[The authors respond:]
We did not write a technical article but rather a dramatic piece whose purpose was to raise the following point: If questions of civil and criminal negligence can be raised with regard to bureaucrats and politicians who knowingly did not provide the means to protect the blood supply, then cannot the same questions be raised about those who knowingly did not provide the means for injection drug users to protect themselves from lethal harm? We do not know the answer, but the question is legitimate.
As to whether the opinions of our decision-makers were properly represented, if only this were not so. Since 1986 both of us have sat on a number of national and provincial ministerial advisory panels, where we have discussed this subject with a host of federal and provincial bureaucrats and ministers of health. Sadly, the statements of our "witness" are virtual quotations from those discussions. If our witness was made to look foolish and weak, then we are better playwrights than we thought, for this is precisely how we believe decision-makers have acted.
Robert Patterson quite rightly asks for a full and proper deliberation. We invite him to read the report of the National Task Force on HIV, AIDS and Injection Drug Use, [1] which brought together national and international experts and evidence in 1997. He might also read the Le Dain Royal Commission report, [2] which was written more than 25 years ago. Unfortunately, these reports have been neglected, not discussed.
Patterson correctly notes that opponents of harm reduction could write a similar script to ours but with a different verdict. We would look forward to reading the testimony of their "witness" about his or her accomplishments over the last 30 years, including the overwhelming success of the war on drugs, the wonderful state of affairs in our inner cities and the tens of thousands of cases of hepatitis C and HIV infection that could have been prevented.
Martin T. Schechter, MD, PhD
University of British Columbia
Michael V. O'Shaughnessy, PhD
BC Centre for Excellence in HIV/AIDS; Vancouver, BC