The Ethicist: Should I Tell My Hosts About My Medical Marijuana?

June 3, 2018 by Joshua
in Ethicist

My series answering the New York Times’ Ethicist column with an active, leadership approach instead of an analytical, philosophical perspective continues with “Should I Tell My Hosts About My Medical Marijuana?”.

I have developed a non-life-threatening medical condition that is incurable and has only limited conventional therapy. Symptoms appear at night with torturous pain. The physician-prescribed remedies are not working well. After reviewing online articles and discussion with one physician, I decided to try medical marijuana, which I take in pill form before bed. It has been marginally successful in providing some relief and allowing me to sleep. This is legal in my state, and I have gone through appropriate channels to purchase tablets at an approved dispensary.

I will be visiting a number of friends and family over the summer and have been invited to stay overnight with them — some in states that approve of medical marijuana, others not. Should I inform these people that I will be bringing this substance into their homes? Should I stay in a hotel? In some instances, I will be driving and can lock the drugs in the car, but I will be under their influence in the home at night. Also, if there are children in residence, am I obligated to disclose this information beforehand? The tablets are in childproof containers within childproof envelopes.

I suppose that there is an ethical question, too, about carrying such substances across state lines, which you may opine on as well if you choose. I am not submitting that question.

My response: I recommend a different perspective than asking what others think you should do. There are many choices you can make where you don’t know all the possible outcomes, who will like the results, who might get hurt, and so on.

What should you do? I recommend:

  1. Figuring out what resources you have—relationships, time, etc
  2. Figuring what skills you have and can create
  3. Creating as many options as you can
  4. Considering what outcomes each option will result in
  5. Choosing which option to act on based on those outcomes, evaluating them using empathy
  6. Implement the option you like most
  7. Do the best you can, knowing that problems will arise

The New York Times response:

You need tell your hosts what you’re taking only if the presence of the drugs in their homes, or your behavior under their influence, exposes them to some risk. You surely pose no danger, and the childproof protections for the drugs suggest that children face no real risk of consuming them. Then there’s the theoretical legal risk in states where the possession of your medication is illegal. When it comes to those states, you could consult a lawyer and learn the nature of that risk or just tell your hosts what you’ve told me and let them make the judgment.

The real ethical question here is unaffected by what you’ve told your hosts. It’s raised by the simple fact of your breaking the law, including the federal law that forbids taking even small amounts of medical marijuana across state lines for your personal use. Some scholars argue that we have moral reason to obey the law only if compliance is independently the right course of action. For them, the answer would be: Go ahead. In my view, so long as a law isn’t seriously immoral, it has a general (if overridable) claim to our respect, even when it’s silly. It’s part of an overall scheme of cooperation from which we benefit, and we should do our fair share to sustain it. At the same time, what you’re proposing poses very little serious risk to the fabric of the law; if breaking it is wrong, it isn’t very wrong.

I am 65 and have been close friends with “Elle” for more than 40 years. She is 81. She lives alone but has a son in the small community where she lives. (He has grown children and takes the lead in “handling” Elle’s former husband, who is in a nursing home.) Her other son lives across the country, although he and his wife speak with Elle frequently, and they have a great relationship.

Elle has dementia. She has been on medication for it for at least three years, but her problems are intensifying. She buzzes around in her car every day and spends hours each day “chatting up” people at restaurants, frequently strangers. She has in the past invited some of them to her home.

She often drives out of town and sometimes gets lost. I won’t ride with her anymore, as I have had to intervene twice to keep us from wrecking. Her car has several deep creases in it from turning too sharply. She also gets confused, leaves her purse or keys in various places and frequently cannot find her car in small parking lots. Sometimes she has to have the police help her. Once one of her former students had to help her and then insisted on following her home.

A year ago I talked with Elle’s “away” son and daughter-in-law, who had recently visited, about the things that really frighten me for her safety. They agreed that they had seen some of what I told them, and I left it with them to handle or talk to the in-town brother. Since then, the behaviors have accelerated. Elle went to a neurologist six months ago, and he did a brain scan but reported “no change.” I suggested someone go with her who could talk to the doctor, but she went alone.

She volunteers her time at a thrift shop and gets great pleasure from it. Where we live there are no taxis or buses, and I know she will not be willing to give up driving. I try to have lunch with her once a week, but it usually leaves me worried, and it is hard to be with her, as I am hard of hearing and her voice has gotten very soft. But she has been a very good, kind, dear friend to me for so long, and combined with annoyance is the worry for her safety. I don’t know what to do that will be the right thing.

My response: We’ve all experienced trying to help someone only to find what we meant to help got the other person angry, frustrated, or the like. We’ve also all experienced someone trying to help us who only made things worse.

I usually respond to letters with no questions by saying something like, “Thank you for sharing your story,” and not giving advice or commenting much more. Not commenting may sound like an easy way out of more thoughtful and helpful writing, but I’ve learned many times in coaching, teaching, and friendships that helping people who haven’t asked for it is a recipe for disaster.

My starting point for why is that what different people consider “helping” depends on their values, views, goals, and other factors that you, giving unasked advice, don’t know. For example, offering potential solutions to someone who just wants to be heard often leads to exasperation, frustration, and feeling devalued. But just listening to someone who wants advice can lead to impatience, frustration, and other emotions neither party wants.

However obvious you consider your interpretation of what the letter-writer wants, dozens of other interpretations exist, any of which the writer may have meant, or not. Acting on unchecked assumptions risks imposing your values on others, which usually provokes responses you wish you hadn’t from others.

I’ve found the best policy to keep neutral until the person clarifies what they want so I know what “help” means to them in that situation.

The New York Times response:

You don’t mention taking these issues up with the person who is best placed to make decisions here, Elle herself. But I’m going to assume that you’ve tried. The next person to approach is the local son, and you don’t mention talking to him either. If he knows the facts to be as you say they are, he should have been trying to persuade her to move into the next phase of her life, which will presumably involve increased levels of assistance as her capacities fade. (If you haven’t been talking to him, you don’t know he isn’t working on this.) Should that fail, you can get back in touch with the other brother about your worries for his mother’s safety — and the safety of others.

Her driving represents the most immediate danger here. Tell her that it’s time to give up her car keys. (If she won’t, you could report her to your state motor-vehicle agency; it would then be up to the state to carry out a review. In your state, they’ll respond to your report only if you identify yourself, but they’ll do what they can to keep your name from her.) Bear in mind that in a town like yours, giving up your keys is a huge sacrifice. See if you can figure out ways in which you and others can drive her where she needs to go. Her social disinhibition is a problem, but loneliness can be destructive, too.

Although keeping her out of the driver’s seat won’t protect her from the other risks you’ve identified, it might force her to face her need for help. You’ll rightly feel terrible if you do nothing further and the worst happens.

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