, Research Paper
Taking Away the Right of Privacy
The global AIDS epidemic is having very strong social impacts on many societies. AIDS is being compared with the Bubonic Plague which swept Europe in a mad fury leaving only two thirds of the original population alive. People speculate that this disease is going to be the be all and end all of the human population as we know it. It has been sent to us to end our existence because of what we have done wrong, to the earth and to each other. These are the beliefs of many very frightened people who fear the demise of the human race from this devastating disease. There has been extensive research done on this topic so people know how it is transmitted and how to avoid contraction of it, yet sometimes, that is what scares them.
Many people infected do not know they are infected, putting others in sexual contact with them at a high risk level. Also, many know they are infected and do not care what happens to the others around them. There have been many proposals of mandatory HIV screening and testing for these reasons. Some people want mandatory testing for HIV for all people in a certain age range. This seems like a good idea at first because it would lessen the risk of contracting HIV. People would know if they were infected, but there are some problems with this. If people knew they were infected, would they necessarily disclose this information to all people it should be told to? To combat this problem, some people think that this information should be available to people in contact with the infected person. This then would be a direct violation of privacy. So, is this violation of privacy permissible because it would protect the community? Is this a violation of the prima facie rights given to us as humans? In examining these questions, I will use two essays found in Contemporary Issues in Bioethics by Beauchamp and Walters. The first, used only for statistics, by Cochran and Mays is called “Sex, Lies, and HIV.” The second is the focus of this paper and it is called “Mandatory HIV Screening and Testing” by Childress.
In the essay “Mandatory HIV Screening and Testing,” Childress argues why mandatory HIV testing is unjustifiable. It is a violation of respect for autonomy, rules of liberty, rules of privacy, and rules of confidentiality. The way he argues this is by stating what must be the conditions for overriding prima facie principles and rules. He states and explains these rules one by one an makes it extremely clear why the prima facie principles can not be violated on this issue. According to Childress, there are five conditions which must be met “to justify infringements of these [prima facie principles and] rules” (Childress 559). The first of these conditions is effectiveness. In this case, someone would have to show that violating these rules would benefit and protect the health of society. But, “a policy that infringes the moral rules but is ineffective simply has no justification; it is arbitrary and capricious” (Childress 559). The second of these conditions is proportionality. It involves the actual rules being violated and the consequences of this violation, yet it also includes the consequences that may occur in the future because of the violation of this rule. Next Childress describes that condition is necessity. If there is a better choice, or even a reasonable alternative, the choice or alternative should be taken. The fourth condition is that of least infringement. This is explained best by a quote from the essay. “When liberty is at stake, the society should seek the least restrictive alternative; when privacy is at stake, it should seek the least intrusive and invasive alternative; and when confidentiality is at stake, it should disclose only the amount and kind of information needed for effective action” (Childress 559). The final condition is the principle of respect. This principle is very large and entails a lot of detail. “Even if it is essential to infringe a person?s rights in order to protect the public health, that person should not be reduced to a mere means to the goal of public health” (Childress 560). These are the five conditions that must be met to infringe the prima facie principles and rules. Childress explains why a mandatory HIV test does not meet all of these conditions and therefore can not be permissible. There are other reasonable alternatives which give less invasive outcomes.
Medical counseling or even education will help protect the public health without violating the right to privacy or any other prima facie principles. This is the main point of Childress? essay. He goes on to discuss mandatory screening under certain circumstances including obtaining a marriage license, having a baby, and being admitted into a hospital. They are just more specific arguments about the same big picture. That is why they are not the focus of my argument. Childress? actual thesis was just that a mandatory HIV test is not permissible. This topic is very confusing in some aspects. A mandatory HIV test can be argued for because it will save many lives and protect the society. It will make people more aware of the gravity of the situation because if everyone must be tested, it must be a very big problem. So, in that aspect, it is a really good idea. But privacy is an enormous issue. If there was mandatory HIV testing, would those results be available to the public? Would the results be given to people in sexual contact with the patient or even given to the patient?s employer? Because if it was available to some people, that is a complete invasion of privacy and there are laws of confidentiality that this country is envied for. But, if this information was not available to people, would it be of use to take the test in the first place? According to a study of 665 students ages 18 to 25 at colleges in Southern California, the mandatory HIV test without revealing information to relevant people would not do as much good as would be hoped. According to this information, 20 percent of men stated that they would lie about having a negative HIV antibody test, 34 percent of men have told a lie in order to have sex, 60 percent of women have been lied to in order to have sex, and 47 percent of men, and 43 percent of women would understate the number of previous sexual partners (Cochran and Mays 539-340). This information shows that even if everyone was forced to take an HIV test, if there was no disclosure of information to others to protect the privacy of the HIV positive individual, there is a good chance that the individual will not share that information with people at risk of contracting the disease from him. Another reason the mandatory HIV test would not work as well as it sounds is that HIV can stay in the body without showing up for up to six months. So unless an HIV test was required every six months for the rest of your life, it would not be worth it. If someone has an HIV test and earlier that month contracts HIV, there is a possibility the test will still come out negative and therefore that person can still infect others without knowing. The discrimination this country has towards people that are different from the “normal” people is extremely harsh. If the information about HIV test were made public, those positive people would have trouble getting jobs and be treated differently by many people. Although there are anti-discrimination laws in place in this country, there are always ways to get around them and it is very difficult to prove the reason for either firing or not hiring was actually discrimination. This is another negative result that a mandatory HIV test with disclosure of information would cause. The above stated arguments against a mandatory HIV test are the reasons I feel the test should not be obligatory. I completely agree that there are certain principles governing the laws our country can make and in this case make it impermissible to have a mandatory HIV test. Childress makes a very good point. But he misses the details. He argues that the test can not be permissible only for the reason that it does not meet the five conditions to break the prima facie principles. This is a very good point but there are other reasons also. The reasons I mentioned above are the reasons I believe to be more important. I think that Childress believes that a mandatory HIV test would help save lives and make people more aware of their actions, yet he has come to the same realization that I have. It is just not feasible. The way to help combat this epidemic is obviously not the mandatory test. There are too many reasons that it would not work. The way to not allow this disease to take over the world and to not allow the prophecy that it is the end of the world to come true is education. It is the only way that rights will not be violated and people will become more aware of the gravity of the situation. “Because of the physical and social ruin this infection occasions, we cannot afford to be ambivalent toward those who unreasonably risk infecting others or who will not share information that can literally save lives”(Schoeman 547). The way to stop these people from infecting the world is the education of the society. The only way to not get HIV is to not share needles and to not have any type of sexual contact. This is an unreasonable request of people but if people understand how not to get the disease, they can use that information when choosing a sexual partner. They can help spread the information to their friends. Although it is not a foolproof method of getting rid of HIV and there are still people that will contract it, it will at least help the situation. It is the only way to combat this killer without violating the rights of the people in our society.