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AIDS: Ethics and Public Policy.

AIDS: Ethics and Public Policy

Social scientists were relative latecomers to the AIDS industry. Ethicists and lawyers, to their credit, recognized much sooner the pertinence of their expertise to the difficult problems raised by the epidemic. By the beginning of 1988, however, the pioneers from all three disciplines had been joined by hundreds of their formerly reticent colleagues. This surge of interest is being fueled with funds from federal agencies and foundations. Issues that had been addressed mainly by social scientists and philosophers who were considered marginal because of their interest in "applications" were now part of the mainstream. In December 1987, for example, the Social Science Research Council permitted a staff member to say, in a widely circulated publication, that AIDS was now "a challenge for the social sciences."

None of these points about recent history is made in the books under review, mainly because the technology of publishing cannot cope with the rate of change in the social response to AIDS. One, Feldman and Johnson, appeared in 1986. The other, Pierce and VanDeVeer, though copyrighted 1988, has no citations later than the fall of 1986.

But there is another reason. The editors of both books have curious definitions of the words they chose for their titles. For Feldman and Johnson, "social dimensions" include the sociology of organizations, social psychology, behavioral science, and epidemiology, but exclude the politics and priorities of social science disciplines, ethics, economics, law, and public policy. For Pierce and VanDeVeer, "ethics and public policy" includes the history of venereal disease and homosexual rights and issues of quarantine and testing, but leaves out biomedical research, the allocation of scarce resources, and the organization of health services. Neither set of editors is curious about why we have an AIDS industry--just as we have cancer, mental health, heart disease, and brain injury industries (alongside textiles, automobiles and the rest) in the United States.

Despite their inattention to the politics and economics of AIDS, however, these books are substantial contributions to a growing and, alas, repetitive literature. The Feldman and Johnson collection has strong sections on "Social Epidemiology," "Lifestyles and Behavioral Change" and "Health Beliefs and Behavior." Particularly notable papers in these sections include William E. Darrow, et al., "The Social Origins of AIDS," (which provides much of the scientific grounding for some lurid passages in Randy Shilts's And the Band Played On); Don C. Des Jarlais, et al., "AIDS and Needle Sharing within the IV-Drug Use Subculture," and Diane Bolognone and Thomas M. Johnson, "Explanatory Models for AIDS." The remaining articles are entirely respectable, although several are plodding exercises in social science methodology. (Indeed, the only contribution with ideology and politics in the title addresses the problems of organizing a dedicated ward for persons with AIDS.) Most important, this book offers evidence that by 1985 a substantial number of gifted social scientists were working hard at problems raised by AIDS; and that none of them held senior rank in academic disciplines at our major research universities.

The Pierce and VanDeVeer collection seems to have been prepared for use by educators. The editors' "General Introduction" and "Previews" of each section are among the best contributions in the book; solid reviews of biological, epidemiological, ethical and--in a limited way--public policy issues. The papers are mainly excerpts from published work (many without precise citations). Familiar contributors include Allan M. Brandt (who may be losing count of how many times he has summarized his 1985 book, No Magic Bullet), Ronald Dworkin, Ronald Bayer, Alvin Novick, and David Richards. The editors commendably make available outside the gay press two articles on gay perceptions of policy by Richard Mohr and include sensitive contributions on language by Judith Wilson Ross and "The Punishment Concept of Disease" by Loretta Kopelman. The essays on law are now obsolete with the publication, in the fall of 1987, of the Yale Law School volume, AIDS and the Law.

Both books are good primers for people interested in ethics and social science whose knowledge of AIDS comes entirely from newspapers and television. For more knowledgeable readers, these books are case studies of how much further we need to go to synthesize what we claim to know about individuals, small groups, and organizational behavior with our understandings about the economy and the polity.

Donald VanDeVeer, editors. Belmont, CA: Wadsworth Publishing Company, 1988. x + 241 pp. $13.50, paper.
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Author:Fox, Daniel M.
Publication:The Hastings Center Report
Article Type:Bibliography
Date:Aug 1, 1988
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