AT WHAT POINT DOES “HELPING SOMEONE” BECOME AN EXCUSE FOR TAKING AWAY THEIR AUTONOMY? We say we want to save lives. And obviously, we should. But there’s a complicated question underneath that conversation: Who gets to decide what makes a life worth living? People who use drugs are often treated as though their substance use automatically invalidates their other decisions. If they use drugs: “They can’t make rational decisions.” If they’re homeless: “They don’t know what’s best for themselves.” If they refuse treatment: “They don’t understand what they need.” If they decline abstinence: “They’re in denial.” If they choose harm reduction: “They aren’t serious about recovery.” Notice the pattern. The moment somebody makes a choice we don’t agree with, we sometimes stop treating that choice as a choice. We reinterpret it as evidence that the person is incapable of choosing. And that’s a dangerous line. Because autonomy doesn’t mean we have to agree with someone’s decision. It means recognizing that adults have the right to make decisions about their own lives even decisions we think are bad. Healthcare already operates around this concept. We inform. We educate. We explain risks. We recommend. We obtain consent. And when a competent adult makes a decision we disagree with, we don’t automatically declare them incapable. People with substance use disorders deserve that same dignity. This doesn’t mean ignoring overdose risk. It doesn’t mean pretending every choice is safe. It doesn’t mean abandoning people. It means recognizing that care and control are not the same thing. You can say: “This decision worries me.” without saying: “You aren’t capable of making decisions.” You can offer treatment without coercing someone into believing your definition of recovery. You can provide naloxone without demanding abstinence. You can provide safer use education without approving of drug use. You can keep a door open without forcing someone through it. Saving someone’s life should never require convincing them that they have lost the right to have a say in it. Written by Meggz