Résumés
Abstract
Racialized people experience excess and preventable harm from substance use, raising questions about how justice ought to be pursued via health policy. This case study is intended to surface how bioethical perspectives may contribute to informing approaches to racial justice in public health policy decision-making about substance use.
Keywords:
- analgesics,
- opioid,
- benzodiazepines,
- methamphetamine,
- harm reduction,
- racism,
- antiracism,
- ethics,
- health equity
Résumé
Les personnes racialisées subissent des dommages excessifs et évitables liés à la consommation de substances, ce qui soulève des questions sur la manière dont la justice doit être recherchée par le biais des politiques de santé. Cette étude de cas vise à montrer comment les perspectives bioéthiques peuvent contribuer à éclairer les approches de la justice raciale dans la prise de décision en matière de politique de santé publique concernant la consommation de substances psychoactives.
Mots-clés :
- analgésiques,
- opioïdes,
- benzodiazépines,
- méthamphétamine,
- réduction des méfaits,
- racisme,
- antiracisme,
- éthique,
- équité en matière de santé
Veuillez télécharger l’article en PDF pour le lire.
Télécharger
Parties annexes
Acknowledgements / Remerciements
MP would like to acknowledge Dr. Ananya Banerjee and the students in her Winter 2024 graduate course on racism, intersectionality, and health equity at McGill University, whose request to learn about bioethics through an exploration of substance use in racialized communities in Canada stimulated the development of this case study. MP is supported by a Canadian Institutes for Health Research (CIHR) Research Excellence, Diversity, and Independence (REDI) Early Career Transition Award.
MP tient à remercier Ananya Banerjee et les étudiants de son cours d’hiver 2024 sur le racisme, l’intersectionnalité et l’équité en matière de santé à l’Université McGill, dont la demande d’apprentissage de la bioéthique par le biais d’une exploration de la consommation de substances dans les communautés racialisées au Canada a stimulé l’élaboration de cette étude de cas. MP bénéficie d’une bourse d’excellence, de diversité et d’indépendance en recherche (PEDR) des Instituts de recherche en santé du Canada (IRSC) en début de carrière.
Bibliography
- 1. Humphreys K, Shover CL, Andrews CM, et al. Responding to the opioid crisis in North America and beyond: recommendations of the Stanford-Lancet Commission. The Lancet. 2022;399(10324):555-604.
- 2. Hagle HN, Martin M, Winograd R, et al. Dismantling racism against Black, Indigenous, and people of color across the substance use continuum: A Position statement of the Association for Multidisciplinary Education and Research in Substance use and Addiction. Substance Abuse. 2021;42(1):5-12.
- 3. Needham BL, Ali T, Allgood KL, Ro A, Hirschtick JL, Fleischer NL. Institutional racism and health: A framework for conceptualization, measurement, and analysis. Journal of Racial and Ethnic Health Disparities. 2023;10(4):1997-2019.
- 4. Elias A, Paradies Y. The costs of institutional racism and its ethical implications for healthcare. Journal of Bioethical Inquiry. 2021;18(1):45-58.
- 5. The Alberta First Nations Information Governance Centre and Government of Alberta. Alberta Opioid Response Surveillance Report: First Nations People in Alberta. Edmonton: Government of Alberta; 2021.
- 6. Substance Abuse and Mental Health Services Administration. The Opioid Crisis and the Black/African American Population: An Urgent Issue. Publication No. PEP20-0502-001. Rockville, Maryland: Office of Behavioral Health Equity, Substance Abuse and Mental Health Services Administration; 2020.
- 7. First Nations Health Authority. Overdose Data and First Nations in BC. Vancouver, British Columbia: First Nations Health Authority; 2017.
- 8. Godkhindi P, Nussey L, O’Shea T. “They’re causing more harm than good”: a qualitative study exploring racism in harm reduction through the experiences of racialized people who use drugs. Harm Reduction Journal. 2022;19:96.
- 9. Ontario Agency for Health Protection and Promotion. Rapid Review: Race-based Equity in Substance Use Services. Toronto: Public Health Ontario; 2022.
- 10. Vearrier L. The value of harm reduction for injection drug use: A clinical and public health ethics analysis. Disease-a-month. 2019;65(5):119-41.
- 11. Fischer B. The continuous opioid death crisis in Canada: changing characteristics and implications for path options forward. Lancet Regional Health – Americas. 2023;19:100437
- 12. US Centers for Disease Control and Prevention. Substance Use: U.S. Centers for Disease Control and Prevention. CDC National Center for Health Statistics; 2023.
- 13. Public Health Agency of Canada. Modelling Opioid-related Deaths During the Overdose Crisis. Government of Canada; 2023
- 14. Dayal P. Canada’s drug crisis affecting newcomers, but lack of data makes it hard to know severity of problem. CBC News. 25 Feb 2024.
- 15. Vu M, Li J, Haardörfer R, Windle M, Berg CJ. Mental health and substance use among women and men at the intersections of identities and experiences of discrimination: insights from the intersectionality framework. BMC Public Health. 2019;19:108.