- © 2005 Canadian Medical Association or its licensors
The de facto criminalization of prostitution in Canada is an anachronistic remnant of this society's vigorous early-20th century efforts to assert dominant moral ideology through the force of criminal law; similarly targeted behaviours include select substance use (“illicit drugs”) and sexual orientation.1 However, as CMAJ's editorial wisely outlines,2 the criminal law is a rather ineffective custodian of moral norms, especially when these are disobeyed by many and disagreed with by many more. Moreover, the ineffective criminalization of private conduct with implications for health can itself produce disastrous consequences, as the excessive human toll of the criminalization of substance use in North America illustrates.3,4 The prostitution issue is not much different: it is an ancient phenomenon that is here to stay; enforcement interventions are symbolic or of temporary displacement value at best; and the only sensible policy approach must be one grounded in pragmatic principles of public health. As our own research suggests, seemingly benevolent “reform” initiatives like john schools are essentially punishment in disguise for largely lower-class offenders, and thus serve to legitimize the status quo of criminalization rather than reforming it.5 It is thus a worthy and laudable cause for CMAJ to argue for a public health based policy framework to deal with the sex trade issue. It is perhaps unfortunate for the prospects of this call — as also shown by our research — that the public's opinion is more or less divided (as it is on many issues of morality control) on the question of whether sex for money should be controlled by punishment.6 This matter has thus become a political “no-winner,” and law and policy reform will occur only if politicians are pressured to assume proactive and determined leadership, which may be poor in terms of potential vote gains but rich in merit for “good government” and public health.