provide education more compelling and is a further argument in favor of making explicit AIDS education more widely available.

Communicating information through education is easy; changing behaviors, especially addictive and pleasurable behaviors, is not. If one adopts the eliminative approach, one is likely to opt merely for a strategy of compulsion and coercion. In a democratic society, however, it is the process that is as important as the result.

Public health cannot be separated from a concern for democracy and its requirements for an educated electorate, for public health in its broadest sense is public welfare and its foundations lie in social justice ( Kreiger and Lashof 1988:414)


ACKNOWLEDGMENTS

I acknowledge the considerable help of Ferdinand Schoeman in the shaping of this paper. Without his invaluable criticisms and suggestions about its focus and direction, my discussion would be far less interesting or compelling. I also thank Frederic Reamer for having sufficient interest in this topic to inspire me to write this piece. His comments and suggestions were germane and truly invaluable. A final word of thanks to my colleague Jerry Wallulis for reading an early draft of the paper.


NOTES
1.
As several authors point out, members of the IV drug-using community (unlike members of the gay community) are more likely to be minority, poorly educated, and of disadvantaged socioeconomic status. Furthermore, the stereotype of the IV drug user is considerably more negative than that of the homosexual/ bisexual male.
2.
As I discuss in my paper, "Social/Sexual Norms and AIDS in the South," Ronald Bayer and others attribute this to an erosion of the alliance between the gay and public health communities--an alliance that promoted a voluntarist approach to controlling spread of HIV. However, as the AIDS profile has changed, the populations most newly affected seem less able to form such an alliance. Whereas the gay community was predominantly white, well educated, middle class, and organized and politically savvy, the populations most newly affected (i.e., IV drug users and black and Hispanic women and children) are not well organized, politically well aligned, or savvy. On the contrary, they are unusually fragmented, historically disenfranchised, and hence more vulnerable to (and less able to resist) the imposition of coercive measures.
3.
This poses a special challenge for American culture, given the moral stigma

-151-

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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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