Bishops’ Position Challenged Jesuit Says Needle-Exchange Opposition Needs Rethinking

A Jesuit priest is challenging Catholic bishops and President Clinton to rethink their opposition to needle-exchange programs, based on new studies that show the programs prevent the spread of AIDS and don’t encourage drug use.

“A fundamental moral issue is at stake: the failure to save lives,” the Rev. Jon Fuller writes in the cover story of an upcoming issue of America, a weekly Jesuit magazine.

Every day, 33 more Americans are infected with the AIDS virus through sharing dirty needles, according to Clinton’s AIDS council.

There are approximately 120 needle-exchange programs in the country, including Spokane, where 109,000 clean needles were handed out last year. That’s up from 64,000 in 1996.

Clinton announced earlier this year that federal money won’t be spent on needle-exchange programs, which allow intravenous drug users to trade dirty syringes for clean ones.

The Catholic Church in America has condemned such programs since 1989, the year the bishops published a pastoral letter that encouraged Catholics to develop ministries for AIDS victims.

Both the president and the bishops say handing out needles sends mixed messages about drugs.

“The bishops were concerned that the message being sent would be that IV-drug use could be made safe, and that would be a false message,” said Sister Mary Ann Walsh, spokeswoman for the United States Conference of Catholic Bishops, which sets policy for American Catholics.

“A better approach would be to increase support for outreach and drug treatment.”

As a priest, Fuller is in a unique position to challenge the hierarchy of his own church. In addition to being a medical doctor, he teaches theology and pastoral care to divinity students and serves as assistant director of the Adult Clinical AIDS Program at Boston Medical Center.

In the America article to be published later this month, Fuller said scientific evidence refutes the fear that providing needles encourages drug use.

Citing a 1995 review of the studies by a panel from the National Research Council and the Institute of Medicine, Fuller wrote, “There is no credible evidence that drug use is increased among participants or that it increases the number of new initiates to injection drug use.”

Among the studies presented last week at the 12th World AIDS Conference in Geneva was a report that the epidemic among New York City’s 150,000 intravenous drug users has been brought under control, thanks to a needle-exchange program.

Just under half of the nation’s 40,000 new HIV infections occur among intravenous drug users and their sex partners. Drug users and their partners are the primary source of AIDS transmission to children, mainly through pregnancy, the studies show.

Very few of Spokane’s drug abusers become infected with the deadly disease, and health officials credit the needle-exchange program.

It’s impossible to tell what’s behind the increase in the number of needles being exchanged, said Lynn Everson, one of the Spokane Regional Health District outreach workers who doles out needles, condoms, bleach (used to clean dirty needles) and information.

She suspects it’s a combination of reasons, including the fact that the program is becoming better known among addicts and a resurgence in heroin and methamphetamine use.

“Of course, we would like it if all of our clients were not using drugs anymore,” she said. “But on the way to a healthy life, small changes occur, not just big ones.”

When Spokane’s needle-exchange program started in 1991, there was heavy local opposition from neighborhoods, politicians and law enforcement. The county prosecutor even went to court, saying the program violated drug paraphernalia laws. The state Supreme Court disagreed.

Through it all the Spokane Catholic Diocese was silent.

That’s typical, said the Rev. Rodney DeMartini, executive director of the National Catholic AIDS Network. The official opposition has always been controversial, even among the bishops themselves, he said.

Spokane Bishop William Skylstad was out of the country this week and not available for comment.

Since 1988, the Spokane Diocese has been active in AIDS ministry, sponsoring education programs, a special speaker’s list and an AIDS task force. Catholic Charities worked with several other community agencies to provide housing and support groups for victims and their families.

Donna Hanson, secretary for social ministry in the diocese, said in all that time she has never heard any discussion from the bishop or other Catholics opposing the needle-exchange program.

DeMartini and Fuller hope the America article will inspire individual bishops to support needle-exchange programs where there are none.

In many cities, Catholic Charities already provides a big chunk of the services to AIDS patients and would be in an ideal position to form needle-exchange programs, DeMartini said.

“The Catholic Church has a long and rich tradition of defending human rights and honoring human life,” he said. “So it has an important role to play in preventing the spread of AIDS.”

SIX-PRONG TEST JUSTIFIES PROGRAM, PRIEST SAYS The Rev. Jon Fuller draws upon a Catholic theological tool called the “principle of cooperation” to morally justify needle exchange programs. The six-prong test is used by theologians when faced with the prospect of cooperating with individuals whose goals they don’t fully share: 1. The action in question must be either good or morally neutral. Fuller’s view: Exchanging one needle for another is morally indifferent. 2. The action can’t promote illegal activity. Fuller’s view: Needle exchanges are intended to save lives, not promote drug use. 3. The action itself can’t be illegal. Fuller’s view: Exchanging needles isn’t the same as buying and injecting illicit drugs. 4. The action must be as far removed from the illegal activity as possible. Fuller’s view: Exchanging needles isn’t connected to the act of injecting drugs. 5. Cooperation must be justified by sufficiently grave reasons. Fuller’s view: AIDS is deadly, and intravenous drug users account for almost half of new cases. 6. Assistance offered must not provide the means to conduct illegal activity. Fuller’s view: Since needles are exchanged and not simply handed out, users are already fully equipped to inject the drugs. Fuller’s article is available online at www.americapress.org/fuller.htm. - By Kelly McBride