Chronic disease and disadvantage: the new politics of HIV infection

HIV infection is now perceived as the end stage of a chronic disease that is spreading most rapidly among blacks and Hispanics. The politics of the HIV epidemic in the 1980s were dominated by four interacting factors: fear and fascination; who had the disease and to whom it seemed to be spreading; the endemic problems of United States social policy; and the impact on policy of advances in scientific knowledge. This paper analyzes the political history of each of these factors and describes the dominant policies of the federal government and the states regarding HIV in the areas of surveillance, prevention, research, and financing. Four uncertainties will have a profound influence on the future politics of the HIV epidemic: how the states and the federal government will address the general problems of paying for the care of people with chronic diseases and providing access to care for the uninsured and the underinsured; the number and distribution of the sexual behaviors that transmit infection with HIV and the effectiveness of policies to persuade people to modify these behaviors; precisely who uses addictive drugs and the effectiveness of measures to change their behavior; and the natural history of the virus.     

Introduction to the Baby Jane Doe papers

A conference was held at the State University of New York at Stony Brook in October 1984 to discuss the controversy concerning treatment of a newborn with severe congenital defects that became known as the Baby Jane Doe case. Fox provides some background information on the case to introduce a set of of six articles consisting of papers delivered at the conference. These articles deal with historical aspects of the treatment debate (Stanley J. Reiser), problems of clinical decision making (John M. Freeman), the legal issues involved (John A. Robertson), coverage of the case by the media (Stephen Klaidman and Tom L. Beauchamp), federal efforts to regulate the treatment of handicapped newborns (Lawrence D. Brown), and the alliance that arose between opponents of abortion and advocates of the rights of the handicapped (Constance Paige and Elisa B. Karnofsky).