When is coercive methadone therapy justified?

Heroin use poses a significant health and economic burden to society, and individuals with heroin dependence are responsible for a significant amount of crime. Owing to its efficacy and cost-effectiveness, methadone maintenance therapy (MMT) is offered as an optional alternative to imprisonment for...

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Bibliographic Details
Authors: D'Hotman, Daniel (Author) ; Douglas, Thomas (Author) ; Pugh, Jonathan 1974- (Author)
Format: Electronic Article
Language:English
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Published: Wiley-Blackwell [2018]
In: Bioethics
Year: 2018, Volume: 32, Issue: 7, Pages: 405-413
IxTheo Classification:NCH Medical ethics
Further subjects:B Autonomy
B methadone
B Criminal Justice
B Neuroethics
B Drug Policy
Online Access: Presumably Free Access
Volltext (Verlag)
Volltext (doi)

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520 |a Heroin use poses a significant health and economic burden to society, and individuals with heroin dependence are responsible for a significant amount of crime. Owing to its efficacy and cost-effectiveness, methadone maintenance therapy (MMT) is offered as an optional alternative to imprisonment for drug offenders in several jurisdictions. Some object to such ‘MMT offers’ on the basis that they involve coercion and thus invalidate the offender's consent to MMT. While we find these arguments unpersuasive, we do not attempt to build a case against them here. Instead, we explore whether administration of MMT following acceptance of an MMT offer might be permissible even on the assumption that MMT offers are coercive, and in such a way that the resulting MMT is non-consensual. We argue that non-consensual MMT following an MMT offer is typically permissible. We first offer empirical evidence to demonstrate the substantial benefits to the offender and society of implementing non-consensual MMT in the criminal justice system. We then explore and respond to potential objections to such uses of MMT. These appeal respectively to harm, autonomy, bodily and mental interference, and penal theoretic considerations. Finally, we introduce and dismiss a potential response to our argument that takes a revisionist position, rejecting prevailing incarceration practices. 
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