In the Classroom: Students Challenge Their Ethical Assumptions.
“Disease has no civil rights!”
At the front of the classroom in GH 795: Global AIDS Epidemic, a debate is in full swing over AIDS colonies. A team of four students are arguing against quarantining individuals who are HIV positive—as a violation of human rights, an economic and social detriment, and a danger to the health of those individuals.
The three students arguing in favor have taken on personas: an epidemiologist, a resident of an AIDS colony, and the Minister of Public Health of Cuba, where AIDS colonies were created in the 1980s.
This is the last of three debates to conclude the course taught by Lisa Messersmith, associate professor of global health. Students have already debated mandatory testing and treatment of partners of HIV positive individuals, and whether harm reduction or arrest and retention is the best way to manage HIV risk among people who inject drugs.
In this final debate, both sides make powerful, impassioned arguments. The AIDS colony resident, a Cuban former sex worker who now counsels other young women, says her quality of life was improved by the education, care, and resources she received: “Living in an AIDS colony saved my life.”
The epidemiologist cites an estimate that 90 percent of all people who have been infected with HIV would not be if all countries affected by the epidemic had immediately created colonies. In “the balance between individual civil liberties and public health,” she says, “this is an instance when the latter should take precedence.”
The other team has also done their homework. They point out their opponents’ focus on Cuba, and offer Cambodia’s “AIDS prisons” as a deplorable counterexample. They argue Cuba’s success in combating HIV/AIDS is more attributable to the government’s “saturation” of vulnerable populations with prevention resources. They also question the epidemiologist’s interpretation of the data: “We can’t just measure success in numbers,” they argue. “You also have to measure it in quality of life.”
Through it all, the rest of the class cheers, exhales, oohs, laughs, and, as the debate opens up, dive right in.
“I’m always so excited about the debates,” says Messersmith, who has concluded the course this way for the last five years. “It’s an opportunity for the students to critically analyze a position and use all kinds of evidence—morality, emotion, science, art, whatever they want to bring to this position that they may or may not believe in. The skill of developing that kind of position is invaluable.
“People get really involved,” she adds. “They become passionate about the work, and that’s what I really love.”
“It’s so rewarding to see people develop these ideas,” agrees Student Life Program Manager Chase Crossno ’15, who serves as the TA of the course. “If you really know the other side, if you really know their argument, then you have the fuel to change their perspective.”
Salome Kuchukhidze, who played the Cuban public health minister, afterwards praised the debate for taking the students out of their comfort zone. “We assume that things are the right way to do things because we are public health professionals and we know the right way to do things, but through this exercise we found that there are people who do things in a different way, and guess what? An argument can be made for their viewpoint as well.
“That challenged my ethical assumptions about public health.”