Opposition to State-Mandated Premarital HIV Screening

Opposition to State-Mandated Premarital HIV Screening

When screening for HIV became possible in mid-1985, debates began concerning the role of such screening in controlling the spread of AIDS. One such debate concerned state-mandated premarital HIV screening. This policy was proposed to the CDC conference in February of 1987, but never received much widespread support, because it satisfied neither the proponents of public health nor the proponents of civil liberties (Reamer 37). This essay will show that the state is unjustified in enacting such policy and hopefully also shed some light on why such policy received so little support.

In a liberal society such as the United States that values both civil liberties and public health, it is often unclear which policies best address the threat posed by the AIDS epidemic. It is clear that on the one hand, the United States is committed to respect the privacy and personal autonomy of its citizens. Though not expressly written in the constitution, the right to privacy is implicit in the right to deny illegal search and seizure of home and explicit in the recent laws that protect the privacy of internet and credit card users. On the other hand, the United States is also committed to "promote the general welfare", meaning it has a moral obligation to promote public health. Traditionally, in the struggle between civil liberties and public health, the United States has given precedent to civil liberties but yielded to departures when it was proven that doing so was justifiable by the resulting benefits to public health. AIDS, however, challenges the balance between civil liberties and public health like no other previous epidemic, due to the strong threat it poses to public health and ...

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...avior, they could probably have been identified through programs aimed at groups with a higher prevalence of seropositives. Hence, the last two conditions of our ethical framework are also not met.

Using an ethical framework borrowed from Childress, it is clear that a state committed to upholding the civil liberties of its citizens as well as promoting public health is unjustified in mandating premarital HIV screening. Such screening infringes on civil liberties and does not promote public health in an efficient way. The state is obligated to seek other policies by which to promote public health, such as voluntary testing and educational programming for married couples, which do not violate civil liberties and which more efficiently target those who are seropositive.

Works Cited

Reamer, Frederic G. AIDS & Ethics. Columbia University Press: New York, 1991.