Biographical note

The beneficial medical properties of cannabis plant (Cannabis sativa L.) are widely recognized. Yet the plant is still listed in the most tightly restricted category reserved for illict  drugs that have "no currently accepted medical use". This status has prevented the medical use of cannabis and relevant research and triggered the debate between government officials on one side, and active members of civil society, patients and individual doctors  on the other side, whether to legalize the production, possession and use of the plant for medical purposes.

Public health is what we, as a society, do collectively to assure the conditions for people to be healthy, happy and feel-well. It refers to "the science and art of preventing disease, prolonging life and promoting human health through organized efforts and informed choices of society, organizations, public and private, communities and individuals." In many countries public health is already  providing leadership on matters critical to medical cannabis and  health and engaging in partnerships where joint action is needed. Also, it helps  shaping a  research agenda and stimulating the generation, translating  and dissemination of the  relevant knowledge and  articulating ethical and evidence-based medical cannabis policy options.  Human rights lens also inform the decision making processes and development of optimal medical cannabis policies. Human rights are often divided between those that protect individual, civil and political rights on the one hand,  and economic, social, and cultural rights on the other. Human rights perspective recognizes, among others,  the right of everyone to the highest attainable standard of physical and mental health and well being, including the right to treatment with medical cannabis and necessary  services.

However, in most countries, including Slovenia, medical cannabis policies are still the product of controversy and  remain surrounded by controversy as they are implemented.  Related ethical issues  pose many moral and social  dilemmas rather than  black and white moral questions.  The scientific considerations blend with political and ethical conflicts, questions of public and  individual rights are central and scientific evidence should become imperative to inform appropriate regulation and prescription of the plant.  Public health ethics requires careful balancing between individual interests in personal (e.g., autonomy, privacy, and liberty) and economic (e.g., contracts and property) freedoms on the one hand and collective interests in health safety and security on the other.   

Part of the public (society)  already recognizes that cannabis prohibition clearly causes more harm than good. Many individuals and groups began advocating for effective government regulation of cannabis. Until recently, many medical doctors have been reluctant to publicly voice their opposition to the prohibition of the plant. But through scientific evidence and measuring patients’ experiences many doctors and other health professionals had recognized that prohibition was ineffective and harmful. One of the most egregious outcomes of cannabis prohibition was  that many sick people could not  legally  access the medicine that could work best for them. At the same time, the prohibition  had not  prevented children from accessing the drug and  it had led to the proliferation of  more dangerous synthetic cannabinoids.

This  presentation will not offer clear-cut answers to many of the ethical issues raised. However, it will provide public with many perspectives on the role of public health concerning  medical cannabis . For example: What is the meaning of the most common  concepts in public health, such as:  population,  risk, harm, and benefit in the context of medical cannabis ? How does the population perspective differ from the individual perspective? When it is necessary and appropriate to intervene to protect human rights? And when it is necessary and appropriate to intervene to protect the public’s health? Are factors such as risk, effectiveness, cost, burdens and  fairness  the best ways to evaluate public health interventions ? To what extent should social justice be an advocating value in public health? It is essential to recognize that scientific and ethical arguments about the cannabis prohibition and access to medical cannabis have to be joined to political solutions. This may help us think more clearly and constructively about the medical cannabis challenge that will affect many types of health and social issues common with many people and life in communities.

The  presentation will provide many thoughts by both  authors and some conclusions by first autor with which not everyone will necessarily agree but which can open dialogue with others.