Heroin prescription and biomedical ethics

Due to increasing public health and social issues as secondary problems of opiate dependence (e.g. mortality, risk of HIV- and hepatitis infection, hi gh rate of criminal activities) heroin prescription to opiate addicts has b een suggested. Scientific data do not yet allow a solid evaluation of this treatment. As generally accepted, the main criteria for an ethical evaluati on of new treatments are a) beneficence (duty to help patients further thei r important and legitimate interests), b) respect for the patient's autonom y and c) social justice in the allocation of the limited resources of the h ealth care system. Ethical problems of heroin prescription relate to the di fferentiation between medical concern for the individual patient's health a nd the public interests in reducing social problems, the problematic capabi lity of addicts of a balanced evaluation of heroin prescription and oeconom ic considerations of the costs of heroin prescription in comparison with ot her forms of treatment of opiate addiction, especially methadone maintenanc e treatment.