A decade of a maturing epidemic: An assessment and directions for future public policy

L. Gostin

Research output: Contribution to journalReview articlepeer-review

Abstract

It has been nearly a decade since the first cases of AIDS were reported by the United States Centers for Disease Control (CDC). During that time there have been over 200 statutes enacted in every jurisdiction in the country. Unfortunately, the content of the legislation is highly diverse, even inconsistent, from state to state, and there is very little guiding federal legislation or regulation. The profound social, moral and public policy dilemmas that are magnified by the Human Immunodeficiency Virus (HIV) epidemic are still no closer to resolution. Should testing for HIV infection be voluntary, routine or compulsory when there is a higher risk of transmission of HIV? Should America return to traditional moral values of abstinence outside of marriage and zero tolerance of drug use, or should we teach safe sex and use of sterile injection equipment? Should health care professionals maintain strict confidentiality or do they have a duty to protect third parties in imminent danger? If there is a duty to protect, to whom does the duty apply and what steps need to be taken to provide protection? Is current anti-discrimination law necessary and sufficient, and should health care professionals have a duty to treat all persons infected with HIV? How much does it cost and who should pay for the care and treatment of persons with HIV disease - self-pay, private insurers, state or federal government? Should public health officials conduct, or condone, needle distribution programs to protect drug users from the needle-borne spread of HIV? After almost a decade of a maturing epidemic, there are still few innovative statutes to answer these critical public policy questions. The Harvard University/World Health Organization Collaborating Center on Health Legislation initiated the Harvard Model AIDS Legislation Project in early 1988. Supported by the Sloan Foundation, the New York State AIDS Institute and the Robert Morris Foundation, the Project developed model legislative guidelines on five of the most important public health issues raised by the HIV epidemic; a summary review of existing state AIDS legislation is published elsewhere. By early 1989, nationally recognized scholars drafted papers for the Project and submitted them to a group of distinguished public health and legal commentators.

Original languageEnglish (US)
Pages (from-to)1-32
Number of pages32
JournalAmerican Journal of Law and Medicine
Volume16
Issue number1-2
StatePublished - Jan 1 1990

ASJC Scopus subject areas

  • Health(social science)
  • Law

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