PubMed · 11496577
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W Kanapaux. 2001. ECT: the debate returns.. https://pubmed.ncbi.nlm.nih.gov/11496577/
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This paper argues that cash incentives offered to drug addicts in return for sterilisation are both legally and morally unacceptable. Such incentives act coercively, undermines one's freedom and autonomy and importantly invalidates real consent. This has important implications for any clinicians involved in such a scheme. The paper prompts more detailed studies into the use of incentives in modern-day health care.
The Minister of Health, Welfare and Sport and the Minister of Justice requested advice from the Health Council of the Netherlands, on options for the treatment of detainees addicted to drugs. It is estimated that 15,000 to 23,000 people per year with addiction problems are detained. On the basis of the Custodial Institutions Act detainees have the right to adequate medical, psychological and psychiatric care, including treatment for drug addiction. The legal possibilities for using compulsion in the treatment of addicted persons in detention are very limited. A consensus needs to be reached on methadone medication; professional groups must reach this consensus. As well as abstinence, Addiction Support Sections should aim to achieve harm reduction, for example, by means of stabilisation with a maintenance dose of methadone. The success of interventions among addicted detainees is largely dependent on both the introduction of pressure in the area of follow-up care and the continuity of care. Bearing in mind the frequent psychiatric comorbidity, more psychiatric care should be available within the penitentiary setting. The Penal Care Facility for Addicts [Dutch acronym: SOV] is a new sanction option in the Penal Code with which drug-addicted repeat offenders can be involuntarily admitted to a drug addiction treatment centre for a maximum of 2 years. There is not enough scientific evidence to support the effectiveness of the SOV approach. The compulsory placement of an addict in the SOV could reduce the addict's motivation to do something about his addiction problem. SOV is a harsh sanction that should only be used once lighter sanctions (based on pressure by means of special conditions) have been shown to be ineffective for the persons concerned.