title: Is groin injecting an ethical boundary for harm reduction?
abstract: BACKGROUND
  Femoral vein (or groin) injecting by street drug users is an emerging public health issue in the UK. It has been proposed that groin injecting is becoming normalised among UK injecting drug users (IDUs), yet harm reduction strategies are currently piecemeal and some may be crossing the boundary of responsible provision of information. This paper discusses the interventions available to service providers dealing with groin injecting and explores the utility of ethical frameworks for informing service provider decisions.
  
  
  METHODS
  Methods analysis of possible service provider responses using White and Popovits' ethical decision-making framework.
  
  
  RESULTS
  The use of ethical frameworks suggest that different types of groin injectors should receive different interventions. Injectors for whom the groin is a site of 'last resort' should be given information about how to inject there less dangerously, whereas 'convenience' groin injectors should be actively encouraged to inject elsewhere.
  
  
  CONCLUSIONS
  Groin injecting is a behaviour which represents a boundary for some harm reduction practices (such as providing 'how to' booklets to all injectors) as well as being an argument for more complex and environmentally appropriate harm reduction responses such as drug consumption rooms and training IDUs to maintain healthier injecting sites.
authors.affiliation: National Addiction Centre, Institute of Psychiatry, King's College London SE58AF, UK. P.Miller@iop.kcl.ac.uk
authors.forename: Peter G
authors.initials: PG
authors.lastname: Miller
authors.forename: Nick
authors.initials: N
authors.lastname: Lintzeris
authors.forename: Luciana
authors.initials: L
authors.lastname: Forzisi
mesh_terms: D001291:Attitude of Health Personnel; D002755:Choice Behavior; D003661:Decision Support Techniques; D055030:Drug Users / Q000523:psychology; D005268:Femoral Vein; D006119:Groin / Q000098:blood supply*; D040261:Harm Reduction / Q000941:ethics*; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000941:ethics* / Q000523:psychology; D006297:Health Services Accessibility; D006801:Humans; D007275:Injections, Intravenous; D010353:Patient Education as Topic / Q000941:ethics; D026684:Personal Autonomy; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000523:psychology