A CALCULUS OF NEED
Byrn, Robert M.
A CALCULUS OF NEED Funding AIDS research & care Robert M. Byrn ~ hen a large, cohesive, well-connected activist group decides to embrace a cause, the sociopolitical status of the cause...
...Of course, it is possible to argue that PWAs do not deserve support because all but a small percentage of them have become infected through immoral conduct, usually by sharing a contaminated needle to inject an illegal drug or by engaging in illicit sexual activity with someone who is already infected...
...Some of them kill a lot more people than AIDS does...
...The fear is that as infections and deaths decrease among the white middle class, PWAs will lose their strongest advocates...
...THE INSTITUTE OF SACRED MUSIC AT YALE UNIVERSITY A Cross-Disciplinary Center for Music, Liturgy and the Related Arts "Common ground for musicians and ministers, for scholars and practitioners" Degrees Offered through the Yale School of Music Master of Music r Artist Diploma Master of Musical Arts r Doctor o f Musical Arts Degrees Offered through Yale D i v i n i t y School Master of Arts in Religion r Master of Divinity Master of Sacred Theology Joint Degrees and Double Majors are offered through the two schools...
...Viral plagues require focused attention because viruses have a way of circumventing the defenses we erect against them...
...Many in society stigmatize AIDS patients, a number of whom react with feelings of guilt...
...Those who would turn us against each other in pursuit of some other agenda are wrong...
...Unless cheaper medications are developed, these people face a lifetime of exorbitantly expensive treatment...
...de Vito the land...
...My own and others' admittedly anecdotal experiences seem to indicate that there has been a recent increase in deaths among longterm patients who fall into the medication-resistant groups...
...Likewise, the medications do not cure the isolation and depression characteristic of the lives of so many PWAs...
...There are certainly other life-threatening diseases out there...
...9 Fourth: It is true that the new medications have effected an overall decrease in AIDS deaths, but PWAs are still dying, and the rate of infection--which is hightest among minority groups--has not decreased significantly...
...Downsizing assistance will hurt PWAs...
...Currently, these deaths exceed deaths from AIDS by more than a third...
...therefore, spend less on AIDS...
...Ninety percent were under fifty...
...Perhaps perceiving an imminent reversal of fortune, individual AIDS advocacy groups, with divergent agendas, have begun to compete with each other for bigger slices of the funding pie...
...Many remain disabled by long-term, chronic infections that the new medications have not helped to cure...
...Funds are raised...
...9 Finally: I can hardly claim to be anything special, either as a volunteer on the AIDS wards (many others do far more than I) or as a veteran of prostate cancer (many others have far worse prognoses than I...
...They may not be among the envious, but they feed the envy of others...
...AIDS is a virus, an infectious plague...
...I volunteer on the AIDS ward of two hospitals...
...I want a cure for AIDS...
...Prostate cancer kills forty thousand men every year in the United States...
...AIDS infections kill more African-Americans between the ages of twenty-five and forty-four than any other disease...
...That peril would seem to render irrelevant the objection that the special funding/publicity status of AIDS is primarily the result of organized pressure...
...they do not conquer...
...Those whom it infects teach that because some people have advantages that the rest don't, no one should have them...
...9 First: Besides AIDS, another dangerous virus plagues Commonweal | 3 October 9, 1998 Egyptian Interval "Kiss," said the camel driver, and the camel, from its lordly height, bent its head, and briefly nuzzled that grizzled proffered cheek...
...Besides, a triage system of funding would not seem to be a salutary approach to conquering deadly diseases...
...More than 50 percent of PWAs are resistant to the new life-extending medications...
...9 Third: Families and friends typically rally around people with conventional diseases...
...it will help no one...
...Were I to do so, then according to the principles of traditional Roman Catholicism to which I subscribe, I would be guilty of the capital sin of envy, which "wishes grave harm to a neighbor [on account of] displeasure caused by his prosperity" (see the Catechism of the Catholic Church...
...Kiss," said the driver once again...
...Although AIDS and breast cancer share a spotlight, the reaction of a large segment of the public to those who suffer from the diseases is quite different...
...Not only do they fail to serve us and all the diseased, they also undermine the determination of a nation to see to it that cure and care are somehow available where cure and care are needed...
...People who write about AIDS ought to begin by revealing their own qualifications, biases, and potentially gored oxen...
...Last year, for example, Martin Delaney, a California AIDS activist, was quoted in the New York Times (November 12, 1997) condemning the "exceptional" status claimed for AIDS: "Why do people with AIDS get funding for primary medical care...
...This figure includes not only people whose resistance was built up by older medications, but also those who were never warned that the virus would learn to resist the new medications if there were a substantial interruption in taking them--because no one knew of that problem...
...It simply becomes a politically advantageous "cut in spending...
...I have been doing this for more than three years...
...It also includes street people who cannot or will not maintain a medication regimen that may require taking more than twenty pills every day, at rigidly set intervals, and other pills and/or IV infusions at other times during the week...
...Even those who are now benefiting from the new medications continue to need financial assistance and moral support...
...PWAs do not die of AIDS...
...What is at issue is the cynicism of those who campaign for it by creating resentment against special programs for PWAs...
...Frequently, the hospital visits lead to follow-up visits to nursing homes...
...True as that may be, it pales into insignificance in the face of the real and urgent needs of the imperiled--needs that would not be met except for the special funding/publicity status of AIDS...
...He demonstrated that illness could Commonweal | 4 October 9, 1998 be an occasion to prove God's love for his people and not the sin of punishment" [italics mine...
...I don't want people to die of AIDS infections...
...None of this is true of breast cancer...
...Nowhere in the Gospels is there a record of Jesus having conditioned a cure upon the cause of the illness...
...The pope specifically mentions "relief centers for AIDS patients" as one of the "eloquent expressions of what charity is able to devise in order to give everyone new reasons for hope and practical possibilities for life...
...A second Times artide ("New Studies Offer Hope and Caution on AIDS Therapies," November 14, 1997) highlighted new medications that seem to have turned AIDS from an inevitably fatal affliction to a manageable chronic disease...
...These patients, together with the homeless for whom AIDS is a particular problem, require special support services...
...And AIDS is particularly complex...
...Of course, not everyone who argues for reductions in AIDS funding and programs is ill-motivated...
...They often abandon PWAs...
...A CALCULUS OF NEED Funding AIDS research & care Robert M. Byrn ~ hen a large, cohesive, well-connected activist group decides to embrace a cause, the sociopolitical status of the cause changes...
...I want a cure for prostate cancer...
...Delaney favored replacing separate programs for AIDS with a national (universal) health-care system...
...One way of getting tough is to cut funding...
...Witness AIDS and breast cancer...
...Although I do not have AIDS, it has become a significant part of my life...
...But anyone familiar with welfare programs knows that things don't work that way...
...Money cut from a program typically is not diverted elsewhere...
...On the other hand, within the past year I have undergone treatments for another deadly disease--prostate cancer...
...E.B...
...Red and pink ribbons are de rigueur, feature stories are common, and with greater-than-usual ceremony, private industry pledges support and politicians announce new funding for research, treatment, and care...
...According to the bishops: "[Jesus] relieved suffering and 'cured all who were afflicted' (Matt...
...Even some sympathetic individuals have become uncomfortable with what they now see as a disproportion in the financial support available to PWAs...
...The larger number of PWAs remain in peril...
...Few volunteers are able to avoid such emotional involvement...
...Even my disease is a bigger killer than AIDS...
...My medical condition apart, my strong and frequently expressed public opposition to legalized abortion, euthanasia, and homosexual practices makes me an avowed moral conservative...
...And as the camel that he knew as he knew his wife, bent down to oblige, I turned away to screen a shared moment between man and beast from an unwanted, and even what might seem to them, a "vulgar gaze...
...During that time, I have lost to the disease people whom I truly came to care about--and grieve for...
...Whether or not such a system is feasible or desirable is not at issue here...
...9 Second: If, as some say, AIDS is not "exceptional," it is at least different...
...With all this baggage in hand, let me now offer a few comments...
...I thought of a royal gesture long ago, when the King of Spain sent the English King a gift of five camels, and with them, a note of instruction: they were to graze in the park each day, but must be returned by evening so as to protect them from the "vulgar gaze...
...Resentment, envy, and cynicism divide...
...I may die of metastasizing cancer...
...This identifies the sinner with the sin...
...the media take notice...
...I don't want to die of it...
...they die of one or more of the twenty-six opportunistic diseases--ranging from cancer to pneumonia to multidrugresistant TB--that take advantage of damaged immune systems...
...the public reacts...
...There are rumblings of a reaction against the intense public focus on A~DS...
...To many Americans, people with AIDS (PWAs) personify the degenerate state of society...
...But here the bishops of the United States, in their 1981 statement on health and health care, and Pope John Paul II, in his 1995 encyclical Evangelium vitae, make relevant observations...
...Scholarship awards are based on need and merit...
...I did not "catch" prostate cancer...
...Herewith the relevant facts of my own situation: I am neither HIV positive (the precursor of AEDS) nor a member of any H1V risk group...
...The subverted self-esteem, isolation, and depression of many PWAs may be as much a part of AIDS as the lymphomas that kill so many of them...
...And those who die are young...
...yet care for PWAs is supported by public funds...
...8:16...
...Even if it were diverted, it would more likely follow greater influence than greater need...
...politicians listen...
...But in the meanwhile, he seriously challenged the morality of a public policy that gives special attention to AIDS, a challenge that questions the validity of at least some AIDS programs, regardless of the availability of a substitute system...
...Prizes in Organ Performance and Choral Conducting are available for qualified applicants...
...More recently, another Times article ("Wave of Laws Aimed at People with H.I.V.," September 25, 1998) noted a "backlash" among legislators across the country who have come to believe that "we have been soft on the epidemic" and that soRobert M. Byrn, professor emeritus, held the Leonard F. Manning Distinguished Professorship at the Fordham University School of Law...
...Also to be distinguished from the envious are those who advocate a national health-care system that would fairly and adequately encompass all diseases...
...In 1995, two-thirds of those who died of AIDs-related infections were under forty years of age...
...ciety now needs "to get tough on people with AIDS...
...I am not...
...Some genuinely believe that the money may better be spent elsewhere for what they perceive to be a greater need...
...I now spend parts of at least three and as many as six days a week with AIDS patients...
...So conventional wisdom would seem to put me in sympathy with arguments that favor eliminating support for PWAs...
...Should I now lobby for less money for AIDS...
...Addms inquiries to: Office of Admissions, Yale Institute of Sacred Music, 409 Prospect St., New Haven, CT 06511 PHONE (203) 432-5180 FAX (203) 432-5296 E-MAIL ruth.lackstrom@yale.edu WEBSITE http://www.yale.edu/ism Commonweal | 5 October g, 1998...
...In context, it translates: We spend more on AIDS than on some other deadly diseases...
...But then one need not be a Catholic to recognize how mortally and morally perverse this political virus really is...
...I thought too of an Arab who had said a man knows his camel as he knows his wife-can recognize these contours at a distance, even when no more than a dark shape silhouetted by the setting sun...
Vol. 125 • October 1998 • No. 17
