The Pharmaceutical Journal
Vol 269 No 7213 p278-281
31 August 2002

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Letters to the Editor

Needle exchange

Slightly queasy about mixing issues

From I. L. Marsha, MRPharmS

I read the Broad Spectrum article about the ethics of needle exchange schemes (PJ, 17 August, p214) with much interest, as, I am sure, did many others. The author eloquently discussed the issue, and in the process gave us an insight into his own views on the subject. It is not my intention to decry any of his thoughts through these columns.

The only points I would make are that first, in any issue, it may seem as though a relatively simple decision will be arrived at by one person that will cause a profound ethical, perhaps insoluble, dilemma for another. Whether or not we agree with the decision of anyone formulating public health policy to provide a service, we should credit them with an appropriate amount of thought, utilitarian or otherwise, before the decision is made.

Secondly, I am always slightly queasy about mixing issues in any serious debate, in this case a comparison between the provision of nicotine replacement products to smokers and needles to drug misusers, especially when the issues are not discussed fully and a subsidiary one is merely mentioned as a thought provoker. This concept is usually less than well conceived.

I am sure that the article will continue to incite much lively argument.

Ian Marsha
Aseptic Services Unit Pharmacist/Teacher-Practitioner
Department of Pharmacy and Pharmacology,
University of Bath

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