Civil libertarians against public health

Rich Lowry
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Posted: Feb 04, 2005 12:00 AM

Do we as a society prefer sick or healthy babies? Do we want babies to be infected with a potentially deadly virus or not? The answers seem obvious, but in a decade-long debate, a host of liberal groups, in effect, came down on the wrong side. Fortunately, in New York City -- once the epicenter of the epidemic of babies born with HIV -- their lunatic obsessions were rejected, and now the scourge of newborns infected with HIV has been all but eliminated.

    According to The New York Times, in 1990 there were 321 newborns infected with HIV in New York City. In 2003 there were five. A decade ago many pregnant mothers didn't know they were HIV-positive. They weren't urged to get tested, and so they couldn't take drugs that would make it less likely their babies would be infected. Newborns were tested, but -- incredibly -- in blind tests, meaning the mothers wouldn't be informed of the results. The mother wouldn't know to get treatment for her child or herself.

    As AIDS expert Roland Foster points out in a recent study, the most common AIDS-related opportunistic infection is pneumocystis carinii pneumonia. Babies with it generally die in a month. According to a New England Journal of Medicine study in the mid-1990s, two-thirds of children with this infection weren't getting treatment, because no one knew they had HIV. It is hard to imagine a more cruelly negligent public-health policy.

    Liberal Democratic New York assemblywoman Nettie Mayersohn was appalled -- as would be anyone with a wit of common sense -- when she learned of the situation. She resolved to pass a law mandating that all newborns be tested and their mothers informed. For this, Mayersohn seemingly bought the enmity of the entire liberal world.

    Gay groups, the HIV/AIDS lobby and the American Civil Liberties Union all opposed her on privacy grounds. As if a newborn has a "right" to have his infection kept from his mother so he can potentially die or get sick. Where does it say anything about that in the Bill of Rights? Feminist groups from NOW to NARAL attacked her for supposedly proposing to violate the reproductive rights of women. Her district office was picketed. Opponents argued that pregnant mothers just couldn't handle testing. "I'm sure we are going to see some women completely freaking out, committing suicide and running away from the whole situation," the director of the HIV Law Project predicted.

    "Just the opposite has happened," Mayersohn says. After a three-year fight, her bill passed in 1996. It revolutionized public health in New York. "The way they used to do counseling," she says, "they told women, if you get tested and test positive, you will lose your home and lose your job. After the law passed, they told women, your baby is going to get tested anyway, so if you get tested now, you can do something to keep your baby from being born HIV-positive."

    More mothers and babies now get care. An HIV-positive mother has roughly a 25 percent chance of delivering a baby infected with HIV. If she takes the right drugs during pregnancy she can drastically diminish those odds. An HIV-positive mother can also pass the infection to her uninfected baby during breast-feeding. If she knows she's infected, she can avoid that. Finally, if a baby is infected with HIV, he can be treated early with drugs that might wipe out the infection.

    Then-Rep., now Sen. Tom Coburn pushed legislation similar to Mayersohn's at the federal level in the 1990s, but was frustrated by the same forces that opposed Mayersohn. Consequentially, the testing policy varies from state to state. Nationally, the rate of infants infected with HIV has declined, but it has not been stamped out. California -- where lunatic obsessions still reign supreme -- has resolutely resisted the New York approach. In 2002, the Los Angeles Times reported that cases of HIV among children were actually increasing.

    So let's ask one more time: Do we want healthy babies or not?