Prohibited substance regulation and compliance testing: A principalism approach

Abstract: Background : Prohibited substance regulation and compliance testing programmes are required to minimise risks to health and safety in the workplace due to inappropriate use of legal (alcohol, cannabis) and illegal substances. A compliance drug test is in principle an invasive biomedical intervention which infringes on the autonomy and other rights of the individual giving rise to ethical dilemmas.  Objectives: The principalism approach by Beauchamp and Childress was employed to reason and motivate for the minimum ethical requirements for this type of biomedical intervention. Methods: The ethical aspects relevant to the mandatory guidelines of the Substance Abuse and Mental Health Services Administration of the United States of America (SAMHSA) protocols and procedures were extracted and interpreted with reference to the principalism approach. Results : The principalism approach was found to be highly applicable to the ethical requirements of a prohibited substance regulation and testing programme. Conclusion: Ethical dilemmas could be explained and motivated by using the four principles of respect for autonomy, beneficence, non-maleficence and justice as a starting point.