If this thread is genuinely about ethics, rather than about AIDS specifically, then we can apply the basic questions in the OP to other pandemics.
Would a proposal similar to that set forth in the OP have been justifiable in terms of - say - Spanish Flu?
Unlike HIV and Malaria, which we in the West have a high ability to protect ourselves against even when visiting places in which those diseases are endemic, Spanish Flu knew no boundaries and was virtually impossible to protect oneself against or to treat; it was also extremely virulent. It’s also extremely likely that people would have lined up to get “flu shots” during the time of the pandemic if those shots had been promoted as a vaccine. It’s almost certain that tens of millions of lives would have been saved under such a hypothetical situation.
Beeblebrox, your analysis of the ineffectiveness of justinh “solution” is well-reasoned, but it is ultimately irrelevant. Nor do I find the ongoing discussions about the actual risks caused by AIDS, while again excellent, relevant either.
I think the key issue that justinh utterly ignores is a simple one - human survival without values is not worthwhile. Let us assume for the moment that the idea could work, and that more people would eventually be saved by exterminating every HIV carrier than the number of HIV carriers so murdered.
We still should not do it - because we do not want to live in a world where we do such things.
It is well-established that we hold values to be paramount, even when those values cost human life.
Our protections of defendants in the criminal justice system directly cost lives - murderers do go free because of the high level of proof needed to convict. But we have those protections because our values require a high level of certainty before we deprive someone of their freedom (or their lives)
Our protections of free speech and free exchange of ideas directly cost lives - Tim McVeigh did not come up with the ideas that led him to his evil by himself, but learned them from others. But our values hold that it is better to take the risk that evil will arise from the free exchange of ideas than to impose government censorship.
The list goes on.
The deliberate murder of 40 million people is evil. The benefits of the murder are irrelevant.
Beeblebrox
I think you’re missing the point I was trying to make. Let’s take a slightly different example. Say there is a famine in North Korea. Now from a public health perspective, starvation and malnutrition are quite easily treatable. Nobody lies awake at night worrying about what to do if a famine breaks out. Obviously this doesn’t mean there isn’t serious malnutrition and starvation in the world.
Suppose, however that for political reasons, North Korea refuses to accept food aid. Does this mean that everyone should rush off to do research and “think outside the box” in order to figure out new ways of treating famine? Of course not. The proper response is to bring political and economic pressure to bear on the North Korean leadership to force them to accept food aid. This isn’t smug Westerners telling a developing nation to “let them eat cake,” it’s a practical response to a political crisis.
A similar response applies to AIDS, not just in Africa, but in Asia as well. Some African and Asian countries are taking the culturally necessary steps to combat AIDS and it’s working quite well.
I’m a bit concerned about your comment
I’m going to assume that it doesn’t mean what it appears to mean. I’m sure you realize that when it comes to AIDS, Mbeki is a particularly unattactive cross between a raving lunatic and a drooling idiot. You bet “thinking outside the box” is necessary to find Mbeki’s “African Solution” A couple of speedballs, 50mg of acid and a quart of Jack Daniels won’t hurt either.
The situation in SA is a classic political problem. It’s what happens when you have no effective opposition to keep the government on the straight and narrow. Appearently, Mbeki can say any damn fool thing he wants and no one will call him on it. This doesn’t, however, mean that the rest of the world can or even should attempt to accomodate his foolishness out of “respect” for other cultures. On the contrary, out of respect for the people of South Africa, the rest of the world ought to, metaphorically, put his head in a vice until he gets with the program.
You’re not going to have any argument from me about the man being a nutcase. Maybe I let my devil’s advocacy get away from me a bit, but what I was trying to get out is since the nutcase doesn’t seem to be going away any time soon, we may have to work within his considerably flawed system - and that would entail new types of thinking to get around the flaws.
Again, no argument here. Please notice that I named the hypothetical anti-vaccine “Eradication Vaccine decreed by International Law”. Notice the acronym. But I disagree with the benefits being irrelevant. I was trying to tell justinh that it wouldn’t work, but that it does raise interesting ethical issues.
Sua, efrem, imagine if a next generation swine flu was isolated in a small town of 2500 in Wyoming. The mortality rate is 70%. The President has declared a national emergency and FEMA has issued a quarantine which the national guard is enforcing. I think it would be foolish to assume that the Guard could never use lethal force in maintaining the quarantine. It may take more than simply asking them nicely. Is that evil?
I am not sure of justinh’s intentions in starting this thread, but I think he inadvertently stumbled over some interesting questions. I may start a thread on the ethics of quarantines and extreme measures in the next week or so to further discuss the subject without all the irrelevant AIDS stuff. Till then,
Beeblebrox,
You are correct that I used a bad example for quarantine. I have found that if you use a generic ethnical question then the discussion gets to idealistic. I tried AIDS cause it is widespread, dangerous, growing, and personal (most people know someone with it). But AIDS causes too many kneejerk reactions.
And the idea of the plague being found in an isolated city is too simplistic although interesting. I would expand the scenario to a small town and everyone who had visited in the last 3 months. Great idea for a movie.
How far could the govt go to protect the general population from the infection by this group? Erecting lethal barricades around the town and then importing anyone proved to have visited in the last 3 months? What about anyone having sex with one of the visitors?
Napalming the town?
Thousand questions. How much would the selling of the solution by the govt affect the popular opinion? Any historical references? (Ethnic cleansing doesnt apply since there isnt a direct threat to the population for the most part.)
Vanilla,
Because your husband didn’t infect who then he is not a threat?
Justin, I am aghast at your implied attitude that you (or the group you posit as developing this so-called cure) have the right to decide who is to live or die.
Let me offer one further suggestion. Suppose your hypothetical scenario comes true, and is put into place two weeks from today. And suppose in that two weeks you are injured with substantial loss of blood, taken to the hospital, given a transfusion – but, despite the ARC’s best efforts, this transfusion contains HIV virus from a donor who was not aware of being HIV+ and slipped through the various checks to prevent this from happening.
Now, is it a good idea?
Oh, and just for the record, vanilla’s husband died of AIDS. I sincerely think you owe her an apology for your snotty comment to her regarding someone she cared about deeply who died of it. You may disagree, but most decent people would do so, and I believe you can act in a courteous, civilized manner when you so choose.
Vanilla,
I cannot imagine your grief with the lost of your husband. My prayers are with you and all the others who has lost loved ones to this disease. I often rant and forget that these are very personal issues with some members. I get emotional trying to protect my family.
That is what disturbs me about AIDS. I can’t believe that we cannot combat it. The current passive strategy just doesnt work.
My mother-in-law’s answer is to pray for their souls. My answer is something must be done to stop it. I know 2 people who have it. Neither one of them did anything to get it. But all the same they are condemned by a blood transfusion and a druggie wife. How could we have stopped them from getting it???
I don’t know the answer, but I know what the answer is not. (education, research into cure, false sense of security)
AIDS is not the issue here. If they find a cure next week for it then we still have the same issue. With genetic engineering, world wide commerce, terrorist, biological warfare,… we are threatened by a plague that the world has never seen. Something that won’t just run its course.
Do we recognise this and change our approach to defend ourselves or do we stay as caring, compassionate souls and just die off?
Polycarp,
Thanks for the slap in the kisser. My wife says I am a boob and sometimes I must agree. Glad everyone is not like me.
**
I’m sorry, but I have no idea what you’re trying to get at here. Are you concerned about globalisation? Terrorism? The effect of genetic testing on insurance rates? Designer babies? What?
Wow, you’d (theoretically) kill millions of people to protect your family from something that they can protect themselves from with a little common sense?
It works just fine, if people actually do the things they’re supposed to do to avoid getting it. If they are willfully ignorant, are unable to gain access to the information they need, or it is forced upon them, that is another situation, but if they know what not to do and do it anyway, those are the risks you take in life. Life is risk. Are you going to “protect your family” from terrorism by never boarding a plane again; from drunk drivers by never driving again; or from slip and fall accidents by never taking a shower again?
In the first case, blood screenings have been in place for years. When did this person contract HIV? Getting it was a horrible, horrible accident, but the fact remains that safeguards are in place and are working. In the second case, perhaps helping his wife get off drugs? Yes, this is tragic - no one should have to have this disease. But wiping out millions of people isn’t the answer by any reasonable stretch of the imagination.
Yes, actually, these are the answers, and we’ve already proven that they’re working, at least in the U.S. We’re also proven that they’re not working in other parts of the world because they’re not being implemented.
You’re right - unreasonable paranoid hysteria is. Educate yourself. Be smart. Make responsible choices. And guess what? You and your family will benefit.
Now you’re sounding positively rabid fundamentalist. Are you?
We can protect ourselves and be caring and compassionate. Why would they be mutually exclusive?
Justinh, dear, you seem to be a bit caught up with movie scripts.
May I suggest that in considering ethical dilemmas, try not to start with proposition: What Would Joe Eszterhas Do?
And if you really insist on doing so, try not using HIV as your proposed Pandemic of Choice. You see, dealing with HIV is complex. It requires nuance, intelligence, and patience.
HIV is in many respects sui generis. No other disease goes silent for so long, which can allow its carrier to infect many while the virus itself remains relatively uninfectious.
(Justinh, if that sentence confuses you - go read a lot on HIV. Now. Start here, with HIV InSite’s background papers on the natural science of HIV. When you’re done with that, work on this, JAMA’s background briefings on HIV. And please don’t post on this until you’re done.)
So yes, you’ve identified a possible ethical conundrum. But you haven’t any facts to back up what you’re suggesting, and you dismiss possible alternative facts that might allow for an analysis. That leaves nothing but a form of auditory masturbation in which you listen to yourself talk and expect us to for an audience. It’s boring. Please stop.