Ethics and Harm Reduction – Addiction Medicine and Case Discussion

with

Host, Amanda Porter

Special Guest, Dr. Thomas Brothers

DISCUSSION QUESTIONS 

• Dr. Brothers mentions that harm reduction approaches have not historically been incorporated in medical education. What might be some of the reasons for this? 

• Why do you think there is a difference in the standard of care in the community setting compared to in the acute hospital setting with regards to harm reduction for people who use drugs? 

• Why do you think that stigma persists in healthcare? 

RESOURCES 

Brothers, T., Mosseler, K., Kirkland, S., Melanson, P., Barret, L., Webster, D. (2022) Unequal access to opioid agonist treatment and sterile injecting equipment among hospitalized patients with injection drug use-associated infective endocarditis. PLOS ONE, 17(1): e0263156. https://doi.org/10.1371/journal.pone.0263156  

Knaak, S., Romie, C., Mercer, S., Stuart, H.: Harm Reduction, Stigma and the Problem of Low Compassion Satisfaction: Tensions on the front-lines of Canada’s opioid crisis. Journal of Mental Health and Addition Nursing. Vol 3 (1) , May 2019. https://utppublishing.com/doi/abs/10.22374/jmhan.v3i1.37  

McKay M., Coldwell, M., Graham, S., Upham, K.: Harm Reduction Position Paper. Doctors Nova Scotia (2023) harm-reduction-position-paper2023.pdf 

Websites: 

• Addictions Medicine Consult Service : https://mha.nshealth.ca/en/clients-and-providers/resources-providers/addictions-medicine-consult-service  [accessed May 12, 2025] 

• Canadian Centre for Substance Use and Addiction: Lived and Living Experience | Canadian Centre on Substance Use and Addiction [accessed March 17, 2025] 

• Nova Scotia Health: What is Harm Reduction. Harm reduction | Nova Scotia Mental Health and Addictions [accessed March 17, 2025]