Drug Enforcement, Legal Actions, and Ethical Considerations

• Drug Enforcement Administration (DEA) was created on July 1, 1973
• Purpose of DEA


  • Enforce the controlled substances laws and regulations of the United States
  • Bring to the criminal and civil justice system of the U.S., or any competent jurisdiction, organizations and their principal members involved in the growing, manufacture, or distribution of controlled substances appearing, in, or destined for, illicit traffic in the U.S.
  • Recommend and support non-enforcement programs aimed at reducing the availability of illicit controlled substances
• DEA was created to consolidate and coordinate the government's drug control activities
• DEA today


  • Enforces the provisions of the controlled substances and chemical diversion and trafficking laws and regulations of the U.S.
  • Conducts operations on a worldwide basis
  • Disrupts and dismantles these organizations by arresting their members, confiscating their drugs, and seizing their assets
  • Creates, manages, and supports enforcement-related programs - domestically and internationally - aimed at reducing the availability of and demand for illicit controlled substances
• Legalization


  The complete removal of sanctions, making a certain behavior legal, and applying no criminal or administrative penalties
• Legalization is not a single event, but rather a series of unfolding changes
• Legalization process


  • Vote
  • Establishment of a regulatory system
  • Emergence of retail sales outlets
  • Development of an adequate legal supply of product
• Retail shops have additional regulatory hurdles - electricity, computer systems, water usage, and environmental safety
• Drug Liberalization


  The process of eliminating or reducing drug prohibition laws
• Decriminalization


  The removal of sanctions under the criminal law, with optional use of administrative sanctions
• Administrative sanctions


  • Civil fines
  • Court-ordered therapeutic responses
• In 2001, Portugal decriminalized all drugs
• Portugal legislation


  • Treated possession and use of small quantities of drugs as a public health issue, not criminal
  • Drugs remained "illegal" but getting caught with them is a small fine, potential referral to a treatment program
  • No jail time
  • No criminal record
• A lot of good things resulted from Portugal's decriminalization, including reducing illicit drug use among problematic drug users and teens, reducing burden of drug offenders on the criminal justice system, reducing opiate-related deaths and infectious diseases, retail prices of drugs also reduced, increased uptake of drug treatment and the amounts of drugs seized by authorities - for sales in foreign markets
• Depenalization


  The decision in practice not to criminally penalize offenders, such as non-prosecution or non-arrest
• Ethics


  The systematizing, defending, and recommending concepts and actions behind right and wrong conduct
• Conduct


  The way a person behaves especially in a particular situation or context
• Bioethics


  The study of ethical issues emerging from advances in biology and medicine
• Bioethics is moral discernment as it relates to medical policy and practice, and includes the study of values relating to primary medical care and other branches of medicine
• Scope of bioethics


  • Debates over the boundaries of life (abortion, euthanasia)
  • Surrogacy
  • Organ donation
  • Medical care refusal for religious or cultural reasons
  • Cloning, gene therapy, life extension, human genetic engineering, Astroethics, and life in space
• Medical Ethics


  The study of moral values and judgments as they apply to medicine
• Medical ethics seeks to inform healthcare professionals and enable them to make moral decisions by providing a set of values that professionals can refer to in instances where confusion/conflict arise, allowing doctors, care providers, and families to create a treatment plan and work toward the same common growth
• Autonomy


  Self-determination that is free from both controlling interferences by others and personal limitations preventing meaningful choice
• Respect for persons


  • All individuals should be treated as autonomous agents
  • They can deliberate about personal choices and act upon those deliberations
  • Individuals who have diminished autonomy must be protected
• Conditions flowing from Respect for persons

  • Voluntary consent
  • Informed consent
  • Protection of privacy and confidentiality
  • Right to withdraw without penalty from a study
• Beneficence


  Moral obligation to act for the benefit of others
• Obligations of Beneficence


  • Confer benefits
  • Prevent and remove harms
  • Weigh and balance the possible goods against the costs and possible harms of an action
• Beneficence requires the examination of the risks and benefits of the study, the study should do no harm, benefits must be maximized while harm is minimized, and the risks are justified by the benefits of the study
• Confidentiality


  The information a patient reveals to a healthcare provider is private and has limits on how and when it can be disclosed to a third party; usually the provider must obtain permission from the patient to make such a disclosure
• Non-maleficence / do no harm


  An obligation not to inflict harm intentionally
• Equity / Justice


  Giving others what is due to them; is comprised of a group of norms for the fair distribution of benefits, risks, and costs
• Types of Justice


  • Distributive
  • Criminal or punitive
  • Rectifactory