Is the legalization of medical marijuana morally sound? There are two opposing positions: for the legalization of medical marijuana and against the legalization of medical marijuana.
Those in favor of legalizing medical marijuana believe it is an appropriate therapy in treating certain severe illnesses in which other legal therapies have been ineffective and/or created intolerable side effects. This side of the argument disagrees that the general population will be more likely to engage in illicit drug use if medical marijuana is provided to patients as a palliative therapy. This side also disagrees that marijuana is a gateway drug leading to use of harder drugs. Legal argument is based on California’s Compassionate Use Act of 1996.
The argument against legalizing medical marijuana believes that as a Schedule I drug, as defined in the Controlled Substances Act, it is harmful, addictive and leads to more harmful drug use. Another belief held by this group is that legalization may lead to the belief that recreational use of marijuana is acceptable and may be good for your health. Legal argument is based on the Controlled Substances Act.
After studying articles for this paper I suggest the legalization of medical marijuana is not morally legitimate. Scientific research can be conducted without legalization. The evidence showing detriment of marijuana use outweighs anecdotal evidence as a palliative medical therapy. The risks to society outweigh the benefits to be gained by the few. This is not to suggest that those who suffer terminal illness could not benefit from medical marijuana. However it is important to evaluate the drug and its use very carefully before broad medical use is available—especially if that will lead to legalization of recreational use. It is my attempt to use the premise of moral realism to examine the moral legitimacy of medical marijuana.
Identify the Problem
Is the legalization of medical marijuana morally sound? Marijuana is classified as a Schedule I drug as defined by the Controlled Substances Act. There are people suffering debilitating illnesses, such as AIDS wasting, nausea caused by chemotherapy treatments in cancer patients, and rheumatoid arthritis, claiming that marijuana has a palliative effect. There is little scientific study of marijuana to substantiate these anecdotal claims. Proponents of medical marijuana cite folk legend and historical use as reason for legitimacy. Those against the use of medical marijuana cite the legal status of the drug and problems associated with drug addiction. The problem of medical marijuana is important because if it is proven to be a palliative medical treatment, reconsideration of the drug’s status would be required. If Congress reassigned the status of marijuana to a Schedule II drug, it could be regulated and possibly taxed. Regulation would alleviate fiscal strain of fighting illegal use. Taxation would provide state and federal income in the form of an excise tax. If medical marijuana is proven to not be a valid medical treatment, a Schedule I status could remain with justification of scientific evidence and a reasonable control policy could be established.
Clarifying Concepts is a section for defining terms the reader is likely unfamiliar with; most of this information has either already been relayed or is more appropriate to other sections of the paper.
Some acronyms used in discussing medical marijuana include: CSA, the Controlled Substances Act; CUA, Compassionate Use Act(s) depending on the state; DEA, the Drug Enforcement Agency; and NIDA, the National Institute for Drug Abuse. A Schedule I drugs is defined as having “both a high potential for abuse and no acceptable medical use” (Dresser, 2009).
Possible Solutions to the Problem
Solutions to the problem include conducting scientific research to determine medical benefits of marijuana and conditions for which it is palliative. Establishing effective controls for regulation of medical marijuana would also be required to prevent it from being funneled into the illegal marijuana market. Effective punishment for illicit recreational use of marijuana would be needed to protect those needing the drug for medical reasons. It is evident that anecdotal evidence of the legitimacy of medical marijuana is not enough to change the classification of medical marijuana from a Schedule I drug to Schedule II. “Medical marijuana should be subjected to the same scientific scrutiny as any drug proposed for use in medical therapy, rather than made legal for medical use by popular will” (Christensen, 2004). The Congressional mindset surrounding marijuana is a significant obstacle to studying scientific study. Cooperation with realistic controls is needed. Concern that legalization of medical marijuana will lead to increased recreational use must also be addressed. Current state laws allowing medical use of marijuana contain vague language that makes adequate control of the substance difficult and also leaves patients, physicians and suppliers vulnerable to prosecution.
Assumptions and Points of View
Proponents of medical marijuana believe they have the right to use a drug of choice that adequately addresses their medical needs. Marijuana is believed to have a palliative effect. Opponents cite the illegal status of the drug and consider it a gateway drug. As such, it is believed that legal medical use will increase illegal recreational use.
There is anecdotal evidence that has “demonstrated that the drug is safe and effective in controlling nausea and other adverse effects of chemotherapy, relieving multiple sclerosis-induced spasticity, easing certain types of pain, and ameliorating weight loss accompanying AIDS” (Cohen, 2010). Additionally, proponents cite the high costs of controlling marijuana. From an economic standpoint for President Carter noted “that ‘penalties against the use of a drug should not be more damaging to an individual than the use of the drug itself…nowhere is this more clear than in the laws against the laws against the possession of marijuana’” (Wodak, Reinarman, Cohen & Drummond, 2002). There is also the argument that definition of harm when discussing medical drug treatments is “a relative, not an absolute concept” (Block, 1993) when examining potential benefit to potential harm. When considering harmful substances, legal tobacco and legal alcohol are considered to have much more adverse health and social affects. Legalization could funnel money now currently used fighting illicit use into education and treatment of drug abuse. It is also thought profits from illegal sale would disappear (Block, 1993).
Opponents consider marijuana a gateway drug and that accepted medical use will increase recreational use (Cohen, 2010). Mental illness, psychosis and depression have been linked to use of marijuana along with risk of schizophrenia. It is not know if marijuana causes these conditions or if it exacerbates the condition in people with predisposition to the illnesses. “Length of exposure to use of cannabis predicted the severity of the psychoses…not explained by use of other drugs” (Rey & Tennant, 2002). Educational campaigns used to curtail tobacco smoking point to its health hazards, but no such campaign is in place to show smoking marijuana has similar health hazards. Smoking marijuana can be more hazardous than tobacco due to the fashion in which it is inhaled. “Smoking cannabis entails a two thirds larger puff volume, a one third larger inhaled volume, a fourfold longer time holding the breath, and a fivefold increase in concentrations of carboxyhaemoglobin” (Henry, Oldfield & Kon, 2003). Individuals smoking marijuana habitually and long term have the same potential risk involved in smoking tobacco including damage to the heart and lungs.
It is understood that there are political barriers preventing scientific study of marijuana. However, it is worth considering that marijuana has an illegal status for more than just political reasons. There are medical reports showing a link between marijuana use and depression and psychosis. Kantian ethics see this as part of the reasoning process to determine medical marijuana is not morally legitimate. Duty to follow the law is “the nature of the obligation” (Waller, 2008, p. 23). Feelings about its legitimacy are not part of the thought process. Utilitarianism emphasizes pleasure but is also interested in minimal suffering. A policy of moderation is probably best in addressing the issue. Lung disease and cardiovascular disease are issues present with smoked marijuana. In issues of AIDS wasting and cancer treatment, it is possible marijuana is simply another drug being prescribed for the dying. But without the reasoning prompted by scientific data, the drug is illegal and can lead to legitimate health problems.
There are laws in some states allowing the use of medical marijuana. Anecdotal evidence suggests it is beneficial for patients living with cancer and chemotherapy treatments, HIV and AIDS wasting, and other conditions in which there is pain and other legal treatments have not been helpful or have created undesirable side effects. California, New Jersey and Colorado have Compassionate Use Acts allowing medical use of marijuana. The legal issue in medical marijuana is determining which set of laws has jurisdiction to regulate it as a controlled substance: federal or state. The CSA “makes it unlawful to ‘manufacture, distribute, or dispense, or possess with intent to manufacture, distribute, or dispense, a controlled substance,’ except where allowed” (Muldrew, 2004). Kant’s moral imperative would suggest we must consider marijuana an illegal substance since this is its lawful definition. Social contract theory would also require the same.
Ambiguity is added to the legal status in the current view of enforcing the CSA. The DEA “would limit future raids and other enforcement activity to individuals violating both federal and state criminal law” (Dresser, 2009) with regard to marijuana. This also presents a problem of moral ambiguity to a physician suggesting use of marijuana to his/her patients. The physician is less likely to suffer criminal charges in breaking federal law if he/she is complying with state laws which allow medical use. Add to this the imperative a physician has to care for patients and provide any and all possible therapies and a moral decision must be made regarding medical care and the law. Since there is lack of scientific research, physicians are further burdened in rationalizing use of marijuana in weighing physical and psychological side effects of an illegal substance against possible palliative benefits.
Legal concerns are made worse when there is difficulty determining if cultivation and dispensing of marijuana is for legal medical purposes or if it is being funneled into the illegal drug market. There is regulatory failure in the legalization of medical marijuana where there is not with prescription drugs (Barkacs & Barkacs, 2010). An additional legal issue resides within state laws. States that allow medical marijuana allow individual jurisdictions the choice on how to regulate the drug. While business licenses and permits may be granted based on city or county regulations, there is no regulation for the source of the marijuana. Lack of regulation of the source “has led to litigation between regulators, dispensers, producers and their patients” (Ward, 2010).
From a utilitarian perspective, the moral legitimacy of medical marijuana would be decided based on the maximization of pleasure and minimization of pain. Act-utilitarianism would look at this argument from an individual perspective. Rule-utilitarianism would look at this argument from a societal perspective. Medical marijuana is supposed to provide relief to patients suffering certain diseases and/or ease suffering from medical treatments. However, as an illegal substance, there is greater concern for drug trafficking and cartels involved in the illicit distribution of marijuana. Since there is no regulatory practice for cultivation and distribution—regulating the source—there is no method of prevention of medical marijuana being funneled into the street sale of drugs. Additionally, in state CUA’s in which medical marijuana is allowed for any condition in which it is beneficial, there is an available avenue for legal sale of recreational drugs on a state level. This undermines palliative medical use. Prescription drugs are regulated to prevent legal recreational sale.
My opinion is that legalization of medical marijuana is not morally sound. Currently there is greater evidence to support it remaining an illegal substance. Legalization will require a paradigm shift in thinking about the classification of illegal and legal drugs and will require a similar shift in thinking about what is acceptable recreational drug use, as is mentioned in moral realism. But until there is scientific evidence as well as evidence that fair and realistic controls could be put in place delineating legal medical use of marijuana, it will be hard to change the mind of either side of the argument. It is entirely reasonable that marijuana could be regulated for medical use, but illicit use must also be addressed. Medical legalization will not necessarily stop the illegal trade. It is also fair to legitimize medical use through scientific study to validate patients who receive medical benefit from marijuana and the physicians who suggest its use, so that they can be viewed as something other than drug users and drug dealers.
Consequences include medical marijuana not being available to those who find it helpful as well as legal repercussions for patients, doctors and cultivators/distributors. Illegal status could also create continued hindrance to scientific, medical study. Additionally remaining an illegal substance reduces those who use it medically to drug users and the physicians prescribing it to drug dealers. Remaining an illegal substance does nothing to curtail the illicit drug market and keeps costs of enforcing illegal status high and cumbersome.