The limits of equivalence: Ethical dilemmas in providing care in drug detention centres

This article considers the phenomenon of detention centers as a purported means of drug treatment, common throughout much of Asia. It describes the growth of the drug detention center model over the past decade – a system where people suspected of using drugs are rounded up on suspicion of drug use or a positive urine screening, and sent to closed settings without due process or means of appeal. Inside, detainees receive no effective drug treatment, little medical care, and insufficient food. Indeed, they are more likely to face what amounts to torture, cruel, inhuman, and degrading treatment. In some countries, they are forced to work or face severe punishment.

This article explores the ethical dilemmas inherent in providing care within an abusive system. For organisations offering health education, food, or even lifesaving medical care inside drug detention centers, what are the limits of providing ethical care, without risking legitimising the system or building its capacity to detain more people? We explore how organisations might weigh the risks and benefits of their engagement.