As the second decade of AIDS begins: an international perspective on the ethics of the epidemic
Bayer, R.
Aids 6(6): 527-532
1992
ISSN/ISBN: 0269-9370 PMID: 1388872 Document Number: 323803
An international perspective on the ethics of AIDS focuses on the dichotomy between the liberal view of the right to privacy and the communitarian view of traditional public health practices. Although most liberal societies espouse the right to privacy, Western countries differ widely in how they handle such issues as closing of gay baths, reporting HIV/AIDS, performing seroprevalence surveys, contact tracing, use of isolation and quarantine, prosecuting those who spread HIV sexually, and informing patients that clinicians have HIV. Common questions confront all societies, despite their different traditions and legal systems. Conventional approaches to public health stemming from epidemics of the 19th century included mandatory screening, isolation, quarantine, contact tracing, and breaking patient confidentiality. There are indications that the new approach for HIV, termed "HIV exceptionalism" is changing: in the US contact tracing is appearing; and better management of the disease is prompting early identification. The political choices for the West involve ensuring that the interests of the weak and powerless will be protected in a way that is compatible with the liberal tradition as well as the scientific tenets of public health. The most profound political challenge, however, is how to deal with the massive suffering of people with AIDS in the Third World, who are enduring an epidemiologic catastrophe willfully ignored by the wealthy nations.