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Using ignorance to know if mandatory drug testing laws are sound

16 Comments
Daniel Fleming |  13 August 2017

 

Sometimes ignorance can be a virtue in political decision-making. The great 20th century political philosopher John Rawls had a thought experiment called the 'Veil of Ignorance' which he suggested should be applied to any political decision to test whether or not it is just.

xxxxxAn adapted form of the experiment functions like this: shut your eyes and imagine that you’ll wake up tomorrow with the legislation passed and enacted and, crucially, you are no longer yourself, but someone else for whom the legislation will have a concrete impact. If, after doing this, you can honestly say that the legislation serves the interests of the common good, then it is just. If not, it may be that it is serving other interests or ideologies.

In a few weeks, legislation will be voted on which would result in a trial of mandatory, randomised drug-testing of new welfare recipients. In part, the stated goals of the legislation are to prevent income support payments funding prohibited substance addiction and “that people in these situations are given every assistance to improve their lives.”

These may seem like reasonable motivations but those voting on the legislation might use the Veil of Ignorance to consider whether it will have its desired effect and promote the common good. An MP voting on the legislation might imagine opening her or his eyes in the following scenario, in which they awake as Jeff, a 28 year old diagnosed with a clinical addiction to methamphetamine.

Jeff has been in treatment for a year, has been holding down a job at a local supermarket during this time, and has a dependent child. Two weeks ago he had a relapse following a stressful encounter with his ex-partner, lost his job, and he and his clinicians are now working on getting him back on track.

Jeff is confident that he’ll be able to get back to work, but for now he needs income support to pay for the basics: rent and food. On arriving at Centrelink, he is informed he’ll need to undertake a mandatory drug test.

He stresses out and leaves, knowing it’ll come back positive given his recent relapse. He cannot pay his rent, nor afford food for his daughter. He relapses again. His clinicians attempt to support him, but since Centrelink won’t accept clinical addiction to a prohibited substance as a reason to look favourably on Jeff’s situation, their hands are bound. He and his daughter are now homeless.

Or, an MP might imagine opening her or his eyes as the CEO of a for-profit drug testing company, whose bottom line has dramatically increased as a result of the legislation being enacted.

 

"The Veil of Ignorance might have uncovered that the legislation won’t serve its purpose after all, thereby suggesting that there might be better ways to give every assistance to people suffering from addictions."

 

Or, perhaps they might imagine opening her or his eyes as a specialist in addiction medicine who is in charge of a clinic. The clinic’s already busy clinical schedule is now being over-loaded with referrals from Centrelink from clients who – following their drug test – are required to undergo treatment as a condition for their benefit.

The clinic has had great success in the past, primarily because the patients they see have come of their own volition and because clinicians are able to cultivate a relationship of trust with them. Staff are now finding it harder to treat new arrivals, and every now and then when one of them relapses they’re getting used to hearing this plea: 'please don’t let them know – I can’t afford to lose my benefit'.

The specialist is not sure what to do – bound by legislation to let Centrelink know on the one hand, but knowing this will undermine the trust that is essential for care to be effective. The specialist has had to put on extra administrative staff to deal with the new reporting requirements for these patients and yet they have received no new funding to manage the influx.

After undertaking these exercises, if the MPs who are to vote on this legislation are satisfied it really does serve its stated goals, then they can proceed confidently. If not, the Veil of Ignorance might have uncovered that the legislation won’t serve its purpose after all, thereby suggesting that there might be better ways to give every assistance to people suffering from addictions.

 


Frank BrennanDaniel Fleming is Group Manager, Ethics and Formation, St Vincent’s Health Australia.

 


Daniel Fleming


Comments

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Submitted comments

So your point is that when laws are considered, they must not have a negative effect on someone with 'a clinical addiction to metamphetamines ... with a dependent child ...' and his own clinicians. Is it any wonder people regard Abbott and Bernardi as the great hopes for the country?

Frank 14 August 2017

I think there is little doubt that politicians 'being hard on drug users' in this particular instance are pandering to misguided public opinion. It also makes politicians feel powerful in that they are controlling people's lives. Income support is one of the necessary protections in a caring and civilised society. I know there are many - not the majority - who misuse and abuse it. There are sensible ways of dealing with that. I think we need a new approach to drug dependence - including prescription drugs - in this country. There is a nexus between illegal drugs and organised crime in this country and those criminals are bad, bad people. That nexus needs to be broken. The decriminalisation, even legalisation, of marijuana and the provision and medical supervision of safe injecting rooms for registered addicts would be a good start.

Edward Fido 14 August 2017

I must admit, until today, I have been ignorant about the 'Veil of Ignorance'. The case of Jeff is probably all too common and has resulted in homelessness for two vulnerable people, Jeff and his daughter. When attempting to help people by our own rules, it may be wise to understand our own ignorance.

Pam 14 August 2017

Thanks heaps, Daniel. An illuminating way to introduce the Veil of Ignorance test for whether policy decisions are just or not! Law-makers tend these days to give instant priority to populist knee-jerk reactions against complex and unprecedented supposedly negative social phenomena, such as the sudden and sustained appearance of a large number of asylum-seekers on our doorstep. John Howard was responsible for embedding this deplorable practice with his failed War on Drugs initiative, later to gain a firm foothold in his refugee turnback policy and now on shameless show throughout the Trumpian political world. One of the most egregiously but hidden unjust side effects of a populism that reduces democracy to its lowest common denominator instead of privileging a reflective and cautious resort to a stone-cold and sober consideration of consequentialism! By way of common good enhancing contrast, witness the wise leadership of Chancellor Merkel to asylum-seekers, when she urged her constituents to consider them as a gift to her country in the form of a boost to its inexorably declining population, especially in its younger and able-bodied demographic categories.

Dr Michael Furtado 14 August 2017

Good morning Dan. Congratulations on the new job ! Catholic Health Care can only improve ! Looking forward to your assessment of the potential pitfalls in applying The Veil of Ignorance.

john frawley 14 August 2017

"they must not have a negative effect on someone with 'a clinical addiction to metamphetamines ... with a dependent child ...' and his own clinicians." That seems to be a pretty good start for considering the effects of public policy - that it won't cause harm to citizens.

ralph 14 August 2017

I worked in drug rehab for 18 years & am now over 31 years drug free I know what works & it definitely not forced treatments how about putting more money into treatment centres & decrease the long wait for those that want to change

sue clegg 14 August 2017

Congratulations, Dr Furtado, on a couple of brilliant candidates for the title of'Sentence of the Year'.

Gavan 14 August 2017

I think you've missed the point of the article, Frank. Daniel is asking us to consider what might be called the collateral effects of proposed legislation before enacting it. And as Edward points out, despite the stated objectives, this proposal is as much about 'being hard on drug users' - especially if they can be characterised as 'dole-bludgers' too - as anything else. If the minister was serious, he would be proposing mandatory random drug testing of all recipients of government support including those receiving child care subsidies, aged pensions, student loans, parliamentary pensions, etc. Surely we don't want public funds funding their addictions either?

Ginger Meggs 14 August 2017

A great, spot-on article, Daniel Fleming. Drug addiction is a health problem not solved by our government's attitude that stigmatisers users and offers no real help, empathy or compassion.

Annette Culley 14 August 2017

A great topic to open debate. Like Frank, I also have a reaction thinking it reasonable that people who receive income benefits satisfy intoxication rules. Whilst it will have a deleterious effect on some, it strikes as a highly reasonable hurdle for people to jump and to continue to jump. Are we actually not helping the drug affected in this instance make the right decision ? Light the pipe and lose job, benefits and ability to care for dependent ( presumable a young child ) or light the pipe again and again and again with no increasing pressure. Legislated rules are by their very nature imperfect. One size does not fit all. We have to ask ourselves: what is the goal we are working towards ? The answer is a deceased rate of drug dependence. We don't move toward that goal by making it easier for people to be drug dependent. We should continue to tighten these benefit frameworks and I think, happily most Australians will agree. Love isn't always easy.

Patrick 14 August 2017

Precisely, Patrick. A pitfall perhaps, Dan?

john frawley 15 August 2017

You're probably right, Patrick, most Australians would agree, but is that the correct ethical yardstick? Why should drug-addiction be a crime for some CentreLink clients but not a crime for people like us? And where is the evidence that such laws actually work for the true-good of those targeted rather than for the feel-good of majority?

Ginger Meggs 15 August 2017

If the one without sin is casting the first stone and suggesting punitive measures, let's take it all the way and impose strict regulations to wean our governments, financial institutions off addiction substances and activities too - ie, gambling taxes, pokie revenue, banks laundering proceeeds of drugs crimes. People on welfare payments can hardly afford to buy the amount of drugs required to become hardened addicts without being involved in criminal activity at some level - and now we know that the CBA was/is involved in that. And if that's what we now know, imagine what we don't know!

AURELIUS 15 August 2017

This is a dreadful policy, but I am not sure a Rawlsian approach is required to understand why. What is wrong with our own ethical tradition? Consider the question in light of the proposition that one cannot do good by evil means. If, on the facts you state, it is known that a man and his daughter will lose their housing and ability to eat consequential upon such a policy then it is not a permissible policy. Even if there were no child, the fact that it might be legitimate for there to be consequences to drug use, it is not legitimate that those consequences involve homelessness and starvation. Sometimes I am ashamed to be a Liberal.

Adrian 17 August 2017

Thanks Daniel. This is a useful exercise which should prevent us from rushing into some apparently attractive, but ultimately destructive course of action. However, it doesn't give us any way of balancing the respective positives and negatives that arise from any course of action. Its value is also limited by our imagination. What if we just don't think of some of the positive or negative effects that will follow from a given course of action?

Roger 18 August 2017

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