What Kind of Science for What Kind of Decision? The Discourse on a Danish Heroin Maintenance Experiment

Abstract

Following the reports on the Swiss heroin trials, Denmark has experienced a lengthy discourse on a possible Danish heroin experiment. Opponents have criticized the Swiss experiments on methodological grounds: they do not live up to rigid standards of scientific stringency, primarily the demands for a randomized clinical experiment (RCE). The article analyzes the basis for the Danish discourse, maintaining that the RCE design is not adequate for the relevant research questions. Instead, other types of scientific analyses might be applied, e.g., based upon self-selection. It is maintained that the scientific appearance of the discourse is in reality a disguise for moralistic political viewpoints, influenced by the war-on-drugs thinking, which is opposed to any harm-reduction measures that might raise fundamental questions about repressive drug policy. The background for the outcome of the Danish heroin discourse—as opposed to the Swiss and the Dutch—is analyzed in terms of differences in influences and ideology of the national medical “establishments.”