The Supreme Court of the United States (handily referred to in short as SCOTUS) a href=http://www.bloomberg.com/news/2013-04-22/anti-prostitution-rule-questioned-by-u-s-supreme-court-1-.htmlheard arguments/a on April 22, 2013, weighing speech rights of grant-receiving non-profit organizations against the rights of the U.S. government to put restrictive conditions on the grants which they give. At issue is whether the U.S. government, through the U.S. Agency for International Development (USAID) can require groups doing anti-HIV work supported by USAID to take a stance against prostitution.
SCOTUS is tasked with testing whether laws and policies conform with the Constitution of the United States and its penumbrae as explored in the rich history of U.S. case law as well as within the nation’s founding document. Such tests of constitutionality rightly address matters such as freedom of speech, and whether these anti-prostitution requirements are constitutional; a lower court previously found that they were not. SCOTUS is the court of last resort for both USAID and the petitioner, Alliance for Open Society. While SCOTUS may only be concerned with constitutionality and thus primarily with speech rights, bioethicists ought to pay a different kind of attention, namely to the effect of such policies on public health efficacy, and their intrusive effect on medical professionals’ judgment.
When President George W. Bush took office in 2005, one of his first acts was to reinstate the Global Gag Rule, AKA the Mexico City Rule, first put in place by President Reagan and discontinued by President Clinton. This rule, like the Obama administration’s anti-prostitution approach, used USAID grant criteria to restrict the speech and actions of grant recipients. In the case of the Global Gag Rule, organizations receiving family planning grants were prohibited from performing abortions, providing information about abortion, or referring patients to abortion-providers. The Rule was so troubling for women’s health that one of President Obama’s a href=http://www.cbsnews.com/8301-503544_162-4749442-503544.htmlfirst executive orders/a upon taking office was to end it. Many a href=http://womensbioethics.blogspot.com/2009/01/obama-repeals-global-gag-rule.htmlbioethicists/a had long criticized the global gag rule for its intrusion into the decisions of health care providers and public health workers, and for its a href=http://www.thefreelibrary.com/Ipas+declines+to+sign+the+global+gag+rule%3A+public+statement.-a0115972726negative effects on public health/a: more unintended pregnancies, more unsafe abortions, and more maternal and child deaths. Indeed, preventing just such negative outcomes was generally a primary purpose of family planning grants through USAID.
It has magical effects on erection best tadalafil and can cause troubles of erection and potency. Typically, viagra 10mg check for more info now this condition is known as impotence. Kamagra drugs for erectile dysfunction become viagra price uk effective in as little as 30 to 45 minutes and stays active in the body for about 5 hours. Nitric oxide produces when a man is sensually online viagra prescription aroused and ready to get into the game. The Obama Administration’s anti-prostitution requirements also stifle discourse and intrude on public health work. Whereas the Global Gag Rule prohibited both actions and speech, the anti-prostitution requirements paradoxically require speech and prohibit action. This risks alienating and stigmatizing one of the populations which can most benefit from anti-HIV efforts and is most important in stemming the tide of HIV/AIDS. To receive USAID grants, organizations must pledge in writing that they endorse the Obama Administration’s stance on eliminating prostitution and sex trafficking. In a href=http://www.prostitutionresearch.info/pdfs_all/trafficking%20all/SSRN-id1478667.pdfaddition/a, they are forbidden from advocating rights-based or harm-reduction approaches that would advocate for decriminalization or legalization of prostitution, regardless of any public health rationale which might (or might not) support such a position. In iThe Guardian/i’s “Poverty Matters” blog, Chi Mgbako a href=http://www.guardian.co.uk/global-development/poverty-matters/2013/apr/22/anti-prostitution-pledge-sex-workers-hivargues that/a this anti-prostitution pledge is deeply problematic for anti-HIV efforts. She describes a “chorus of voices from the public health community”—including Partners in Health, Amfar, the Center for Reproductive Rights, and Planned Parenthood—speaking out against the policy. That chorus takes the form of an amicus brief submitted to SCOTUS arguing that such intrusion is nearly always counter-productive, regardless of its content, and that best practice comes from public health professionals operating without ideological restrictions.
So we see that the Obama Administration’s anti-prostitution policy can be critiqued on many of the same grounds on which Obama critiqued the Global Gag Rule: it intrudes on the work of public health professionals, overriding their professional judgment and requiring them to take stances which can affect their ability to interact with the very people whose health they are being asked to protect, and it undermines the primary purpose of the grant.
In truth, these concerns may not play much of a role in SCOTUS’s determinations about whether speech rights are unduly infringed (though with public health community amicus briefs in hand, we can hope). Regardless, these concerns ought to play a role in the decision-making of bioethicists and policy-makers. They say money talks. But perhaps there are some things it ought not to say.br
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