Prohibited substance regulation and compliance testing: A principalism approach

IF 0.5 Q4 MEDICAL ETHICS

South African Journal of Bioethics and Law Pub Date : 2020-12-15 DOI:10.7196/SAJBL.2020.V13I2.00711

J. Laurens, P. Carstens

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Abstract

Abstract: Background : Prohibited substance regulation and compliance testing programmes are required to minimise risks to health and safety in the workplace due to inappropriate use of legal (alcohol, cannabis) and illegal substances. A compliance drug test is in principle an invasive biomedical intervention which infringes on the autonomy and other rights of the individual giving rise to ethical dilemmas. Objectives: The principalism approach by Beauchamp and Childress was employed to reason and motivate for the minimum ethical requirements for this type of biomedical intervention. Methods: The ethical aspects relevant to the mandatory guidelines of the Substance Abuse and Mental Health Services Administration of the United States of America (SAMHSA) protocols and procedures were extracted and interpreted with reference to the principalism approach. Results : The principalism approach was found to be highly applicable to the ethical requirements of a prohibited substance regulation and testing programme. Conclusion: Ethical dilemmas could be explained and motivated by using the four principles of respect for autonomy, beneficence, non-maleficence and justice as a starting point.

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禁用物质法规和合规测试:一个原则的方法

摘要:背景:为了最大限度地减少因不适当使用合法(酒精、大麻)和非法物质而对工作场所健康和安全造成的风险，需要禁用物质法规和合规测试方案。依从性药物测试原则上是一种侵入性生物医学干预，侵犯了个人的自主权和其他权利，造成道德困境。目的:采用Beauchamp和Childress的原则方法来推理和激励这类生物医学干预的最低伦理要求。方法:对美国药物滥用和精神卫生服务管理局(SAMHSA)协议和程序的强制性指导原则中涉及的伦理问题进行提取，并参照原则主义方法进行解释。结果:发现原则方法高度适用于禁用物质监管和测试计划的伦理要求。结论:以尊重自主、仁慈、无害和正义四项原则为出发点，可以解释和激发伦理困境。

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