Thursday, December 21, 2006

Compulsory HIV tests for couples

Recently, I've been listening to World, Have Your Say on the BBC World Service. The programme can best be described as a global discussion forum for news. I was particularly interested in what was discussed on Wednesday's programme, which was the plan by an Indian state for compulsory HIV tests before marriage. This plan intends to make it compulsory for couples to undergo HIV tests before any marriage can be registered. This, along with other measures, is intended to reduce HIV rates in the state. More details about this news can be found on BBC's website here.

Listening in to the programme, I found that there were two general views on this plan. The first view expressed support for the plan, citing the benefit towards combating the spread of HIV. The second view, which appeared to be more biased towards Western thinking, criticized the plan on issues such as invasion of privacy and loss of freedom. The comments can be accessed here.

While I describe myself as a (classical) liberal thinker, I find myself unable to accept most of the objections raised against the plan. First, consider the objection of privacy invasion. Admittedly, we would not like for our entire health history to be made available to the general public. However, this ignores two considerations which are vital to the issue. The first consideration is that of communicable and highly infectious diseases. If someone were to carry a highly dangerous and infectious disease, such as Ebola or SARS, and chooses to hide the knowledge of his disease, citing privacy as a reason, the outcomes are clearly disasterous. It is sometimes neccessary for everyone to lose a little privacy for everyone's best interests. This consideration is highly relevant to the issue of compulsory HIV testing, because HIV is a pandemic.

The second consideration takes marriage into context. I would seriously question the character of a person who hides a disease as grave as HIV from his or her spouse. Such malice goes against the conception of marriage itself, which should be that one not harm one's spouse. Furthermore, another belief regarding marriage is that couples should be able to share much between themselves.

By similar arguments, we can dismiss the objection that these measures are too draconian. While I admit that forcing people to undergo medical tests seems unreasonable, we must remember that this plan does not does not really curtail a servere reduction in personal rights and freedom. Firstly, this compulsory testing is not frequent, and most people would only be required to undergo one test. Furthermore, the test itself is not for trivial or meaningless reasons. Hence, while the idea of compulsory tests seems unpalatable, it is actually quite reasonable. Still, I would agree that this opens some ground for a slippery slope, but with care, this should be avoidable.

In short, I believe that the plan is sound, at least on moral grounds. However, this judgement is only applicable to this particular social context. I have serious doubts whether this plan can be applied to other nations, especiallly Western states. The benefit in reducing HIV rates hardly seems worth the loss in social liberties in those states, considering the lower rates of HIV there. Furthermore, the relative wealth of the West allows for other methods to be used. In other words, the medicine must match the patient.

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