Editorials

COMHONWEAL Testing for AIDS The announcement in June of President Reagan's sketchy battle plan against AIDS was slow in coming and disappointing upon arrival. Its major shortcoming is less in what...

...It is simply not apt to succeed...
...It will influence states and localities and help form public attitudes...
...The pope is convinced that you either understand events at a moral level or you don't understand them at all," a senior Vatican official told the New York Times following the visit...
...Reagan's groups poses its own special problems...
...It also means that one is able, indefinitely, to infect others...
...Waldheim but of the Austrian bishops that pressured the pope to receive Waldheim...
...Elie Wiesel said as much to President Reagan at the White House prior to the Bitburg visit, with little effect...
...Over one hundred thousand drug addicts are thought to be infected right now in New York City alone...
...It believes that AIDS demands aggressive and massive measures but not necessarily mandatory ones, precisely because making them mandatory may defeat their objective...
...We think the third camp is right...
...Even anti-discriminatory legislation may not bring protection when, like a recent case concerning job discrimination, the court's proceedings outlast the life of the AIDS patient...
...In all frankness, I do not know...
...Even forty years after the Holocaust, Christians have yet to come to terms with anti-Semitism...
...For example, drug addicts and their sexual partners, people who may not speak English, may be school dropouts, illiterate, and not affiliated with organizations and institutions, in short, unreachable by the print media and other standard communications techniques appropriate to the general public...
...Christianity, like Judaism, is not a religion of forgetfulness...
...he searches for a lost key not by the door where he dropped it but by the lamp post "because that's where the light is...
...If testing is made a condition for access to facilities like methadone clinics or sexually transmitted disease clinics, then individuals may simply not avail themselves of those services, with negative consequences for society as well as for the individuals...
...Pope John Paul II praised Mr...
...Over 60 percent of the AIDS cases reported in the U.S...
...Opposing them are the Technological Fixers, those who, out of faith in science or fear of curtailing personal liberties, seek remedies that will be as "value-free" as possible and rest on nothing more than each individual's enlightened self-interest...
...Why should people be tested for the AIDS antibody...
...3) a strategy (or the appointment of a commission able to design such a strategy) tailored to reach members of the highest-risk groups...
...Remember last year's great war against drug abuse...
...Reagan focuses instead on immigrants, federal prisoners, and patients in Veterans' Administration hospitals...
...Astonishingly, President Reagan's battle plan includes only one of these high-risk groups: persons seeking treatment at sexually transmitted disease centers...
...The direction taken by federal policy on testing is crucial...
...Those told to be quiet were precisely those who sought to raise the painful moral questions the Vatican official proudly thought he was espousing...
...Unfortunately, the handiest places in which to make that display are largely irrelevant...
...Negative test results may only mean that the antibodies which form in reaction to the virus have not yet had time to develop...
...For it was neither politicians nor diplomats who were made uncomfortable and unwelcomed at the Vatican, and clearly not Mr...
...Waldheim for his contributions to peace, but made no response whatsoever to the Austrian's war-time activity with the Nazis...
...We are a people whose life and being are rooted in more than the present...
...When there is evidence that mandatory measures might work better than voluntary ones, then the knottiest issues of civil liberties might have to broached...
...that it would provide epidemiological data needed to trace the spread and extent of the epidemic...
...It was a telling gesture, and one that deserves to be emulated...
...Therefore, the object of testing is to identify carriers, to counsel them about their own condition, and to educate them about modifying their behavior so as to reduce the risk of spreading the virus...
...Which presidential candidates will lead in rejecting such a superficial approach to so serious a public concern...
...It is that same hierarchy and Waldheim who will welcome the pope to Austria next year...
...Clearly not because there is any cure to offer those who test positive...
...Already there are counterproductive laws on the books, including the nine states which 404 require that the names of all people who test positive for the AIDS virus be reported to health authorities...
...He [the pope] does not care if that leaves politicians and diplomats feeling uncomfortable, because the moral always supersedes the political...
...And a negative test is only as good as one's last sexual partner or needle swapper...
...An adequate policy proposal would have included: (1) a commitment to the education and voluntary testing/counseling of high-risk groups...
...When the Grand Rabbi expressed his pain over the Waldheim visit, Cardinal Decourtray responded immediately: "This event is painful to me as well...
...Neither "getting tough" nor relying on technology and enlightened self-interest is a sufficient answer...
...Testing of immigrants and federal prisoners has already begun, and the military has been tested for some time...
...It holds AIDS to constitute a crisis requiring outspoken educational efforts but efforts that are willing to be as direct and outspoken about questions like early or promiscuous sexual behavior as about condoms...
...Fortunately, there are the makings of a sizable third camp...
...Theirs is a "declare war" mentality that believes the innocent side can easily be separated from the "aggressors" not just the disease itself but those who carry it or those whose, mores or behavior facilitate AIDS' spread...
...Its major shortcoming is less in what the program proposes than in what it fails to do...
...Anonymous testing, where a number is used instead of a name, is possible and sensible, given that it provides a crucial measure of confidentiality...
...It has been discovered, in forgotten documents of the very world body Waldheim served, that in 1948 the UN Commission on War Crimes listed him as wanted for murder and the taking of hostages...
...In practice, well, watch out...
...Politically he was responding to the Get Toughers' demand that the nation do something where something means a muscular display of government power...
...When Alfred Wemer was dragged through the streets of Vienna in 1938 by the Gestapo there were 185,000 Jews in Austria...
...Yet the very fact that Mr...
...Now is the time to begin that needed soul 405 searching...
...2) an appropriation of funds toward this end, realizing that the groups most at risk are often the most difficult to reach...
...p. 418) made a point of visiting the city's Holocaust museum, set up during the just-completed Barbie trial, and of visiting the synagogue of Lyon...
...The administration has announced that, beginning in 1988, a random sampling of 45,000 Americans will be conducted, using a yet to be disclosed anonymous and voluntary procedure...
...Epidemiological data should be gathered through a scientific sampling of the entire population...
...When necessary, we have a duty not simply to remember but to make recompense...
...For individuals who would willfully spread the virus, criminal sanctions are already being formulated in legislatures, and, as cases reach the courts, existing law is being applied as well...
...Reagan's proposal contains no provision for testing them or the other groups most at risk...
...For example, in an effort to promote universal or broad-based testing, claims have been made that testing would provide an educational opportunity par excellence...
...The issue most vigorously debated before and after the president's proposal has been testing, particularly the mandatory testing of several specific groups...
...It is not hard to see how the president got himself in this mess...
...That sentiment is noble, if not entirely unique...
...In principle, that isn't bad...
...That is, unless a government commission, recently established to investigate the president's war-time record, has decided against him, and Waldheim abandons his post...
...One camp call them the Get-Toughers demands that the public be protected from a threatening epidemic by a quick resort to mandatory measures...
...But first things first...
...The hope is that most people who receive such testing and counseling will indeed change their behavior in responsible ways...
...That is why ours must continue to be a religion of remembrance and habitual self-reflection...
...Namely, to initiate an effective strategy to halt, or at least retard, the spread of the AIDS retrovirus...
...Because each of these populations is clearly under federal jurisdiction, and mechanisms are already in place to facilitate blood tests...
...This, however, is not a major reason for testing...
...The administration's weak mix, by contrast, should have been booed not by gay-libbers as much as by everyone alarmed about the spread of the disease...
...So far, there is no vaccine to protect anyone against contracting the virus...
...A confirmed positive test for the AIDS antibody means that the carrier runs a strong likelihood of developing AIDS within five or ten years...
...Reagan's proposal highlighted essentially captive populations exposes the flaw in the notion...
...It is reported that it was not only the importuning of Mr...
...Why have so many public health professionals, including Surgeon General C. Everett Koop, warned that mandatory testing is likely to be counterproductive...
...It is true that once medical remedies have been found, virus carriers who have been identified through testing programs could be reached for treatment...
...The administration has stumbled on the next question Should testing be mandatory or voluntary...
...Austria was often referred to as Eretz ha-domim, "the land of blood," in Jewish chronicles in the late Middle Ages...
...politics is how we should get a fix on society's pressing issues...
...Such active reflection clearly differs from the habitual patterns of obfuscation we have come to identify with Mr...
...Rome maintained a sense of impenetrability throughout...
...It wants to protect the public from a new and deadly threat, but it refuses to stigmatize AIDS sufferers in the process, both out of basic decency and because stigmatization will work against the public's protection in the long run...
...that it would identify carriers who could then be isolated or quarantined on behalf of the larger society...
...Mandatory testing, which means, of course, regular mandatory retesting for those who test negative, magnifies the problem...
...Here, the president's vague statement encourages a trend: nine states already have mandatory marriage license testing laws in force, and thirty-two others are considering such legislation...
...Once again, being tough-minded verges on being soft-headed...
...SEEING WALDHEIM The dismay that had been touched off by the announcement of Austrian President Kurt Waldheim's visit to the Vatican last month was not relieved by the actual event...
...There is no treatment for virus carriers that will lessen the infective potency of the virus they are able to transmit...
...Nor is there any reliable way to 403 reduce the chances that the virus will later develop into ARC (AIDS-Related Complex) or AIDS itself...
...But there are also catastrophic failures: the intolerance...
...These donors aside, the debate about mandatory testing rages on...
...Waldheim himself...
...On the eve of the Waldheim reception at the Vatican, Lyon's Cardinal Decourtray (cf...
...What is more, in this race against disease, not only time, but also the careful placement of resources are of the essence...
...For blood, sperm, and organ donors, a mandatory blood test for the AIDS virus is essential, a fact which has been obvious enough to transcend controversy...
...It is not likely to be anonymous...
...Christians daily recall the creation, the fall, and the words of institution: "Do this in memory of me...
...But the past will not die...
...As for the president's proposed testing of applicants for marriage licenses, while the danger of infecting offspring is real and testing for couples should be encouraged, as a group engaged couples are at very low risk...
...Waldheim...
...So far, the search for such a strategy has been blocked by a battle between two camps, each representing a generalized attitude toward AIDS, sexuality, and social change...
...Waldheim's response was one of glowing satisfaction: "I appreciate the full significance and high value of this encounter...
...As an educational tool, testing low-risk groups is not only expensive, it could even backfire by giving false assurances...
...If the goal of testing is to reduce the spread of the AIDS virus, testing should be geared toward the highest-risk groups: over 90 percent of AIDS virus carriers are to be found among gay and bisexual men, intravenous drug users of both sexes (who are disproportionately black and Hispanic), the sexual partners of intravenous drug users (particularly teenage black and Hispanic girls, a group, incidentally, which has the nation's highest fertility rate and is likely to produce AIDS-stricken infants), prostitutes of both sexes, and persons who have other sexually transmitted diseases...
...Necessary ingredients would be strong anti-discrimination laws with tough penalties for employers, landlords, and insurance companies who fail to comply...
...Next question: Who should be tested as a matter of policy...
...There is in Christianity the glory of the saints...
...AIDS is apt to be an issue in the coming election campaign...
...But in this case the sentiment was not only undermined by the application, it was in the reality stood on its head...
...And you shall confess your sins and those of your fathers," says Leviticus...
...In sum, the White House proposal on testing misses the mark...
...On June 25, there was not moral clarity at the Vatican but only the gray haze of diplomatic smoke...
...Testing provides essential information which, along with solid and sympathetic counseling, could motivate a change in behavior...
...the abandonment of compassion...
...But if the pope's coming visit is to be a reckoning of the Gospel rather than a diplomatic quid pro quo, it must come to terms with the questions the Vatican visit raised loud and clear...
...are composed of gay and bisexual men...
...It must be undertaken not only in Austria, but in the entire universal church...
...Waldheim has not only lied about his past, but has spent decades repackaging it...
...I ask myself what might have been the motives leading to the decision...
...the fratricidal wars...
...But each of these claims falters...
...The president's policy resembles the inebriated gentleman in an ancient joke...
...He recalled seeing at the time a memorial tablet in medieval Latin which commemorated an earlier expulsion of the "Hebrew dogs...
...They know how many individuals among the high-risk groups fear that a positive virus test or the onset of ARC or AIDS, if known, could result in discrimination against them: from social ostracism to the loss of their jobs, homes, or health insurance...
...Meantime, common sense and sheer pragmatism argue for creating a climate favoring vigorous, precisely targeted campaigns for voluntary testing among high-risk groups...
...The primary reason for testing is to reduce the spread of the virus...
...Obviously there are some basic questions that need to be addressed...
...Other reasons to test for the AIDS antibody have been argued but not convincingly...
...Without sufficient protection confidentiality in testing and treatment, and anti-discrimination laws even voluntary testing may be avoided by those most at risk...
...Once funds and programs have been directed toward these groups, then, if finances permit, a solid and comprehensive program of education and testing could be designed for the public at large, perhaps allaying the anxieties that, on the basis of media attention alone, have led large numbers of low-risk individuals, including single women, to pack testing centers...
...Furthermore, each of Mr...
...AIDS requires hard-hitting programs that are, however, carefully targeted and not wasteful or counterproductive...
...It is a sordid past, and Waldheim has only recently admitted some mistakes, mostly in calculating what to hide rather than in what he did...
...By 1945 there was much more blood and only 3,000 surviving Austrian Jews...
...Notions of isolating or quarantining the estimated 1.5 to 2 million carriers of the AIDS virus for life, or until a cure is found are totally unrealistic, not to mention inhumane and totalitarian...

Vol. 114 • July 1987 • No. 13


 
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