Thursday, September 21, 2006

Ethics and Evidence In Drug-Testing Schemes

Here's a plea by Neil McKeganey (professor of drug misuse research at Glasgow Universit)in the Herald on the 20th September 2006 for more evidence-based approaches to reducing the use of drugs by young people, specifically regards drug testing in schools. He's not afraid to wade into controversial policy areas (he has in the past called for drug dependent women to be paid to use contraceptives )

Here he suggests that drug prevention may include random drug-testing, but only on a trial basis to determine whether such schemes might be effective or not. He bemoans the absence of empirical evidence in existing drug prevention strategies and notes the ambiguity of much US "evidence" for or against drug testing. On this he is doubtless correct, as the recent ACMD report has stated, the evidence base for the effectiveness of drug testing is extremely poor.

towards the end of the piece he raises the ethical issues around testing:

"Drug testing, though, raises complex ethical issues. For example, whether young people can give their informed consent to be tested, whether testing impinges negatively on the teacher-pupil relationship and, perhaps most crucially, how you respond when a young person tests positive for illegal drugs."

All well and good, Transform would agree these are the main issues here. But then he apparently seems to want those concerns put aside whilst trials continue:

"There are difficult questions to answer, but they are not so difficult as to rule out even trying to see if drug testing is an effective method of drug prevention. And if drug testing were effective would that mean we were effective would that mean we should mount a national scheme of regular testing? The answer to that question is no."

then, confusingly, having said that even if testing could be shown to be effective (ethical concerns aside) he wouldnt want to see a national scheme, he then says:

"What it would mean is that we could then begin a debate as to whether the ends justify the means, knowing that drug testing is at least one way of reducing teenage drug use."

So he appears to be saying that the ends (ie reduced drug use - for which he thinks there is no evidence) might in theory be justified by the means (unethical testing).

Drug testing in schools, as Tony Blair's launch of the idea in a big News of the World splash last year shows, has always been a policy led by political prerogatives rather than evidence (the pilot testing scheme was part funded by the news of the World and the makers of the testing kits...hmmm). Ethics, however, can't be bypassed, even in the name of evidence gathering.

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