Letter of the Week
Mr. Spencer,Of course, I am terribly sorry for boring Mr. Sisti with what he perceived as my substance-lacking, ad hominem attack on his friend and colleague, Arthur Caplan. But was "tedium" really the word he was looking for to describe my column? From the tone of his email, it doesn't sound as if it bored him. It sounds like it enraged and frustrated him. In fact, I would almost feel "attacked" by his response, if I didn't understand he had to have meant it as constructive criticism. Would it be bioethical of him to have meant it in any other way?
Your article, 'Milton Hershey critics need to wake up' was nothing more than ad hominem-laced tedium that bolstered the strength of the positions of the individuals you attacked. Next time, please present a bit of substance to refute the claims of those with whom you disagree, even if that means spending some time doing background research beyond Googling Dr. Caplan's curriculum vitae.
Your appeal to authority ("The Tully Fitzsimmons and Arthur Caplans of the world flatter themselves into believing that they know better about what is right and what is good for a particular private school than the grownups who have been running that school for years") was particularly ironic considering recent stories about horrible moral failings of longstanding leaders and institutions. Essentially it seems what you're saying is, "Trust the people running the school without question because they know best." Do you really believe this is a legitimate argument? If so, I have many undergraduates who would be happy to tutor you in informal logic and ethics.
Dr. Caplan is a mentor, friend and colleague. Hopefully you won't attack me now on those grounds, though such an attack would be unsurprising.
Dominic A. Sisti, Ph.D.
Perelman School of Medicine at the University of Pennsylvania
Senior Fellow, Center for Bioethics
Director, The Scattergood Program for the Applied Ethics of Behavioral Healthcare
Still, while he claims that the column - in which I criticized Mr. Caplan and others for their rush to self-righteous judgement in the matter of Abraham Smith vs. Milton Hershey School - lacked "substance," surely it contained more information, facts, and analysis than the remarks attributed to Caplan by ABC News. Two previous columns of mine on the same subject were also stuffed with facts about AIDS, teenage sexual behavior, recent outbreaks of HIV on college campuses in North Carolina, and varying standards of acceptable risks, etc. However, I wouldn't be surprised if Mr. Sisti missed both of them.
In any case, Mr. Caplan conveyed to ABC News his astonishment any school in this day and age would think twice about accepting an HIV-positive applicant.
"This notion that you can't put him in residential housing at a school because he is a vector of death is a throwback to 1987, when people were worried you couldn't mainstream children in any school," (Caplan) said. "It sets back what we know to be true about the disease."As I pointed out in my column, Caplan is not epidemiologist. As far as I know he is not a lawyer either, but that didn't stop him from offering his legal opinion on the case either.
Caplan suggested the school use this as a teaching opportunity to educate students about HIV.
"I'd like to see the school hold a seminar," said Caplan. "And if the school isn't going to do the right thing, students need to confront the administration..."
... Caplan said the case reminds him of Ryan White, the teenager who became the face of the AIDS virus in the 1980s after being kicked out of school for fear it would spread through everyday contact.
"I think they'll lose the lawsuit," he said. " So they better get ready to figure out how they're going to accept him."
Furthermore, he and others should know that there are distinct differences between this case and the Ryan White case. White was enrolled in a public school day school, not a year-round, private boarding school. And Caplan apparently assumes (incorrectly) that Milton Hershey officials fear HIV can be spread through casual contact. They don't. And if he had read the legal brief, the school's lawyers prepared and was posted on the Internet before he commented on the matter, he'd have known that. Their concern is the risk that the student in question might have consensual sex with a classmate sometime over the next four years. Given their years of experience, they know that however hard to try to prevent their teenage students from engaging in ill-advised sexual activity, a good number of them will anyway. Having even one sexually active, HIV-positive student on campus 24/7 for four years would have to increase the admittedly low likelihood of another student becoming infected.
Why that is so hard for some supposedly smart people to understand is beyond me.
The Milton Hershey School could certainly lose this case in court. Given the state of the ADA law, their denial of admission will have to pass a standard of pretty strict legal scrutiny. It will be up to a judge to decide if being forced to increase a pretty low risk of HIV transmission on their campus, represents a "direct threat" to the health and safety to their other students.
Finally, at the risk of having Mr. Sisti feel "attacked" by me, let me first assure him that if I do so it's not because he is friend, colleague and mentoree of Mr. Caplan's. I do so because of his own insulting, ill-informed statements and his effort to attribute to me things I did not say.
Essentially it seems what you're saying is, "Trust the people running the school without question because they know best."Funny that, because I'm the one who actually called the school and QUESTIONED them about the decision. I don't suppose Mr. Caplan did that before spouting off to ABC or Mr. Sisti did before sitting down at his computer and firing off what he no doubt thinks is a very clever and substantive email.
Using strawman arguments is no way for a grown-up bioethicist to argue. Here's hoping that Mr. Sisti is not teaching his undergraduates that it is. Many of them are incurring substantial debt to get what they hope is a useful and proper education. They deserve better if this is an example of the best he has to offer.