Lucas Philippe
Studies in Policy and Practice, Faculty of Human and Social Development, University of Victoria, PO Box 1700, Stn. CSC, 3800 Finnerty Road, Victoria, BC, V8W 2Y2 Canada.
Int J Drug Policy. 2009 Jul;20(4):296-303. doi: 10.1016/j.drugpo.2008.09.007. Epub 2009 Jan 4.
This paper is a sociological examination of policies and practices in Health Canada's Marihuana Medical Access Division (MMAD) that presume the illicit intentions and inherent "guilt" of medical cannabis users, hampering safe access to a medicine to which many are legally entitled, and raising doubts about this federal programme's overall effectiveness and constitutional legitimacy. Beginning with a brief historical overview of Canada's federal medical cannabis programme, this paper examines the failure of the MMAD to meet the needs of many sick and suffering Canadians through Hunt's [Hunt, A. (1999). Governing morals: A social history of moral regulation. Cambridge, UK: Cambridge University Press] work on moral regulation and Wodak's [Wodak, A. (2007). Ethics and drug policy. Psychiatry, 6(2), 59-62] critique of "deontological" drug policy strategies. I then cite Tupper's [Tupper, K. W. (2007). The globalization of ayahuasca: Harm reduction or benefit maximization? International Journal of Drug Policy, doi:10.1016/j.drugpo.2006.11.001] argument that shifting to a generative metaphor that constructs certain entheogenic substances as potentially useful "tools" rather than regulating them through inherently moralistic prohibitionist policies would better serve public health, and incorporate Young's [Young, I. M. (1990). Justice and the politics of difference. Princeton, New Jersey: Princeton University Press] theories of domination and oppression to examine the rise of community-base medical cannabis dispensaries as "new social movements". First-hand accounts by medical cannabis patients, federally funded studies, and internal Health Canada communication and documents suggest that current federal policies and practices are blocking safe access to this herbal medicine. The community-based dispensary model of medical cannabis access is a patient-centered "new social movement" that mitigates the stigmatization and moral regulation of their member-clients by creating opportunities for engagement, empowerment and joint knowledge creation. In light of ongoing Charter challenges and patient criticism, the survival of this federal programme will depend on the government's ability to shift away from policies based on the oppression and moral regulation, and towards consequentialist policies that balance harm reduction and benefit maximization. The effectiveness of such an approach is exemplified by the success of the community-based dispensary model which is currently producing more peer-reviewed research and supplying medical cannabis to a far greater number of patients than Health Canada's Marihuana Medical Access Division.
本文是一项社会学考察，研究对象是加拿大卫生部大麻医疗获取司（MMAD）的政策与做法。这些政策与做法假定医用大麻使用者有非法意图及内在的“罪责”，妨碍了许多人合法有权获取的一种药物的安全获取，还引发了对该联邦计划整体有效性和宪法合法性的质疑。本文首先简要回顾了加拿大联邦医用大麻计划的历史，通过亨特[亨特，A.（1999年）。《治理道德：道德监管的社会史》。英国剑桥：剑桥大学出版社]关于道德监管的著作以及沃达克[沃达克，A.（2007年）。《伦理与毒品政策》。《精神病学》，6（2），59 - 62]对“道义论”毒品政策策略的批判，审视了MMAD未能满足许多患病受苦的加拿大人需求的情况。接着，我引用塔珀[塔珀，K.W.（2007年）。《死藤水的全球化：减少伤害还是利益最大化？》。《国际毒品政策杂志》，doi:10.1016/j.drugpo.2006.11.001]的观点，即转向一种生成性隐喻，将某些致幻剂物质构建为潜在有用的“工具”，而非通过本质上道德化的禁止主义政策对其进行监管，会更有利于公共健康，并纳入扬[扬，I.M.（1990年）。《正义与差异政治》。新泽西州普林斯顿：普林斯顿大学出版社]的统治与压迫理论，以考察基于社区的医用大麻药房作为“新社会运动”的兴起。医用大麻患者的第一手叙述、联邦资助的研究以及加拿大卫生部内部的通信和文件表明，当前的联邦政策与做法正在阻碍这种草药药物的安全获取。基于社区的医用大麻获取药房模式是以患者为中心的“新社会运动”，通过创造参与、赋权和共同知识创造的机会，减轻了其成员客户所遭受的污名化和道德监管。鉴于正在进行的宪章挑战和患者批评，这个联邦计划的存续将取决于政府能否从基于压迫和道德监管的政策转向平衡减少伤害和利益最大化的结果主义政策。基于社区的药房模式的成功体现了这种方法的有效性，该模式目前产生的同行评审研究比加拿大卫生部大麻医疗获取司更多，并且向更多患者供应医用大麻。
