Ethical quagmires

For those who haven’t signed up for Dry January, the local pub could be considered a supervised consumption site. Customers consume addictive, unhealthy substances to feel better in the short term. Trained staff, rules of operation, bouncers and laws provide guard-rails to prevent or control excess. Society condones it and many governments benefit from it through taxes; some governments even promote it, justified by arguments that range from reasonable regulation to community standards to advanced civilization. In the context of drug use, on the other hand, supervised consumption sites are being denounced and labelled immoral for aiding and abetting the consumption of addictive, unhealthy substances. The two contexts are not comparable, but they do raise similar ethical considerations and questions about how we use language to bless or condemn activities on a less than clear and consistent basis.

Conflicting interests

Under what circumstances should society restrict, condone or enable high risk, addictive behaviours? To what degree? How should decisions be made for each issue or people in different circumstances? In the case of drug use, provinces are also debating the more complex question of forced treatment in some circumstances. When prohibition of addictive substances does not work, discernment falls into a quagmire of conflicting interests and ethical values that are challenging for any political system, especially populist democracies.

Another emerging case is gambling, and sports gambling in particular. Society has shifted from discouraging gambling to condoning, benefiting and promoting easier access to sports gambling. But TV ads by sports celebrities, like hockey stars Wayne Gretzky and Connor McDavid, crossed some poorly defined line, leading to demands for regulations to ban them. Some of the arguments for banning celebrity ads relate equally to forms of gambling and promotion that are already widely accepted. The lack of consistency in policies and enforcement will result in more aggressive ads and more gambling, likely until some future time when expanded negative effects give rise to serious ethical questions about this area of public policy.

At one level, these cases and others point to the need for more robust ethical frameworks for policy makers and public discussion of issues like these. Evidence-based decision making is a start, but it is inadequate on its own and prone to populist manipulation and inconsistencies. In Ontario, for example, alcohol use is actively promoted by public policies, while some other drugs are demonized based on popular perception more than any rational or holistic approach to prevention and interventions. All current policy is weak in addressing root causes of addictive behaviours.

Meaning and purpose

Digging deeper, one common element of a preventive or protective factor regarding addictive behaviors, especially for young people. is the importance of meaning and purpose in life. These are often referred to as the spiritual dimensions of health or well-being in public health discourse, and they are getting more attention, especially in the fields of mental health and preventing addictions. Many Christians dismiss this as superficial or as undermining Christianity. Dismissal may be valid when it means only life-style actions, like mindfulness moments or yoga classes. When recognition of spiritual health creates space to pay attention to deeper questions of meaning, purpose and our connection to transcendence, it can be an opportunity for Christians to engage in a society that is allergic to traditional churches. Are we ready to step into this space?