New American Reform Responsa
164. AIDS and Free Needles for Drug Addicts
QUESTION:The spread of AIDS takes place in a number of ways. Among them is through infected needles shared by drug users. Among the suggestions of public health officials has been the providing of free needles for drug users. This somewhat curtails the spread of AIDS. Is it ethical to utilize this method which after all enables drug addicts to continue their habit? Ultimately that habit may be as destructive as AIDS. ( Leonard Silberman, New York NY)
ANSWER: As noted in some previous responsa there is surprisingly little material in the vast responsa literature about the use of addictive drugs (W. Jacob Contemporary American Reform Responsa#82). As you have indicated this is a matter of public policy rather than a specifically Jewish issue. We must ask ourselves what are we trying to accomplish. The free needles may somewhat curtail the spread of AIDS. They do, however, continue the problem of drug abuse, and do nothing to help the addict overcome his/her addiction. Can we in good conscience move along this partial path and ignore the larger question of drug addiction and its harm to the individual as well as the broader society?
The use of drugs whose harmful effect is known has, of course, been prohibited by Jewish law (Pes 113a; Eruv 54a; Nid 30b). No person is to endanger his/her life in any fashion (Deut 4.9; 4.15; Ber 32b; B K 91b; YadHil Rotzeah Ushemirat Hanefesh 11.4; Hil Shevuot 5.57; Hil Hovel Umazig 5.1). Even the use of experimental drugs whose benefit is uncertain has been permitted reluctantly, and only with the full consent of the ill person, and if there is reasonable chance that healing will occur. In this instance an additional factor is created by the involvement of health authorities in the use of drugs. In other words making it easier for those addicted to continue their habit.
Those considerations are negative and would lead us to a negative conclusion. There is, however, another side to this question. AIDS is a fatal disease for which no cure is now known. Individuals who suffer from this syndrome can be helped for some time, but eventually death is certain. Use of drugs may also kill, but it is possible to be cured of this habit and only a serious overdose or very long term use will kill. Most deaths result from side effects of the drugs or crimes connected with drugs. Therefore drugs, although a major evil in our society, are the lesser evil for the individual.
We may therefore defend the providing of free needles to known drug users on the grounds that we are helping them to preserve their lives. They will be less likely to be afflicted by AIDS, and so will not spread this disease to others. Furthermore the possibility of a cure from their drug problems, although unlikely, exists. We may therefore say that in order to prevent a greater evil we will condone a lesser evil, and we do so on the grounds that saving a life permits anything accept murder and adultery. In this instance the life saving factor becomes predominant, and we would condone, albeit reluctantly, the distribution of free needles for this purpose.
If needed, please consult Abbreviations used in CCAR Responsa.