Sexually-transmitted disease: the ethical basis of prevention

Gonzalo Herranz, department of Bioethics, University of Navarra, Spain
International Conference Women's Health Issues
Rome, February 18-22, 1998

Abstract

After a brief reference to the general demographic dimension, the temporal trends, and the health costs of sexually-transmitted diseases (STDs), the presenter offers for discussion some critical issues on the role of women on defining the ethical basis for STDs prevention.

In the opinion of the presenter, there is a pressing need to mend the mistakes of the remote past, remnants of which are still among us, with its "Victorian" attitude of double standard (for men or women) of sexual morality connected to stigmatisation and bad-natured moralistic disapproval; as well as to analyze and refute the mistakes of the current official public health doctrine, with its strong prejudice of STDs as mere biological phenomena, amenable only to physical preventative measures and to soft and practically useless educational measures.

In this way, official STDs prevention becomes a procedural question on how more efficiently to uncouple sexual activity from transmission of microorganisms, a problem deliberately separated from any anthropological or moral issues. There is an acknowledged scarcity of scientific data on the effects of "hard" sexual education on adolescents, on the epidemiological results of condom distribution, and on the outcomes of information given by older peers. Regretfully, the reductionistic official approach situation remains almost undisputed and protected by the reluctance of the "establishment" to accept as valid those alternatives based on a personalist view of man and woman.

There is broad place for those alternatives. Curiously, the first two elements of the "ABC" strategy of the official STDs prevention are the neglected Abstainfrom sex and Bemutually faithful (the third is Consistentlyuse condoms). But until now only very few and limited efforts have been made at the educational level to develop a new culture of sexuality based in the principles enunciated by John Paul II on His teachings on women's issues.

From the scientific point of view, the lack of information on truly humane ways of preventing the transmission of STDs opens the way to creative endeavours, stressing the preventive potential of such attitudes as respect for the woman, the dignity of human sexuality, the duty not to harm others, and the value of chastity and self-restraint.