Community without communitarianism: HIV/AIDS research, prevention and treatment in Australia and the developing world.
The advent of HIV focussed broad social attention on the group of people most affected by it in Australia, the so-called 'gay community'. However, what a gay community actually was, and what kind of rights and duties were being attached to it remained unclear. However, it is obvious that such a community--or communities--did not fit the model proposed by communitarian writers like Michael Sandel and Charles Taylor, whereby subjects cannot stand outside their own constitutive attachments. I also consider the common criticism of communitarianism, and see what kinds of collectives can in fact be considered ethical. The first part of the paper looks at the ethical issues surrounding community attachment of this kind in Australia in relation to the ethics of HIV/AIDS clinical research. In particular I examine the way in which certain forms of gay community attachment can be used to strengthen personal autonomy and check exploitation within the prevention and research process. The second part of this paper draws upon the issues just discussed. In particular I focus on the use of 'community' in the research process in developing countries, and suggest ways in which cultural considerations might strengthen autonomy. However, I go on to suggest that in many cases the idea of community has served the opposite purpose, and has in fact been used to oppress certain individuals and groups within the developing world, in the so-called interests of the greater good. In order to avoid this, I suggest a model of social and ethical research whereby all subjects and researchers in the clinical process might stand in greater relationships of equality with each other.
Zion
Deborah
D
Department of Medicine, Centre for Human Bioethics, Monash University, Australia.
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000517:prevention & control*; D001315:Australia; D002986:Clinical Trials as Topic / Q000941:ethics*; D003466:Cultural Characteristics; D003906:Developing Countries; D017007:Duty to Warn; D028663:Ethical Theory; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control*; D018451:Homosexuality, Male; D006801:Humans; D007258:Informed Consent; D008019:Life Style; D008297:Male; D021841:Safe Sex; D012747:Sexual Partners; D012941:Social Responsibility