Academic journal article Journal of Drug Issues

Formalism and Narrative in Law and Medicine: The Debate over Medical Marijuana Use

Academic journal article Journal of Drug Issues

Formalism and Narrative in Law and Medicine: The Debate over Medical Marijuana Use

Article excerpt

The debate over the medical use of marijuana, recently played out in California and of topical significance elsewhere, is often portrayed - by both sides - as a conflict between the forces of rationality against those of emotion. The fact that proponents and opponents are both able to characterize themselves as on the 'right' side of this equation should suggest to us that what is at stake is precisely the meaning of rationality. The author presents the debate on this subject as an ideological struggle about the nature of our society's core values. At the heart of the dispute is a disagreement about what counts as science, as evidence, and as truth. After demonstrating that in the debate over medical marijuana, there are two versions of these concepts being played out, the author goes on to argue that the conflict can be resolved by exploring deeper those philosophical elements which are common to both sides. Characterizing the philosophical disagreement as one between those who value public good' and those who, on the contrary, value private freedom,' Manderson concludes by focusing on the pain which the medical use of marijuana is said to relieve. The control of pain is both a public benefit and a private advantage and, therefore, is an aspect which, the author believes, makes a case for the use of the drug persuasive to both sides.


The '30s, saw films like "Marihuana: Weed of Madness." In the `SOs, the U.S. Congress was told it was a drug that incited "many of our most sadistic, terrible crimes ... such as sex slayings" (Inglis 1975: 183; see also Bonnie and Whitebread 1970; Himmelstein 1983: 19-26; Helmer 1975). In the '70s, the New South Wales parliament heard that it was to blame for "a yielding to homosexual advance" (N.S.W. 1976-77-78: 7779-80). So much, apparently, has marijuana wrought.

In the '90s, the debate has been fought on slightly different grounds. Proposition 215(1) amended the Californian Constitution to permit the use of cannabis as a medicine, in particular in cases of glaucoma, and to combat wasting syndrome and as an anti-nausea agent in the treatment of some cancers, AIDS, and MS (Grinspoon and Bakalar 1993; Vinciguerra, Moore and Brennan 1988; Hepler and Frank 1971; Clifford 1983; Consroe, Wood, and Buchsbaum 1975). But to give full effect to this would require the rescheduling of cannabis under the federal Controlled Substances Act, 21 U.S.C. deg 812(b). As a Schedule II drug it would no longer be prohibited in absolute terms. Like a host of substances including morphine, the barbiturates, and so on, it would finally be capable of medical prescription in appropriate cases.

This step has provoked astonishing resistance and hostility. Although such a proposal does not envisage decriminalization of personal or recreational use, let alone legalization, the issue serves as a proxy war for the drug reform debate as a whole. The fear of floodgates and dangerous precedents undergirds the debate. It may be, therefore, that it will be impossible to understand this small skirmish except by reference to the cold war on drugs and its political imperatives. In 1992, the head of the United States Public Health Service, James Masin, declared that we ought not prescribe marijuana to AIDS patients because, "crazed" by the high, they "would be more likely to practise unsafe sex" (The Economist 1992). If this is what counts as reasoned argument from an alleged expert, then it may be futile to take the opposition to the medical use of marijuana as anything other than a strategic opposition to the forces of drug law reform in general.

Questions of politics have been well documented in this area. We are familiar with the ways in which a continuing atmosphere of drug crisis serves the political aspirations of politicians and protects the budgets and power of institutions (Himmelstein 1978; Dickson 1968; Musto 1973; King 1978). We are also familiar with analyses that focus on the ways in which drug laws come to symbolize a broad range of social fears and insecurities (Helmer 1975; Gusfield 1963; Becker 1963; Manderson 1995). …

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