Between alienation and self-determination: Ethical issues in harm reduction

This article aims to explore the ethical issues surrounding harm reduction (HR) within contemporary healthcare practices, drawing on the philosophical concepts of autonomy and liberty as developed by Kant and Mill. The growing influence of neoliberal logics in healthcare institutions tends to undermine the most humanistic approaches. The article therefore examines how these philosophical concepts can be mobilised to uncover these drifts and preserve the original spirit of HR, in order to prevent it from becoming a tool of control, blame, and, ultimately, marginalisation. Reflections are offered on how to reconcile respect for the autonomy of users with the protection of the most vulnerable, while reaffirming HR as a lever for self-determination.