HIV/AIDS and Suicide: Further Precautions
Mancoske, Ronald J., Social Work
The news on HIV/AIDS remains grim. Despite vast efforts at research and considerable sums supporting care, a cure remains elusive. Glimmers of hope for more effective treatments and for vaccines help those whose lives are affected move forward to face new challenges. Yet the statistics stagger the imagination. For young men in their 20s and 30s, AIDS is the leading cause of death. Approximately 1 percent of young white males, 3 percent of young African American males, 1.5 percent of young Hispanic males, and 1 percent of young African American females are estimated to be infected with HIV (Rosenberg, 1995). For gay men, a generation faces extinction. The Presidential Commission on AIDS characterized the public response as one of apathy. Within the social work profession, it is more than apathy - it is also immobilization and perhaps compassion fatigue.
It comes as little surprise that the criticism of the findings on HIV and suicide comes from one obviously seasoned in the trenches of the struggle to fight AIDS. It is not surprising that some care and some are willing to struggle with the pandemic's impact on those searching for meaning in life despite overwhelming odds. It is not surprising that some feel that the discussion of suicide risk from a mental health perspective is linked to a discussion of a "final exit." Suicide can be a rational choice, especially if one faces a painful, stigmatized, and frightening death. Some, such as the "Samaritans" (Varah, 1985), have led the effort to be supportive when one makes final suicide choices. The Samaritan model is not rejected by the latest NASW policy on assisted suicide, nor should it be, despite the complex legal and ethical morass in which such decisions are embedded. However, how much of the impetus for support of this policy is influenced by lingering despair within the helping professions?
Social workers on the front line of the HIV/AIDS pandemic need support, direction, and training. Are schools of social work facing up to this challenge in their curriculum offerings? Has NASW re-established its HIV/AIDS chapter liaisons? Social workers in unconscionably high numbers report an unwillingness to work with people affected by HIV/AIDS and a lack of training in HIV/AIDS (NASW Task Force on HIV/AIDS, 1995). Some social workers who have for so long carried the burden of care see no relief in sight, see little help from their profession, see the anguish that only worsens, see funds stagnate as the number of infected people grows, and see the most vulnerable of society ravaged. Some perhaps feel that "self-deliverance" is all too rational. Some who witness young, seemingly healthy men and women sit on death watch feel immobilized. …