March 18, 1986

Crucial Steps in Combating the Aids Epidemic; Identify All the Carriers

I have read and listened, and I think now that I can convincingly crystallize the thoughts chasing about in the minds of, first, those whose concern with AIDS victims is based primarily on a concern for them and for the maintenance of the most rigid standards of civil liberties and personal privacy, and, second, those whose anxiety to protect the public impels them to give subordinate attention to the civil amenities of those who suffer from AIDS and primary attention to the safety of those who do not.

Arguments used by both sides are sometimes utilitarian, sometimes moral, sometimes a little of each -and almost always a little elusive. Most readers will locate their own inclinations and priorities somewhere other than in the polar positions here put forward by design.

School A suspects, in the array of arguments of School B, a venture in ethical opportunism. Look, they say, we have made enormous headway in the matter of civil rights for all, dislodging the straight-laced from mummified positions they inherited through eclectic superstitions ranging from the Bible's to Freud's. A generation ago, homosexuals lived mostly in the closet. Nowadays they take over cities and parade on Halloween and demand equal rights for themselves qua homosexuals, not merely as apparently disinterested civil libertarians.

Along comes AIDS, School A continues, and even though it is well known that the virus can be communicated by infected needles, known also that heterosexuals can transmit the virus, still it is both a fact and the popular perception that AIDS is the special curse of the homosexual, transmitted through anal sex between males. And if you look hard, you will discern that little smirk on the face of the man oh-so-concerned about public health. He is looking for ways to safeguard the public, sure, but he is by no means reluctant, in the course of doing so, to sound an invidious tocsin whose clamor is a call to undo all the understanding so painfully cultivated over a generation by those who have fought for the privacy of their bedroom. What School B is really complaining about is the extension of civil rights to homosexuals.

School A will not say all that in words quite so jut-jawed, but it plainly feels that no laws or regulations should be passed that have the effect of identifying the AIDS carrier. It isn't, School A concedes, as if AIDS were transmitted via public drinking fountains. But any attempt to segregate the AIDS carrier is primarily an act of moral ostracism.

School B does in fact tend to disapprove forcefully of homosexuality, but tends to approach the problem of AIDS empirically. It argues that acquired immune deficiency syndrome is potentially the most serious epidemic to have shown its face in this century. Summarizing currently accepted statistics, the Economist recently raised the possibility ''that the AIDS virus will have killed more than 250,000 Americans in eight years' time.'' Moreover, if the epidemic extended to that point, it would burst through existing boundaries. There would then be ''no guarantee that the disease will remain largely confined to groups at special risk, such as homosexuals, hemophiliacs and people who inject drugs intravenously. If AIDS were to spread through the general population, it would become a catastrophe.'' Accordingly, School B says, we face a utilitarian imperative, and this requires absolutely nothing less than the identification of the million-odd people who, the doctors estimate, are carriers. How? Well, the military has taken the first concrete step. Two million soldiers will be given the blood test, and those who have AIDS will be discreetly discharged Discreetly, you say!

Hold on. I'm coming to that. You have the military making the first massive move designed to identify AIDS sufferers - and, bear in mind, an AIDS carrier today is an AIDS carrier on the day of his death, which day, depending on the viral strain, will be two years from now or when he is threescore and 10. The next logical step would be to require of anyone who seeks a marriage license that he present himself not only with a Wassermann test but also an AIDS test.

But if he has AIDS, should he then be free to marry?

Only after the intended spouse is advised that her intended husband has AIDS, and agrees to sterilization. We know already of children born with the disease, transmitted by the mother, who contracted it from the father.

What then would School B suggest for those who are not in the military and who do not set out to get a marriage license? Universal testing?

Yes, in stages. But in rapid stages. The next logical enforcer is the insurance company. Blue Cross, for instance, can reasonably require of those who wish to join it a physical examination that requires tests. Almost every American, making his way from infancy to maturity, needs to pass by one or another institutional turnstile. Here the lady will spring out, her right hand on a needle, her left on a computer, to capture a blood specimen.

Is it then proposed by School B that AIDS carriers should be publicly identified as such?

The evidence is not completely in as to the communicability of the disease. But while much has been said that is reassuring, the moment has not yet come when men and women of science are unanimously agreed that AIDS cannot be casually communicated. Let us be patient on that score, pending any tilt in the evidence: If the news is progressively reassuring, public identification would not be necessary. If it turns in the other direction and AIDS develops among, say, children who have merely roughhoused with other children who suffer from AIDS, then more drastic segregation measures would be called for.

But if the time has not come, and may never come, for public identification, what then of private identification?


You have got to be kidding! That's exactly what we suspected all along! You are calling for the return of the Scarlet Letter, but only for homosexuals!

Answer: The Scarlet Letter was designed to stimulate public obloquy. The AIDS tattoo is designed for private protection. And the whole point of this is that we are not talking about a kidding matter. Our society is generally threatened, and in order to fight AIDS, we need the civil equivalent of universal military training.

William F. Buckley Jr., editor of the National Review, is author, most recently, of ''Right Reason.'' His syndicated column appears locally in The New York Daily News.

Return to the Books Home Page



Help/Feedback | Classifieds | Services | New York Today

Copyright 2000 The New York Times Company