 20 years, with no breaks. Their studies concluded that injection drug use, not only heightens the risk for HIV and AID’s, there is also an increase in Hepatitis B and Hepatitis C. However, there studies showed that there is not an increase rate of cancer diagnoses due to injection drug use. In a study conducted by Bonar and Rosenberg (2014), they wanted to see if self-initiated harm strategies, such as: proper needle sterilization techniques, proper disposal of needles, and cleaning of the pre injected skin, could help improve the health of those that use drugs intravenously. Their study was conducted over an eight-month period, results showed that their

Vancouver Injection Drug User Study (VIDUS) is a project that gives a prospective study and has over 1500 IDU 's enlisted to assist since 1996 and gathers data on drug use, health, sexual activity, etc. Some of the topics discussed included: prison culture, availability and price of drugs and equipment, drug use, VIDUS shows that the risk of HIV infection indicated that incarcerated injection drug users were associated with a greater risk of 2.7 times (Small, Kain, Laliberte, Schechter, O 'Shaughnessy & Spittal, 2005).

Harm reductions recognizes an individual’s willingness to make a change in their life, there is a wide range that these individuals may be along, from not thinking about change, to contemplating change, to taking action, to maintaining change and the other way around. The method of harm reduction first begins with focusing on what stage the individual is on with their drug use. As earlier stated the active participation of individuals who use drugs is at the heart of harm reduction. These individuals are the best source of information in terms of their own drug use and are determined with the help of other service agencies to determine the best form of intervention. There have been many success stories from having injection sites as a form

As the number of intravenous drug users continues to rise, so does the risk of dangerous and potentially fatal complications that are associated with illicit drug use. In this population, death rates are higher due to overdose, AIDs-related mortality, and other blood-borne viruses (Mathers et al., 2013). Mortality rates remain high even though precautions have been taken to reduce them. According to Lavender & McCarron (2013), “Mortality in injecting drug users is up to 22 times higher than for the age-adjusted population, despite increased provision of needle and syringe programs, reduced needle and syringe sharing, and higher uptake of hepatitis B vaccination” (p. 511).

“Harm reduction is based on the premise that people are responsible for their behaviour, that they maker personal choices that affect their health and well-being, and that they can make safer and better decisions if given useful and honest information” (Mathre, 2002, p. 106). Harm reduction recognizes people’s unhealthy choices while also attempting to reduce the harmful effects that come from these unhealthy behaviours (Marlatt, 1998 as cited in Brown, Luna, Ramirez, Vail, and Williams, 2005). Using a harm reduction approach has a positive effect on drug users, as it helps to reduce the negative consequences that come from using drugs. Although harm reduction aims to reduce the harm from illegal drug using, it is viewed as

Imagine for a moment being able to walk down the street without seeing used needles or other drug equipment. Although it will not completely eradicate the problem, safe injection sites will allow users to have a safe and clean environment that they do not have access to now; not just to inject their drugs, but also to dispose of their used syringes. When given a 3-year trial at the first facility in Canada, it was found that fatal overdoses within 500 metres of the facility were reduced by 35 percent, and a 9 percent decrease in the rest of the city (Stueck, 2011). Thus proving the effectiveness of injection facilities not only in Vancouver, but nationwide. Giving access to support can significantly increase the quality of life for intravenous drug users. By providing sterile equipment the

According to the World Health Organization, “globally there are approximately 16 million people that inject drugs and 3 million of them are living with human immunodeficiency virus (HIV).” Once someone is infected with HIV, it is almost always fatal since there is currently no cure for the disease. A major component of HIV prevention is the Syringe Exchange Programs (SEP’s). SEP’s are one of the main resolutions that targets curbing the spread of blood-borne viruses among injecting drug users (IDU’s). With an estimated 1 in 5 injecting drug users worldwide infected with HIV, the program is vital to bringing this epidemic under control. 60 countries worldwide have reported HIV among IDUs and an additional 40 countries report a rash of

Heroin, methamphetamine, and opioids have been around for centuries and the use of these drugs is not a new phenomenon. The use of injection drugs causes individual’s serious harm and have placed large expenses on the health care system. “Heroin, cocaine and other drugs kill around 0.2 million people each year, shattering families and bringing misery to thousands of other people” (United Nations iii); Because of-these incidents harm reduction strategies have been put in place to create a safer and more educated population, but it has only been a start. ‘Safe injection sites’ has become a well talked about term in the last decade. The term itself refers to a physical place

Today, experts in public health policy have been advocated for harm reduction, which is a philosophy that attempts to reduce the negative outcomes of drug use. Safe injection sites (SISs) follow this ideology. They are facilities where addicts are legally able to use opioids, such as heroin, under medical supervision. To stop reusing and sharing of needles, Opioid users will be given access to clean needles, which will prevent hospitalizations from serious infections and the spread of sexually transmitted diseases. Furthermore, opioid addicts will have a clean space and will not fear being arrested by the police. This will eliminate additional anxiety and stress. Advocates for SISs believe that SISs will reduce public drug use and provide a safe space for addicts to consume illicit drugs. They have been successful in many developed countries. In many studies, it has been shown that SISs save taxpayers money and reduce the number of opioid-related deaths.

Needle exchange programs have long been a controversial subject with both the general population and government lawmakers. The primary objective for needle exchange programs (NEPs) is to prevent the spread of blood-borne disease and is very successful in doing so. But, issues of morality due to the perception of drug enablement and the stigma of intravenous drug users (IDUs) and their potential effects on the decline of society are continually used as arguments for those against NEPs. It has been proven through many studies that these programs not only reduce harms associated with intravenous drug use, they are also cost effective and reduce the circulation of used syringes to the general population. Beyond epidemiological efforts, NEPs also provide a de-stigmatized center for gathering and offers health services such as HIV testing, counselling and referrals to treatment for drug addiction. This paper aims to highlight the efficacy of needle exchange programs, safe injection sites and address the social and political issues associated with them.

The role of ethics in organizational behavior is the underlying factor to the success and longevity of any organization. A set of rules and guidelines focusing on promoting safety, trust, and responsible practice within the workplace must be established internally. Organizations develop code of ethics that center upon the promotion of good. Ethics are vital in developing trusting relationships between employees and administration within.

The ethical dilemma is a situation by which it’s difficult to determine whether a situation is can be handled without disappointing both sides. Therefore, an ethical dilemma exists when the right thing to do is clear or when members of the healthcare team cannot agree on the right thing to do. Ethical dilemmas require negotiation of different points of view (potter, Perry, Stockert, & Hall 2011pg 78).

The impact of illicit drug use to the health may cause the users to seek for specialized treatment, overdose that sometimes could lead to death, and prolonged hospital stay. Those who truly rely on illicit drug will need to seek for treatment eventually(n.a, 2010 :5). The drug users that are mostly taking drug by injecting are commonly those drug addicts. They are exposed to HIV (Human Immunodeficiency Virus) through injection drug use (IDU) and sexual contact with those that inject drugs. The HIV epidemics were largely driven by IDU in most parts of the South-East Asia and even the Western Pacific Regions (n.a, 2008 :1). By the end of 2003, it was about 13.2 million people around the globe who injected drugs, the majorities came from developing and transitional countries, while in South and South-East Asia, 3.3 million was estimated (Aceijas, 2004 :2295–2303). Some