Blog | Thursday, June 4, 2015

Misguided morals are making Americans sick


Two stories in the news have brought home the consequences of Americans' willful ignorance of science, an ignorance often driven by a sense of moral outrage. This outrage is misdirected.

A small town in southern Indiana, already suffering from poverty and unemployment, has been hit with the double whammy of drug addiction and HIV. The rates of HIV in and around Austin are insanely high—so far, there are about 135 cases in this town of less than 4,5oo people. Most of those infected acquired it through sharing needles used to inject prescription pain medications. Many are also infected with hepatitis C, a virus that can lead to cirrhosis and liver cancer.

Both HIV and hepatitis C are preventable and treatable. But given the ignorance and high-handed morals of local officials, this epidemic is likely to get worse. The New York Times is reporting that Indiana officials can't seem to decide whether to help the sick or punish them.

Despite the proven success of needle exchange programs, Governor Mike Pence opposes the practice–except for now, in the affected area only. Because we all know that epidemics respect political boundaries like county lines. And local cops don't seem to understand the whole idea. According to the Times, “[T]he police are arresting anyone found with needles but no card, saying it will prod more people to participate [in the official exchange program].” While this approach may sit well with the punitive moral temper of those fortunate enough to have a job and food on the table, it's insane. The response of the cops should be to carry extra needles and hand them out to known users.

People get addicted to drugs. We have the means to prevent them from getting ill, and for treating them if they do, but not if we sit in judgement rather than reminding them they are equally a part of our community and worth saving.

A community in Texas is suffering from a similar strain of stupidity, one that may well lead them toward the problems suffered in southern Indiana. Crane Intermediate School District in West Texas with a tiny student population of about 300 has at least 20 cases of chlamydia floating around, and given how often people have it but don't know, there's probably a lot more.

The school system does not currently provide sex ed classes, and in Texas, sex ed has to be abstinence-based, a failed idea that just won't die.

Similar to the conflicted response in Indiana, Crane doesn't seem to understand how to stem the epidemic. A letter sent home to parents, posted at ABC News, details the diagnosis and treatment of chlamydia, but makes no mention of prevention.

These 2 epidemics have 1 thing in common: they are caused not by the victims but by community leaders. Based on their behavior, these leaders have decided that STDs are just punishment for evil behavior. We know exactly how to prevent HIV, hepatitis C, and chlamydia, and how to treat them. The only conceivable reason not to immediately implement educational programs, easy needle exchanges and anonymous testing centers is the failed morality of community leaders.

The ignorant and immoral responses to health emergencies highlights our nation's failure in science education, and our failure to realize that telling someone not to engage in risky behavior never stopped anyone.

Peter A. Lipson, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. After graduating from Rush Medical College in Chicago, he completed his internal medicine residency at Northwestern Memorial Hospital. This post first appeared at his blog at Forbes. His blog, which has been around in various forms since 2007, offers "musings on the intersection of science, medicine, and culture." His writing focuses on the difference between science-based medicine and "everything else," but also speaks to the day-to-day practice of medicine, fatherhood, and whatever else migrates from his head to his keyboard.