THE ETHICS OF EXPERIMENTAL HEROIN MAINTENANCE

In response to widespread concern about illegal drug use and the assoc iated risk of the spread of HIV/AIDS, a study was undertaken to examin e whether it was, in principle, feasible to conduct a trial providing heroin to dependent users in a controlled manner. Such a trial involve s real ethical issues which are examined in this paper. The general is sues examined are: should a trial be an experiment or an exercise in p ublic policy%; acts and omissions; countermobilisation; termination of a trial, and payment for drugs and for a trial. The specific issues e xamined are: selection of trial participants; privacy; issues for staf f working on a trial; coupling the trial with other treatment, and iss ues for researchers. A number of alternative approaches to the various ethical issues are presented and discussed.