[Acceptability of harm reduction interventions: contributions of members of the population to the debate about public health ethics].
OBJECTIVE
To explore convergence and divergence in ethical stances of public health and of members of the population regarding acceptability of harm reduction interventions, in particular needle exchange programs.


METHODS
Forty-nine semi-structured interviews were conducted with French-speaking residents of Quebec City. Content analysis was done to explore the views of the respondents with regard to injection drug users (IDUs) and interventions addressed to them, as well as Quebec policies on harm reduction.


RESULTS
Four main categories of social representations about IDUs have emerged from the discourses of the respondents. IDU were represented as: suffering from a disease (n = 17); victim of a situation that they could not control (n = 14); having chosen to use drugs (n = 12); or delinquent people (n = 6). Those social representations were associated with different ethical stances regarding acceptability of harm reduction interventions. Main divergences between respondents' ethical positions on harm reduction and public health discourses were related to the value of tolerance and its limits.


CONCLUSIONS
The Quebec City population interviewed in this study had a high level of tolerance regarding needle distribution to drug addicts. Applied ethics could be a useful way to understand citizens' interpretation of public health interventions.
Dubé
Eve
E
Institut national de santé publique du Québec, Québec. eve.dube@ssss.gouv.qc.ca
Massé
Raymond
R
Noël
Lina
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D055030:Drug Users / Q000523:psychology; D005260:Female; D006078:Government Programs / Q000941:ethics; D040261:Harm Reduction / Q000941:ethics*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D018671:Needle-Exchange Programs / Q000941:ethics*; D011634:Public Health / Q000941:ethics*; D011639:Public Opinion; D011792:Quebec; D011049:Social Control Policies / Q000941:ethics*; D015819:Substance Abuse, Intravenous / Q000382:microbiology; D055815:Young Adult