The Williams case entails two seemingly viable options. The first involves creation of a registry for HIV-infected persons by the Public Health department and has been proposed by the New York State legislature. Accordingly it requires that every person diagnosed as HIV positive must be reported on the registry. In other words all carriers of the HIV virus must be on the health department rolls so that each of them can be held accountable for outbreaks such as the one mentioned in the case. The second, also a legislative proposal, recommends that failure to divulge the disease to a sexual partner be made a felony.
This option demands that people who fail to warn their partners are liable to be prosecuted and imprisoned. 2. Recommend a course of action among stated options – based on clear criteria and analysis At first glance the first option of creating a registry to record the names of HIV infected individuals seems like a plausible solution. But then it is silent about what kind of action needs to be taken when a carrier of the virus has infected other innocent people. The second proposal answers this question comprehensively.
Therefore an effective course of action would be a combination of the two proposed legislative proposals. The first step would be to create a registry with the names of the HIV infected people on the list and assign each of these individuals to a health worker who will monitor their actions. Second make it mandatory for HIV infected individuals to warn their partners about their condition prior to the intercourse, failure to do which could lead to incarceration or a more stringent punishment (in case of multiple transmissions) as the case may require.
3. Present a compelling argument for recommendation based on several clear, compelling reasons. The two options, each taken individually, have some inherent ambiguities. For instance as in the first case if a registry with the names of all HIV infected persons is commissioned the advantage is that each of these people can be tracked and their moves can be monitored. But this proposal, however, faces some opposition from those who believe that the names of infected people must be kept anonymous.
This due to the possible negative fallout if the names are made public especially because of the stigma associated with the disease. Another thing this proposal fails to take notice of is the method of tracking these carriers of the virus. It is highly tedious, if not delicate (almost infringing on the right to privacy), for a health worker to keep an account of the various ‘encounters’ that a patient may have. Therefore this proposal needs to be substantiated by some more practical solutions before it can be implemented.
The second proposal recommends imprisonment as a deterrent for the carriers of the virus. It is based on the idea that the threat of prosecution can prevent the infected from transmitting the virus to others. The proposal does not take into account a few important facts. First it is highly improbable that there can be consensual sex when one of the partners is HIV infected, especially because people are a lot more informed nowadays. Second, the proposal’s view that by treating a carrier (who has infected another) as a felon will discourage others is meaningless.
The fact remains that regardless of what punishment is awarded to the person with HIV the partner still contracts the disease. Third the assumption that since in the Williams case they could find the source of the infection, therefore it is possible in the rest of the cases is unfounded. The course of action thus recommended is a combination of the two options stated in the case. The two proposals, if implemented simultaneously, actually complement each other.
For example once a person knows he/she is on the list of HIV carriers he/she will know that they are being monitored closely; and if this isn’t deterrent enough then the threat of jail time as possible consequence of the act, will surely dissuade most people. Hence, a proposal that envisages the merits of both the viable options needs to be tabled and it could also address some other core issues such as the number of health workers needed for the plan, which were left out in the previous proposals.