Life as an Extreme Sport

wide reflective equilibrium and HIV testing recommendations

I spent a few hours this evening reading, and writing up a rough proposal for a paper due soon. This is that proposal,…

Thanks so much for the recommendation of Norman Daniels. I’m not sure how
I’ve not come across him so far, but I’ve picked up both “Seeking Fair
Treatment: From the AIDS Epidemic to National Health Care Reform” and
“Justice and Justification: Reflective Equilibrium In Theory and Practice”
and they’ve helped crystalize a lot of the more abstract nature of Rawls
for me.

For the first paper topic, as we already briefly discussed, I would like
to do an applied analysis of the new CDC HIV testing guidelines. While
there are several major changes in the new recommendation guidelines, what
I am specifically interested in discussing is, I suppose, the fairness or
justness of testing adolescents, particularly those in the 13-18 year old
age range. Limiting my scope to New York State law, the basic problem is
this: an adolescent can consent to HIV testing, and notification laws do
not require that the parents of an adolescent be contacted if the minor is
seropositive. However, a minor cannot consent to HIV treatment, parental
approval must be sought. While family planning clinics can offer HIV
testing, the only treatment they are allowed to provide to a minor is that
relating to family planning – that is, to provide birth control services,
abortion access, and STI testing and medical treatment for that which can
be cured.

The problem, then, becomes a conflict of several interests: the social
obligation to protect those who’re seronegative, the social obligation to
protect the privacy of adolescent sexual lives, and creating a situation
of conflicting interests for health providers, who cannot protect the
privacy of seropositive teenagers and treat them for the disease.

I think that the best way to look at this is simply utilizing Rawls’ wide
reflective equilibrium, basically testing various aspects of the moral
beliefs we hold against one another. Can we use a fair procedure to select
among the various moral beliefs/princinples that are coming in to
conflict, and reach some principled conclusion (whether it agrees or
disagrees with the CDC recommendations)? Daniels provides a framework for
how to approach this, without specifically addressing the issue of opt-out
HIV testing.

I have a feeling that will give me more than enough material for the
suggested length of this particular paper, especially if I follow Rawls
model of showing how his theory differs from what utilitarianism would
demand (and in this case, the utilitarian answer is crystal clear –
interestingly, I’m not entirely certain what the Rawlsian answer will be).

So, I think that’s my topic proposal. Please let me know where you think I
should go with it, or any modifications I should make.