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  6. Harm Reduction In Inpatient Hospital Settings: An Ethics (principlist) Analysis

Harm Reduction in Inpatient Hospital Settings: An Ethics (Principlist) Analysis

Katherine Birkness1, Cheryl Forchuk2,3, Jonathan Serrato4

  • 1Queen's University, Kingston, Canada.

Health Care Analysis : HCA : Journal of Health Philosophy and Policy|June 14, 2025

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View abstract on PubMed

Summary

Harm reduction offers a more ethical approach to the opioid crisis than abstinence-only policies in hospitals. This strategy can reduce stigma and improve healthcare equity for those with substance use disorder.

Area of Science:

  • Public Health
  • Bioethics

Background:

  • The opioid epidemic remains a critical public health issue in North America.
  • Current inpatient hospital policies often favor abstinence-only approaches, which present challenges like withdrawal, secrecy, and stigma.
  • Healthcare providers may lack adequate knowledge regarding substance use disorder.

Purpose of the Study:

  • To evaluate harm reduction as an ethically sound alternative to abstinence-based policies for managing substance use disorder.
  • To explore the application of Principlism (Autonomy, Beneficence, Justice, Non-Maleficence) to justify harm reduction strategies.

Main Methods:

  • Ethical analysis using Principlism.
  • Literature review and conceptual argument.

Main Results:

  • Harm reduction aligns with ethical principles, offering a more viable approach than abstinence.
  • Harm reduction can foster a more equitable healthcare system, decrease stigma, and encourage help-seeking behaviors.

Conclusions:

  • Harm reduction practices are ethically superior to abstinence-based approaches in healthcare settings for individuals with substance use disorder.
  • Further empirical research in diverse settings and exploration of other ethical frameworks are recommended.
Keywords:
EthicsHarm reductionHospitalsPrinciplismSubstance use

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