on much broader interests and institutions. Public strategies can, of course, be more or less irrational, more or less compatible with what science reveals about the world. But within the parameters established by the "facts" there must always remain a realm of uncertainty and of irreducible choice. Recourse to claims about "scientifically justified policy"--typical of all parties to disputes about public health policy-- merely deflects attention from the inherent role of competing social values in the charting of appropriate strategies of social action. Now that the "natural" alliance between proponents of civil liberties and the public health has been ruptured, it will be necessary to confront openly questions posed by Lawrence Tribe, the liberal theorist of jurisprudence, about policy in the face of epidemic challenges. "Who is being hurt? Who benefits? By what process is the rule imposed? For what reasons? With what likely effect on precedent" ( Tribe 1978:891)? How these questions are answered and with what relative weight given to security and safety on the one hand and to privacy and autonomy on the other will determine the shape of AIDS policy and will have significant implications for the contours of the United States as a liberal society in the next years.


REFERENCES

Advocate, March 18, 1982, p. 6.

Altman, Lawrence. 1987. New York Times, February 4, p. 1.

ABA (American Bar Association) AIDS Coordinating Committee. Chicago: August 1988. ABA Policy on AIDS.

ACLU (American Civil Liberties Union). New York: 1990.

ACLU, Southern California Branch. 1986. LaRouche Initiative and Existing Laws. April 10. Mimeo.

AMA (American Medical Association). Board of Trustees. Chicago: December 1989. American Medical News, July 8-15, 1988, p. 4.

ASTHO (Association of State and Territorial Health Officials). 1985. ASTHO Guide to Public Health Practice: HTLV-III Antibody Testing and Community Approaches. Washington, D.C.: Public Health Foundation.

ASTHO. National Association of County Health Officials, U.S. Conference of Local Health Officers. 1988. Guide to Public Health Practice: HIV Partner Notification Strategies. Washington, D.C.: Public Health Foundation.

Bayer, Ronald. 1989. Private Acts, Social Consequences: AIDS and the Politics of Public Health. New York: Free Press.

Bayer, Ronald and Cheryl Healton. 1989. "Controlling AIDS in Cuba". New England Journal of Medicine (April), 321:1022-1024.

Bayer, Ronald, Carol Levine, and Thomas Murray. 1984. "Guidelines for Confidentiality in AIDS Research". IRB (November-December), pp. 1-7.

-47-

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AIDS & Ethics
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Preface ix
  • Contributors xv
  • 1. Aids: the Relevance of Ethics 1
  • Note 22
  • References 23
  • 2. Aids, Public Health, and Civil Liberties: Consensus and Conflict in Policy 26
  • References 47
  • 3. Mandatory HIV Screening and Testing 50
  • References 73
  • 4. Aids and the Ethics of Human Subjects Research 77
  • Acknowledgments 101
  • References 102
  • 5. Aids and the Crisis of Health Insurance 105
  • References 124
  • 6. Ethical Issues in Aids Education 128
  • Acknowledgments 151
  • Notes 151
  • References 153
  • 7. Ethics and Militant Aids Activism 155
  • Notes 186
  • References 186
  • 8. Aids and the Physician-Patient Relationship 188
  • Notes 211
  • References 213
  • 9. Aids and the Obligations of Health Care Professionals 215
  • References 236
  • 10. Aids and Privacy 240
  • Acknowledgments 272
  • Notes 272
  • References 274
  • 11. Aids and the Law 277
  • References 305
  • SUGGESTED READINGS 306
  • Index 311
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