Christ among the Doctors of the Law



Tuesday, February 02, 2010

Arguments against Bp. Hubbard's authorization of "needle programs"

Formal cooperation in another's evil act (that is, undertaking to help expressly another to perform an act known to be evil) is itself evil. Davis, Moral and Pastoral Theology (1938), I: 341-342. There are no exceptions to this rule; no supervening circumstances can ever render formal cooperation in evil good.

The use of [illegal] drugs "inflicts very grave damage on human health and life [and] . . . is a grave offense. Clandestine production and trafficking in drugs are scandalous practices. They constitute direct co-operation in evil, since they encourage people to practices gravely contrary to the moral law." CCC 2291, my emphasis. See also Pontifical Council for Pastoral Assistance to Health Care Workers,
"Charter for Health Care Workers" (1995), n. 94.

I think that one who supplies, without a physician's prescription, needles/syringes (nb: devices with only one practical use) to people whom one reasonably believes will use those devices to inject illegal drugs into their own bodies and/or the bodies of others, encourages those people to practices that are gravely contrary to the moral law, rendering thereby, it seems to me, direct assistance to their commission of an objectively gravely evil act while intending precisely to help them accomplish that act. This conclusion is not contingent on whether the needles are clean, or are merely exchanged, or on any other accidental aspect of the program.* The only question is whether giving a syringe to a drug abuser abets his or her injection of illegal drugs. If it does, then giving a drug user a needle formally cooperates with the specific evil of his or her taking those illegal drugs.

Thus, when, Bp. Hubbard of Albany authorized his Catholic Charities office to distribute syringes to apparent drug abusers, in my opinion, he began formally** cooperating in the grave evil of drug abuse in his diocese.

Now, I can't imagine that any of these observations come as a surprise to the Albany administrators who spent, what? five years? developing this proposal. But the official inadvertance to some pretty obvious objections (at least in the materials I located in this matter so far) is disquieting. Perhaps the powers-that-be will share their analysis more fully, or at least cite us to some experts who are willing to stand behind this program?

In any event, if my moral analysis is correct (and I invite interested persons to carefully investigate the tradition for themselves), then there is an obvious concern for the scandal (in the classical sense of that word, that is, conduct that has the effect of diminishing others' sense of sin and/or encouraging others to commit sin) that is given when, not simply Catholics, but Catholic bishops approve the public distribution, under Catholic auspices, of injection devices to users of illegal drugs.

Indeed, if a bishop, who is to be "an example in holiness and charity" (1983 CIC 387; CCC 893), uses his offices to achieve the distribution of needles to illegal drug users, is he not abusing ecclesiastical power or function and/or placing acts of ecclesiastical power, ministry or functions with harm to others, contrary to Canon 1389? If such actions are undertaken by one who "has been established in some dignity or . . . position of authority or office" (1983 CIC 1326.1.2), does that not make the immediate reversal, or at least suspension and reconsideration, of such a decision all the more urgent? + + +

* To be clear, under Catholic moral analysis, there are no justifications for formal cooperation in evil, so if needle programs are formal cooperations in evil, we need not comment on the various justifications alleged by proponents of needles-for-illegal-drug-users programs. We simply cannot do evil to achieve good. One could, however, if one wishes, see some brief comments by Fr. Tadeusz Pacholczyk, Ph.D., on "safe injection sites".

** In 1999, the Congregation for the Doctrine of the Faith directed an Australian religious hospital to cease providing an injection room for heroin addicts on the grounds that such assistance was "an extremely proximate material cooperation in the grave evil of drug abuse." I don't have all the facts of that case or the entire CDF letter, but it is interesting to note that CDF reproved what it considered to be "only" direct material cooperation in drug-abuse. While I argue that Bp. Hubbard's action here seems to constitute formal cooperation in drug abuse, even if his actions were deemed to be "only" material cooperation in illicit drug use, they would still labor under weighty moral objections.

More from Religion News Service; A brief discussion over at Catholic Answers on-line forum.

See also NCCB/USCC, "A Response to the HIV/AIDS Crisis" (1990), wherein: "Education and treatment aimed at changing behavior are the best way to control the spread of HIV among intravenous drug users and to prevent passage of the virus to their sexual partners and to children in the womb. Although some argue that distribution of sterile needles should be promoted, we question this approach for both moral and practical reasons: More drug use might result while fewer intravenous drug users might seek treatment; Poor monitoring could lead to the increased spread of HIV infection through the use of contaminated needles; Distribution of sterile needles and syringes would send message that intravenous drug use can be made safe. But IV drug users mutilate and destroy their veins, introduce infection through contaminated skin, inject substances that often contain lethal impurities, and risk death from overdoses." My emphasis.

More analysis from Religion News Service, 5 February 2010.

Post-scripta. Feb 4 thru 8.

I have seen a number of reactions to my argument that Albany's Bp. Hubbard is formally cooperating in the evil of drug abuse by his authorization of a needle exchange program under a diocesan office. Some reactions are thoughtful, some are ridiculous, some are signed, others are anonymous, and so on. In no particular order, and with no pretense of completeness, I will offer below, time permitting, some "reactions to these reactions".

1. Somebody wrote that, since the addicts have a needle before the exchange, and they have one after, the status quo is the same, and no harm is done. Great scot. Do we really need to address this? If an addict gets and uses a needle for drug abuse on his own, that's his responsibility; but if I give him the needle, knowing what he plans to do with it, it becomes mine.

Analogy: suppose a man declares his intention to commit a stabbing (that is, to do an evil act), but I notice that the knife he is holding is rusty, covered in excrement, and lacks a safety grip (thus, the device he intends to use poses serious risks not only of cutting, but of infection, to his victim, himself, and maybe to others). Should I call out to him "Wait! that's a dangerous knife you have! You might accidentally infect yourself or others if you use it! While I am opposed to stabbing, and while I sincerely hope that you won't go out and stab someone, since you insist on stabbing someone, at least use a clean knife and thus lower the risk of infections." Whereupon I hand him a clean knife.

How can anyone miss the fact that, in handing a self-declared would-be stabber a knife, I have given him the specific tool that he will use to commit a specific evil act, despite my knowing that he intends to perform the evil act, and thus come share in the guilt of the evil of a specific stabbing?

* A lawyer buddy of mine observes, "Try using that line as a defense to a charge of aiding and abetting muder or attempted murder. You'd be laughed right out of court." And right into prison, I might add.

Likewise arises the guilt of those who give needles, of all things, to drug abusers, of all people.

By the way, the guilt of such persons for an addict's specific act of drug abuse might be higher, because they are not addicted and thus should be in greater control of their thinking and decisions than a drug addict likely is of his!

2. Some else writes, needle exchange programs indisputably reduce the spread of disease (and so should be supported). Well, credible others do dispute the so-called "indisputable", but my argument against needle-exchanges does not rest on whether such program are "effective" in reducing disease, but rather, on my assertion that such programs are morally wrong.

There are lots of ways to achieve "good" results in the world, right?, but some ways are impermissible because they involve doing evil deliberately. There are thousands of examples such scenarios, I need not list them. I am trying to get people to see that the weighing of competing "good" and "bad" outcomes is irrelevant if either result, even the "good" one, is to be achieved through morally evil means.

3. Some folks oppose needle exchange programs on the basis that we/society should be doing more for addicts than giving them clean needles. Personally, I agree with such a claim, but my argument does not rest on it. Mine is not argument of prudence (a la, certain resources should be have better spent, or, needle-exchanges only mask deeper problems), rather, my argument is that this diocesan program constitutes formal cooperation in specific evil acts of drug abuse and so should cease. Immediately.

4. Some observe that the local police have approved of the needle program, so we shouldn't complain about it. First, I don't know exactly what the police (or the City Council, etc.) have said, but whatever they said, it's not relevant to whether this program passes Catholic moral analysis. The police do not determine what is moral, they do not even determine what is legal; they determine, as a practical matter, how to apply their limited law-enforcement resources to the real world. Their decision, then, not to arrest drug abusers in and around this van (if that was their decision) is at most one of prudence, not of morality. I am arguing the immorality of this program.

5. Some seem to think that my opposition to the Albany needle exchange program rests on the assumption that such programs "encourage" drug abuse, iow, that I fear such programs result in a net increase in illegal drug use. They point to studies indicating, however, this is not the case. Okay, fine. I'm not qualified to assess these studies, but, again, I don't have to: my argument against the diocesan needle program is not a prudential one concerned with whether the program increases or decreases drug abuse or disease, it is a principle argument that one may never do evil to achieve good, and that this program formally cooperates in specific evil acts, thus doing evil to achieve good. Again, whether the total number of evil acts goes up or down is not germane to whether this program itself is an evil.

This is why, btw, one may not walk up to an abortionist and kill him despite the forseeable result that by killing him, one would reduce the number of babies he destroys. Obviously, killing an abortionist would bring the number of his future evil acts down to zero, but, in the meantime, one would have committed a grave evil in murdering him. One is not permitted to perform, or to counsel others to perform, or to knowingly equip others to perform, any such evil act.

6. Some folks concede that the Albany needle program is material cooperation in evil (perhaps even a material cooperation to an impermissible degree of directness) but they reject that it is formal cooperation because the program never endorses, and even might counsel against, drug abuse during the actual needle exchange. In other words, these folks seem to believe that the concomitant recitation of words, (nay, the sincere recitation of words) vitiates one's cooperation in evil, rendering merely material what would have been formal.

Not so. Actions speak louder than words, and the action here is to put into the hands of one proposing to do evil the tool used to do that evil, knowing what use the evil-doer has planned. To hold that the offering of advice against an evil action is sufficient to obviate one's cooperation in the evil action performed with one's assistance, is to enable anyone to escape moral liability for assisting in evil action simply upon uttering exculpatory words.

When might words reduce or even eliminate one's liability for cooperation in evil? When the cooperation is merely material to begin with.

Example: If I give a drug addict $ 20, with the advice "Buy some food", I am aware that, yes, he might in fact buy drugs or a syringe with the money. But I have not endorsed such use, I have advised him to a good use, and I have enabled him, here and now, to do that good with what I gave him. If he misuses the tool I gave (the $ 20), that's his responsibility.

But if I give him a tool (a syringe) that can, in the practical order, only be used for evil, and which I am reasonably certain will be used for that evil, my words about "Don't do it, it's bad for you," etc., are belied by my actions, which is to assist him toward his evil plan, knowing of his evil plan. The only thing a drug abuser can do with a syringe (as opposed to doing with $ 20) is take drugs with it, and I know I it (and he knows I know it), and I give him the tool anyway. That makes my cooperation with his evil act of taking drugs formal.

7. Some have asked whether the Albany needle-sharing program falls under the same moral strictures as condom distribution programs. I have not considered that question closely, and I make my case against needle exchanges independently of the condom issue, if only because, in the condom case, the underlying action might be a good (e.g., married sex) that is distorted by condom usage, whereas in the needle exchange scenario, the underlying action, illicit drug use, is always gravely disordered, though it is rendered more dangerous by using dirty needles.

8. Paraphrasing another post here, "the needle program might be evil, but it does reduce disease, so, maybe it's okay for the state to do it, but not the Church." Ummm, the Church (the Diocese of Albany) should not do it because it's evil, but because it's evil, the State should not do it either. Okay?

9. Why is this needle program not acceptable as an application of the principle of double-effect? Because, double-effect analysis, as shown by its first criterion (the action must be either good or at least morally neutral in itself), applies only to situations akin to material cooperation in evil, not formal. Here, I argue that the action under discussion (giving needles to drug abusers who intend to use them to do illicit drugs) is itself a formal cooperation in evil, so the effects (double, triple, whatever) are irrelevant to assessment of the morality of the act.

10. Others ask, isn't it Albany's "intention" here to reduce disease? No, Albany's motive or goal in running the program is to reduce disease, but their intention in doing this needle program is to give needles to drug abusers knowing they will use them to do illegal drugs. Maybe we can make it clearer thus:

10 A) Suppose a trustworthy source says "Ed, please bring this (wrapped) package of food down to those drug abusers at the corner." I say fine, and do so. I have done a morally good (or at least neutral) action because I intended to deliver, and did deliver, morally neutral goods to people who can use them licitly, even if they happen to be drug abusers.

10 B) Okay, now suppose a trustworthy source says "Ed, please bring this (wrapped) package of food down to those drug abusers at the corner." I say fine, and do so, except this time, it turns out that the wrapped package was full of illegal drugs and syringes. Now, even though I intended to deliver food, I actually delivered drug paraphernalia to drug abusers; but even so, I am morally guiltless for the act, because I intended to deliver what I reasonably believed was food to people who happen to be drug abusers.

10 C) Continuing, if a source says, "Ed, please bring this package of syringes to the hospital", and I do so, I have performed a good (or at least neutral) act, because I intended to deliver and did deliver medical supplies to what I was reliably informed was a licit recipient.

10 D) But, in the Albany situation, one says, "Ed, please bring these syringes to the drug abusers on the corner". If I do so, I have performed an evil action because I intended to deliver (and did deliver) drug paraphernalia to people whom I can reasonably predict will use them illicitly. (Nb: if I deliver what I think is drug paraphernalia to drug abusers, but unbeknownst to me the package contains food, I still incur moral guilt because I intended to do, and did do as far as I knew, an evil action!)

Notice, in none of these scenarios was my motive (whether it is to make money, to help in crisis relief, to save my brother a trip, to reduce disease, whatever) relevant to assessing what my intention was in engaging in the specific act of delivering a known something to a known someone who had a known purpose. Obviously, then, the primary factors determinative of the morality of this action are in what is (known or believed) to be delivered to whom and for what use, and not in the motives or goals of the giver.

See also: Some options for responding to the Albany diocese's needle exchange program (10 Feb. 2010)

15 February 2010: I see that Robert Araujo, SJ, of Loyola Univeristy Law School, has weighed in against the Albany needle program.