The B.C. Court of Appeal has taken it upon itself to redefine health care in Canada.

A recent ruling on the legality of Insite, Vancouver’s safe injection site (SIS), shows the court believes that offering destitute drug addicts a safe place, clean needles and medical supervision so they can inject themselves with illicitly obtained heroin and cocaine—the same toxic drugs that are actively destroying their bodies and their lives—is a “health care service.”

Further, because Insite offers “health care programs,” it must be classified as a “hospital” that is under the jurisdiction of the provincial government. As such, the court dismissed the federal government’s challenge to close the injection site.

The court is obviously getting its medical advice from the Jack Kevorkian Book of Proper Patient Care.

While the rest of the world thinks that health care refers to taking active steps to ensure health, B.C. now views health care as a service that, slowly and over time, ensures the physical, psychological and social destruction of an individual.

But the social devastation that stems from this ruling extends far beyond individual drug addicts. The federal government’s attempts to control the illicit drug trade will be severely undermined as the court naively turns a blind eye to the fact that the drugs have been purchased from drug traffickers with money obtained through criminal activity. Thus, the open drug trade of the downtown eastside will expand, crime rates will remain high and criminals will continue to profit.

It’s particularly distressing that only one of the three appeal judges had a problem with this. In a dissenting opinion, Justice Daphne Smith wrote that the very premise of Insite conflicted with the federal criminal laws regarding the distribution, sale and use of drugs in Canada and “eviscerate(s) the efficacy of a criminal law” that seeks to deal with illicit drug use.

This twisted definition of health care necessarily precipitates a similarly twisted redefinition of the roles played by service providers involved with Insite. Medical personnel who were trained to heal now make do with facilitating—not treating—drug addiction in their “patients,” a distinct violation of the medical profession’s founding oath to “first do no harm.” The 65 policemen who patrol the area surrounding the SIS were trained to uphold the law, yet are now prohibited from charging drug addicts. Instead, they are duty-bound to escort addicts to the injection site so they can carry out their illegal activities.

The decision by the Appeal Court could also open the door for SIS’s to be established in other centres, so even more Canadians can bear witness to this bizarre legal and medical circus. The non-profit society that operates Insite has approached the federal government for a legal exemption to operate a crack-cocaine inhalation room. Now that the B.C. courts have ruled that Insite is out of the federal jurisdiction, it’s likely these facilities will soon be available. Given the health care benefits of such “hospitals,” it’s a real shame that Vancouver shut down the opium smoking rooms that, decades ago, were so prevalent in the city.

Insite began as a pilot project in 2003 with a temporary exemption from federal drug laws. This exemption has been extended several times, but the current court battle began when the Harper government announced that it was no longer prepared to facilitate the use of drugs.

A 2008 report by an Expert Advisory Committee estimated that Insite saves one drug overdose death per year. It reveals that only three per cent of addicts are actually referred for treatment, despite numerous claims that Insite serves as a means to interact with addicts and get them into treatment. Even more disturbing is that only five per cent of drug addicts use the site; 18 per cent of those account for the vast majority of visits (86 per cent) and less than 10 per cent use it for all injections. In other words, taxpayers are spending about $3 million per year to maintain about one per cent of all downtown addicts in a pharmacological stupor.

Surely our society has the common sense and compassion to do better than that.

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