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Whether it be on questions of induced abortion, drugs, alcohol, tobacco, or conjugal visits in prison, the satisfaction of maintaining a pure, ethical, and moral position has to be considered against the reality of dead and maimed women and orphaned children from backstreet abortions, of the homicide and community mayhem caused by drug barons dominating the commercial sale of mind altering substances, or people coming out of prison more damaged than when they went in, and the impact of family breakdown on prisoners’ families. Public health must be pragmatic if it is to maintain its humanitarian goals.