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Free Will From the Neurophilosophical Perspective

et al. (2010) deontological justification of HAT who would have access to treatment and who would pay. Their argument for the “right to injectable heroin” suggests that they would advocate more liberal use of HAT among opioid drug users. But providing HAT as a first-line treatment to anyone seeking treatment for heroin dependence would further reduce the numbers of individuals who could be treated. It would also potentially expose individuals to the harms arising from regular injecting heroin use who might have otherwise responded to standard forms of treatment. Lack of access to treatment for opioid dependence is already a major problem in most developed countries. Patients can wait several months to get into OST, even in countries with well-established programs (e.g., Europe, Australia, and Canada). The provision of HAT to 5–10% of addicted heroin users would significantly reduce the ability of treatment systems to provide oral OST to the vast majority of patients (Lintzeris 2009). A case therefore needs to be made that it is ethically acceptable to use limited health care resources to provide a more expensive treatment for a minority of patients at the expense of providing cheaper treatment that benefits many more. We believe that the inability to provide safe and effective treatment to all those in need is a more significant challenge than a putative right to injectable heroin treatment programs. A complete analysis of the ethical acceptability of HAT therefore needs to go beyond the right of individuals to access it, to consider the impact that its provision may have on access to effective treatment for the majority of opioid-dependent individuals.