More on InSite

Recently our friends at the Cardus Centre for Public Renewal published an edition of their legal journal, LexView, that criticizes the Supreme Court of Canada’s decision on the InSite case.

I like a lot of what Cardus does. But I’m certainly disappointed by this take on the InSite decision. Some have asked me to respond to it, and here’s what I wrote Peter Stockland today:

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Dear Peter,

Having defended InSite in my weblog and in print and in a recent public lecture at Regent College with a nurse who has worked there, I am deeply disappointed that Cardus is taking a position hostile to it.

Moreover, I found Mr. Boonstra’s response to be an impressive exercise in prolixly missing the point, even as it misrepresents both the situation at InSite and the place of harm reduction in the context of, and not as a replacement for, other strategies to respond to drug addiction. (For example, his article betrays no knowledge of the work of OnSite, one floor above InSite, as an addiction counseling and detox facility, nor does he refer to the “Four Pillars” strategy that makes much better sense of InSite’s role.) As a scholar who is not averse to reading long, complicated arguments, I confess I found Mr. Boonstra’s article painful to read in its sustained efforts to avoid the fundamental point: Human beings will die needlessly if InSite is closed. Of course more must be done. But not less.

I reiterate that this is not a complex situation, despite Mr. Boonstra’s verbose discussion and the Conservative government’s indefensible prolongation of this matter. Addicts cannot be helped if they are dead. They cannot detox, or get converted, or find new support groups, or embark on any other healthier set of choices if they are dead. And there is no doubt in the minds of those who have studied InSite and published their results in dozens of reputable journals that addicts would be dead without InSite.

Again, InSite was never intended to be a stand-alone response to drug addiction. And of course it isn’t “safe” in any absolute sense, as Mr. Boonstra takes extravagant pains to point out. But it is quite a bit safer than using a shared needle and alley water, and shooting up with no one around to help with overdosing or with rape, theft, assault, or murder when one is high.

InSite is only a harm-reduction centre whose awful work has been necessitated by, among other things, the failure of the Liberal government of British Columbia and the Conservative government of Canada to adequately care for mentally ill, sexually abused, and otherwise deeply damaged Canadians who have turned to strong, illegal drugs as a terrible last resort. (I voted for both of those governments and am dismayed by their subsequent attitudes toward this obvious need.)

I do not defend the Supreme Court’s judicial logic. I defend their humanitarian and realistic judgment that InSite does a necessary thing in a horrible situation. I would like to have thought Mr. Boonstra, and the Cardus Centre, would agree with that basic truth and develop your thinking accordingly. I am deeply disappointed in you that you did not.

Happily, we agree on a great many other matters and I will continue to support your work. But as a friend of Cardus, I simply must register with you, in these very strong terms, my dissent from this regrettable position.

John

0 Responses to “More on InSite”

  1. Peter Stockland

    John – Thanks so much for the thoughtful response. I hope you don’t mind if exercise a right of reply. Two things seems to overlap in your argument that must be kept distinct. The first is the validity of Insite itself as a political and social response. The second is the Supreme Court’s legal response as expressed in its Sept. 30 judgement. Our LexView was an analysis of the legal response. It touched on Insite as socio-political response only to question it as a full response, not to dismiss it – and certainly not to disparage it – as a best-possible-now response. Kevin’s LexView analysis found the Court’s reasoning and reaction woefully deficient. Frankly, I thought he was restrained. My own thinking is that the judgement is, and these are my words not Kevin’s, a legal abomination. It is an abomination on a myriad of levels. I will spare your my forecaster’s song and dance on where it will lead, and my set-piece soliloquy on its harm to the constitutional order. But I do want to impress on you the argument that among its most abominable aspects is precisely the way it lets government off the hook of democratic, political and social responsibilities. Insite should, in a proper political order, be triage. Vital triage, you would argue, and I would defer to your knowledge. But justice and charity both cry out that it should not ever be embedded among the poorest of the poor as enduring health care and, most perniciously of all, as something guaranteed them by a document crafted to protect rights and freedoms. What freedom is guaranteed by the right to spend the remainder of one’s impoverished life walking through squalor to self-medicate the disease of addiction in a state-sponsored facility? The freedom to stay alive, and so the right to life? Short-term, in a world of hard choices, okay, I will agree.What the Supreme Court has done is transform a transient technocratic solution into a social good. In that lies the flight from the moral ground that is sine qua non of a democratic, just, and charitable order. The original argument, which could have been settled democratically, was about closing Insite’s doors. The Court has an opened an escape hatch for politicians to flee through, leaving the horror of the Downtown East Side intact for another generation. By my definition, that’s an abomination.

    • John Stackhouse

      Peter,

      Thanks for this characteristically thoughtful reply. Before I respond in turn, however, I want to apologize to you, to Cardus, and especially to Brother Boonstra for my cranky tone in this post. I was literally kranky (German: Krankheit, illness) yesterday with the ‘flu, and I ought to know better than to post a controversial piece in such a state! Kevin Boonstra is an accomplished lawyer who volunteers time for such work with Cardus, and I was too hard on him in my comments. So I’m sorry about that (I have sent a private note of apology to him as well), and I appreciate your taking the high road in response.

      I think that Kevin’s piece also mixes things together, I’m afraid, as he wonders, for example, if other modes of responding to addiction might work as well or better. Sure, one can wonder that, but the medical studies seem to indicate that InSite plays a key part in a multi-pronged approach to addiction and shutting it down is just a Bad Thing. Since that is what the evidence shows, wondering about the efficacy of alternatives is actually dangerous if in the meanwhile a proven remedy is terminated.

      And I will stick to my guns that Brother Kevin ought to have acknowledged both the grim necessity of a place like InSite and the Conservative government’s perversity in trying to shut it down in the teeth of the strong medical evidence on its behalf.

      Having said that, however, I appreciate that the way the Supreme Court came to its decision might well be bad. I am not qualified to speak to that point, and you and Kevin are. Indeed, I know several other Christian lawyers who are deeply unhappy about its way of deciding this matter.

      When there is a matter of life and death, however, which I think the opening or closing of InSite amounts to, then I trust you will understand if I am glad for it remaining open even if by way of a bad decision. And I then sincerely hope the government will draft appropriate legislation both to retain InSite and to do all that is necessary to make it redundant–and THEN shut it down.

      And if it can straighten out the Supreme Court in the process, all the better!

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