(no subject)

[eirias]

I've been thinking a bit lately about social attitudes toward responsibility and disease. (I'm focusing here on mainstream and conservative attitudes; the majority of you are liberal types with backgrounds a bit different from mine, and so I know that your attitudes may not fit my description.) Under most conditions, upon learning that someone is sick, the socially appropriate response is to offer sympathy. But in the case of certain types of illnesses, there's a split: everyone offers sympathy, of course, but many of those people also privately blame the sick person for his or her affliction. Presumably, the particular circumstances that lead to blame might say something interesting about our society. Are we consistent in assigning personal responsibility for illness? What are the mitigating factors?

I've been thinking about this partially in the context of herpes, which is an STD in the sense that it is easily transmitted by multiple kinds of intimate contact, but gets classified differently by people depending on which quarters of the body it has infected. Admission that one suffers from cold sores is nothing much and barely registers on the TMI scale, but I have only in one instance heard someone say publicly that she suffered from genital sores. Cold sore medications are advertised on TV at all hours, IIRC, while I don't believe I've ever seen a TV ad for genital herpes meds. (If you think it's just about talking about genitals during prime time, compare to ads for Monistat and Viagra.) It strikes me that people's attitudes toward this disease really don't lend themselves to explanations of the "self-preservation" variety, at least not healthwise - compared to other STDs it's awfully minor. Hell, compared to a *lot* of communicable diseases, it's awfully minor. Influenza is highly contagious and sometimes lethal, and yet people don't shy away from telling their friends they've got the flu.

More generally, I think our response to VD is telling in how it differs from our response to other disease, life-threatening or not. A lot of people tend to look at VD as some kind of justice - as if to say, "well, if you didn't want to get gonorrhea, you shouldn't have been such a damn whore." They don't say this to sick people, of course - most Americans are civilized enough and have enough sense to know that that's inappropriate and cruel - but it's there all the same, in the fervor with which sexual abstinence is pushed as the best solution to public health crises, in the silence that surrounds a typical person's diagnosis. Absent wide agreement on the will of God, moralism nowadays is couched in terms of a dearth of personal responsibility. And it's of course true that one can take measures to avoid acquiring STDs, and that, where reasonable, one should do so. But really, one could take measures to prevent acquiring just about any transmissible disease. We (as a society) could take the position that kissing people is risky, and so people who do it are deserving of whatever they get - but we don't; by the same token, we could take the position that handshakes or hugs or air travel or really anything else that puts one in close proximity to a potential disease carrier constitutes a lapse in judgment worthy of punishment - but again, we don't. We could even extend this beyond sex and look at attitudes toward non-transmissible disease - when someone dies of lung cancer, the first question people tend to ask is whether s/he smoked, but when was the last time you heard anybody ask about the dietary habits of a victim of colorectal or pharyngeal cancer?

I was raised very much according to an ethic that frames itself as prudence: people who engage in certain behaviors under certain conditions are putting themselves at risk, and so when illness or tragedy befalls them, they are not entirely deserving of sympathy. I realized quite a while ago that this is not a particularly nice way to think about things (see above re: civility and sense ;) ), but it's only been within the last year or two, in part thanks to some enlightening conversation with ukelele*, that I've realized that it's also inconsistent with the way we respond to others' personal misfortune more generally. I don't think there's a way to write a formal model of moral responsibility based solely on risk that fully accounts for (mainstream and conservative) attitudes toward VD, abortion, and so on. I think that one could account for a good chunk of it, weighting by something like "perceived utility of behavior" - i.e., taking risk is more permissible if the behavior is something we accept as integral to living a normal life. But I suspect that there would still be a good deal of variance leftover. For instance, automobile accidents are a leading cause of death in my age range; and while it's true that Americans see cars as integral to living a normal life, many of us also use our cars in ways that are not at all necessary and sometimes downright stupid and wasteful. Nevertheless, I don't see anybody pushing for teaching "vehicular abstinence" in driver's ed courses, or urging youngsters to "save themselves for their commute."

I think we must ultimately ascribe this leftover variance in attribution of responsibility for disease to implicit influence from the Judeo-Christian sexual ethic of purity. Those acts which are pure according to this code are blameless, and so we feel sympathy for people who acquire disease while holding to that standard of purity; all others who suffer deserve their fate. But why should we as a society view sex with a lover as less pure than a handshake with a stranger?

*which had nothing to do with herpes.

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(Random note)

[roamin-umpire.livejournal.com]

That's the highest ratio of parenthetical text to non- that I've ever seen. :P