Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-23T18:07:24.228Z Has data issue: false hasContentIssue false
  • English
  • Français

AIDS: From Social History to Social Policy

Published online by Cambridge University Press:  28 April 2021

Allan M. Brandt
Get access Rights & Permissions [Opens in a new window]

Extract

Despite philosopher George Santayana's famous injunction that those who do not remember the past are condemned to repeat it, history holds no simple truths. Nevertheless, there are a number of significant historical questions relating to the AIDS epidemic. What does the history of medicine and public health have to tell us about contemporary approaches to the very difficult dilemmas raised by AIDS? Is AIDS something totally new, or are there instances in the past that are usefully comparable? Are there some lessons in the way science and society has responded to epidemic disease in the past that could inform our understanding of and response to the current health crisis?

There are obviously no simple answers to such questions. History is not a fable with the moral spelled out at the end. Even if we could agree on a particular construction of past events, it would not necessarily lead to consensus on what is to be done. And yet, history provides us with one means of approaching the present. In this regard, the history of responses to particular diseases can inform and deepen our understanding of the AIDS crisis and the medical, social, and public health interventions available.

Type
Article
Information
Law, Medicine and Healthcare , Volume 14 , Issue 5-6 , December 1986 , pp. 231 - 242
Copyright
Copyright © American Society of Law, Medicine and Ethics 1986

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

One model has already been proposed in Susan Sontag's brilliant polemic, Illness as Metaphor. In this work, Sontag assessed the important ways in which tuberculosis and cancer have been used as metaphors. Using techniques of literary analysis she demonstrated prevailing cultural views of these diseases and their victims. See Sontag, S, Illness as metaphor, New York, 1978.Google Scholar
The following discussion is abbreviated from my book, No magic bullet: A social history of venereal disease in the United States since 1880, New York, 1985; rev. ed., 1987.Google Scholar
On the problem of ophthalmia neonatorum see Wolbarst, AL, On the occurrence of syphilis and gonorrhea in children by direct infection, American Medicine 1912, n.s., 7: 494; Von Blarcum, C, The harm done in ascribing all babies' sore eyes to gonorrhea, American Journal of Public Health 1916, 6: 926–31; and Kerr, JW, Ophthalmia neonatorum: An analysis of the laws and regulations in relation thereto in force in the United States, Public Health Service Bulletin 1914, no. 49.Google Scholar
Burr, AH, The guarantee of safety in the marriage contract, Journal of the American Medical Association 1906, 47: 1887–88.Google Scholar
See Brieux, E, Damaged goods, trans. Pollack, J, New York, 1913. On the critical reception of the play see Demoralizing plays, Outlook 1913, 150: 110; Rockefeller, JD, The awakening of a new social conscience, Medical Reviews of Reviews 1913, 19: 281; Damaged goods, Hearst's Magazine 1913, 23: 806; Brieux's new sociological sermon in three acts, Current Opinion 1913, 54: 296-97. See also Rosenkrantz, BG, Damaged goods: Dilemmas of responsibility for risk, Health and Society 1979, 57: 1-37.Google Scholar
Kelly, H, Social diseases and their prevention, Social Diseases 1910, 1: 17; Kelly, H, The protection of the innocent, American Journal of Obstetrics, April 1907: 477-81.Google Scholar
On prostitution in Progressive America see Boyer, PS, Urban masses and moral order, Cambridge, 1978; Rosen, R, The lost sisterhood: Prostitution in America 1900–1918, Baltimore, 1982; and Connelly, MT, The response to prostitution in the Progressive Era, Chapel Hill, 1980.Google Scholar
On non-venereal transmission see especially Bulkey, LD, Syphilis of the innocent, New York, 1894.Google Scholar
What one woman has had to bear, Forum 1912, 68: 451–54. See also New laws about drinking cups, Life 1911, 58: 1152.Google Scholar
The wartime policy for the attack on the red-light districts and the testing and incarceration of prostitutes are described in greater detail in Brandt, No magic bullet, supra note 2, at 80–95.Google Scholar
Gregory, TW, Memorandum on legal aspects of the proposed system of medical examination of women convicted under section 13, Selective Service Act, National Archives, Record Group 90, Box 223. See also Dietzler, MM, Detention houses and reformatories as protective social agencies in the campaign of the United States government against venereal diseases, United States Interdepartmental Social Hygiene Board, Washington, D.C., 1922.Google Scholar
Pierce, CC, The value of detention as a reconstruction measure, American Journal of Obstetrics 1919, 80: 629.Google Scholar
AFRAIDS, The New Republic, October 14, 1985: 7–9. See also Krauthammer, C, The politics of a plague, The New Republic, August 1, 1983: 18-21.Google Scholar
New York Times, June 26, 1985.Google Scholar
Winsten, JA, Fighting panic on AIDS, New York Times, July 26, 1983.Google Scholar
The fear of AIDS, Newsweek 1985, 106: 18–25. On the school controversy see New York Times, October 13, October 24, and December 8, 1985. Also Rothman, DJ, Public policy and risk assessment in the case of AIDS, forthcoming, United Hospital Fund.Google Scholar
Eisenberg, L, The genesis of fear: AIDS and the public's response to science, Law, Medicine & Health Care 1986, 14: 243–249; Balzell, R, The history of an epidemic, The New Republic 1983, 189: 14-18; Goldstein, R, The uses of AIDS, Village Voice, November 5, 1985: 25-27.Google Scholar
Fear and AIDS in Hollywood, People, September 23, 1985: 28–33; New York Times, November 7, 1985; Washington Post, July 28, 1985.Google Scholar
Life 1985, 8: 12–21.Google Scholar
See Bayer, R, Homosexuality and American psychiatry: The politics of diagnosis, New York, 1981.Google Scholar
New York Post, May 24, 1983.Google Scholar
Quoted in New York Times, March 18, 1986.Google Scholar
Goffman, E, Stigma: Notes on the management of spoiled identity, Englewood Cliffs, N.J., 1963.Google Scholar
On the Justice Department ruling see New York Times, June 23 and 27, 1986; Wall Street Journal, June 17, 1986.Google Scholar
New York Times, June 26, 1986.Google Scholar
Krauthammer, C, Fear him and fire him, Washington Post, June 27, 1986.Google Scholar
New York Times, July 1, 1986.Google Scholar
On military testing, see New York Times, October 13, 1985, January 31 and February 2, 1986; Science, July 18, 1986. Military screening has shown relatively high rates of infection. In Manhattan, 2 percent of individuals applying to enter the service were found to be infected; these numbers are 15 to 20 times higher than the estimated national prevalence.Google Scholar
Among those who have recommended mandatory screening for high-risk individuals are Lewis Kuller, professor of epidemiology at the University of Pittsburgh, and Paul Starr, professor of sociology at Princeton. See Chronicle of Higher Education, June 4, 1986.Google Scholar
Buckley, WF Jr., Identify all the carriers, New York Times, March 18, 1986.Google Scholar
See, for example, Senak, M, Ban AIDS blood tests, New York Times, May 27, 1986.Google Scholar
New York Times, June 11, 1986. See also the full-page advertisement of the American Council of Life Insurance and the Health Insurance Association of America, Washington Post, May 11, 1986.Google Scholar
Quoted in Washington Post, June 20, 1986, June 28, 1986.Google Scholar
New York Times, January 10, June 8, and November 3, 1986; on the problem of financing AIDS see also Seage, GR, The medical cost of treatment of AIDS/ARC patients, Boston Department of Health and Hospitals, May 12, 1985; Lee, PR, AIDS: Allocating resources for patient care, Issues in Science and Technology 1986, 2: 66–73; and especially Fein, R, AIDS and economics, AIDS Institute of the New York State Department of Health, May 29, 1986.Google Scholar
Washington Post, May 25, 1983, July 23, 1985; New York Times, June 15, 1983, July 29 and October 24, 1985; and especially, Office of Technology Assessment, U.S. Congress, Review of the Public Health Service's response to AIDS: A technical memorandum, Washington, D.C., February 1985.Google Scholar
Fineberg, HV, A way to tackle AIDS education, New York Times, July 13, 1986; also Cleary, P et al., Health education about AIDS risk, Health Education Quarterly, forthcoming.Google Scholar
New York Times, July 6, 1986.Google Scholar
For an analysis of the difficult social policy questions raised by AIDS, see Bayer, R, AIDS, power and reason, Milbank Quarterly 1986, 64 (supp 1): 668–82. On legal issues see Gostin, L, Curran, WJ, Clark, M, First line of defense in controlling AIDS, American Journal of Law and Medicine, forthcoming.Google Scholar
See Eisenberg, , supra note 17; also Conrad, P, The social meaning of AIDS, Social Policy, forthcoming.Google Scholar
Henig, RM, AIDS: A new disease's deadly odyssey, New York Times Magazine, February 6, 1983: 36.Google Scholar
See, for example, Knowles, JH, The responsibility of the individual, Daedalus 1977, 106:68; and Carlen, R, Against free clinics for sexually transmitted diseases, New England Journal of Medicine 1982, 307:1350.Google Scholar
Dowling, H, Fighting infection, Cambridge, Mass., 1977: 228–50; New York Times, January 23, 1977.Google Scholar