Ethische Aspekte der aktuellen Rechtsprechung in der Substitutionsbehandlung

Definition of the problem

Although maintenance therapy is known to increase the health status and to simultaneously decrease criminal behaviour of opiate-dependent patients, German legal regulations interfere with this therapy by ordaining not only the therapeutic goal (abstinence) but also therapeutic procedures that aim to control patients’ therapeutic compliance. German physicians who did not strictly adhere to these regulations were frequently sentenced to imprisonment.

Arguments

As the article shows, the current regulations mislead in achieving goals like the protection of the community regarding the illegal “marketing” of opioids and simultaneously impact the physician–patient relationship of maintained patients by facilitating control instead of motivation and confidence.

Conclusion

Reaching the goal of protecting the public from illegal and potentially dangerous opiates cannot be achieved by restrictive regulatory frameworks. Necessary control mechanisms regarding maintenance therapy should focus on patients’ health instead of the adherence to abstract legal norms.