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So, who's the User?

Cotton, Chris (SAAS) trauma-list@trauma.org
Sun, 16 Jun 2002 16:44:12 +0930

Dave wrote:

I see no inconsistency, other than perhaps that demonstrated by a 
medical professional who takes the stance that illegal drug use is ok, 
so long as you're not shooting up on the job. 

I think I've been pretty clear on the reason for the different treatment 
of alcohol and illegal drugs.  Is it your contention that it's 
acceptable for a medic/nurse/doctor to use illegal substances? 
Personally, I have no interest in working with or associating with drug 
users.  Someone used the phrase "...sneaking around like criminals." 
Very accurate, since that's exactly what they are. 

I have an even stronger aversion to being treated by someone, 
credentials and background notwithstanding, who was high as a kite the 
night before on God knows what. 

Dave Adler, EMT-P 
Editor, Prehospital Perspective Magazine 

and ME says...

Wow, i've seen point and counterpoint on this, but i now think it is getting
a little too heated and probably losing the focus i intended with my
original hypothetical. I genuinely appreciate where Dave and Jeff are coming
from, albeit my personal opinion is somewhat different to theirs. But that's
okay by me - i am interested in their opinions and their stance clearly is
the result of their experiences. For what it is worth though, i know of some
brilliant medical people who are "users" in one form or another who i would
gladly entrust my life to in an emergency. I'm not just saying that. I mean
it. I loathe incompetence - and these people are FAR from that. They are
genuinely, extremely competent practitioners in their fields.

Notwithstanding, i would be mortified if they tried to treat me whilst they
were under the influence of their drugs of choice at the time - irrespective
of whether i thought they might still be competent or not. But, because
these people are professional i know they would never jeapordise their
careers or their patients by doing such a thing. They are too intelligent
and dedicated for that. As for what they choose to do with their own time, i
believe that is their business. I don't believe it is unreasonable to say
that they are well informed of the risks and make calculated judgements on
what they do. I will also go so far as to say that one could find it very
difficult to ascertain that they were indeed users of "illegal" substances.
It is not the sort of thing that they would ever let become an issue in
their workplace - they are not that stupid. 

Try and tell them how and what they should and should not do in their own
time (particularly if they have been discreet in the past) would meet, i
think with protest. Not necessarily at the level one would think - they are
smarter than that. They would target the people who count.

Oh, BTW - sadly, what works for some often may have disasterous consequences
for others. So in this debate so far i recognise that for every smart
practitioner who can use their drugs of choice with discretion and control,
there will be a number who will not be so fortunate and will be unable to
exercise the judgement and control of others. For them ... i would advocate
one chance. A chance that would involve counceling and treatment. If they
still come in to work affected after this, then being removed from general
public contact and temptation would be necessary.


Chris Cotton,
Intensive Care Paramedic
South Australia.