Some Ethical Reflections on AIDS

Chisolm R. “Supererogation and Offense: A Conceptual Scheme for Ethics”, Ratio, Volume 5, June, 1963, pp. 1–14.

In what follows. I am presupposing the argument of Hans Jonas, “Philosophical Reflections on Experimenting with Human Subjects”, in Reiser S. J. , Dyck A. J. , and Curran W. J. , eds., Ethics in Medicine: Historical Perspectives and Contemporary Concerns. Cambridge, Massachusetts, MIT Press, 1979, pp. 304–316. His application of the “Social Contract” theme to problems of medical ethics distinguishes a predominantly secular understanding of obligations based on enlightened self-interest from the self-sacrificial theme of much religious morality. I utilize the “Social Contract” theme not on the basis of the validity of any specific version of it, but simply because it offers a plausible framework for understanding the moral obligations of citizens independent of specific religious beliefs. I use the term “natural law” in a similar sense: see O. Gierke, Natural Law and the Theory of Society, translated by E. Barker, Boston, Massachusetts, Beacon Press, 1960. Not all voluntarily chosen values that go beyond the social contract are religious, of course. I use this bifurcation only because of its applicability to the problems of a Christian hospital.

See, e.g., Emmet Dorothy Rules, Roles and Relations (Boston, Massachusetts: Beacon Press, 1966).

Rawls John A Theory of Justice (Cambridge, Massachusetts: Harvard University Press, 1972).

See, e.g., Chapman C. B. , and Talmadge J. M. “The Evolution of the Right to Health Concept in the United States, in Ethics in Medicine, op. cit., pp. 553–572.

Hart H. L. A. “Laws and Morals”, in Ethics and Medicine, op. cit., pp. 104–114.

“Surgeon General's Report on Acquired Immune Deficiency Syndrome”, U. S. Department of Health and Human Services, 1987.

I find no evidence, in relevant literature, of a statistical point at which such measures could be mandated. It will probably come as a result of the recommendation of a consensus among experts at relevant institutions.

See, e.g., Seligmann J. , and Hager M. “A New Worry for Health-Care Workers”, Newsweek, June 1, 1987, p. 55; see also n. 11, p. 349.

This is the figure given in the Surgeon General's Report, op. cit., n. 7.

See Matthews G. , and Neslund V. “The Initial Impact of AIDS on Public Health Law in the United States”, Journal of the American Medical Association, Vol. 257, no. 3, pp. 344–352.

Chase M. “How Insurers Succeed in Limiting Their Losses Related to the Disease”, Wall Street Journal, May 18, 1987.

See, e.g., Outka Gene “Social Justice and Equal Access to Health Care”, in Ethics in Medicine, op. cit., pp. 584–593.

Meyer H. “AIDS Job Bias Growing Fast in Health Industry”, American Medical News, Feb. 27, 1987, p. 34.

Scher R. “As More MD's Develop AIDS, Ethical Issues Come to Surface”, American Medical News, March 13, 1987, p. 35.

See Smart J. J. C. , and Williams Bernard Utilitarianism: For and Against, (Cambridge, England: Cambridge University Press, 1973).

Chase M. “Asking AIDS Victims to Name Past Partners Stirs Debate on Privacy”, The Wall Street Journal, Jan. 29, 1987, p. 1.

See, e.g., “The Nuremberg Code”, in Ethics in Medicine, op. cit., pp. 272–274 and World Medical Association, “Declaration of Helsinki”, pp. 328-330.

Potter R. B. “Labeling the Mentally Retarded: The Just Allocation of Therapy”, in Ethics in Medicine, op. cit., pp. 626–631.

Op cit., n. 11.

There are, of course, consequentialist arguments that do rest upon religious presuppositions. However, I have in mind here the type of deontological reasoning that makes normative judgements according to the “will of God” independent of consequences.

E.g., the assertion by Immanuel Kant that it would be wrong to lie in order to save an innocent man from death, “On an Alleged Right to Life from Altruistic Motives,” translated by A. E. Kroeger in the American Journal of Speculative Philosophy, Vol. VII, 1873.

Scher op. cit., n. 15.

Scher op cit., n. 15.

“Wider AIDS Virus Testing Urged”, American Medical News, March 13, 1987, p. 9.

American Medical News, p. 9.

E.g., Singer Peter Practical Ethics, (Cambridge, England: Cambridge University Press, 1981).

On this problem, see Bok S. “The Ethics of Giving Placebos”, in Ethics in Medicine, op. cit., pp. 248–253.

See May W. F. “Code and Covenant or Philanthropy and Contract”, in Ethics in Medicine, op. cit., pp. 65–77.

It could be argued that while a religious hospital could not turn the (potential) act of self-sacrifice into a legal or quasi-legal obligation, it could promote it as a moral obligation binding on Christians or Jews.