Showing posts with label Disclosure. Show all posts
Showing posts with label Disclosure. Show all posts

Saturday, August 27, 2011

Kaput!


Been talking to this guy for a while now. OK, he's my Facebook crushie. We're not really Facebook friends, but I've seen him, and has checked his page more than a dozen times. Then he got my number. I dunno how, but its most probably via Romeo.

Fast forward. We've exchanged messages via text. Have checked on each other quite a few times, until I finally decided to give him my FB account. We are now FB friends.

Anyway, everything is goin well until this exchange of messages via text today.



[Him] : OK, seen it. So your name is *****. Nice name, just like my brother's.
[Me] : Thanks. Anyway, whatever you know, you just keep it for yourself, ok?
[Him] : No worries, you can trust me. Take your meds and be safe always.
[Me] : I am not yet on meds.
[Him]: Ok, pero wag kana manghahawa ok? (Ok, but do not infect others anymore, ok?)

(Me: at this time, I already got my eyeballs rolling)

[Me] : And whats that supposed to mean?
[Him] : You're smart, you know what I mean. I actually have a friend who has it too, pero di na siya nakikipagsex. (I actually have a friend who has it too, but he doesn't have sex anymore)
[Me] : No worries, I know my dos and donts.
[Him] : Ok, good.
[Me] : I know how to take precautions, but to NOT have sex, that must be hard.
[Him] : I know, pero baka makahawa ka nga. Pano mo ba nakuha yan? (I know, but you might infect others. anyway, how did you get that?)

(My high hopes are starting to turn into frustrations)

[Me] : I got it from my last BF. But doesn't matter now how I got it.
[Him] : You had sex with him 'unsafe'?
[Me] : Why not? He was my BF and I love him. (in my mind: Yeah, I know there is something faulty about this reasoning)
[Him] : Nakikipagsex sex ka ng walang condom kaya mo nakuha yan! (You engage in sex without using condom that's why you had that!)
[Me] : He was my BF and I trusted him. Though I always got myself tested, and always turned negative, I never got him to get tested. Maybe I was careless. But blaming anybody wouldn't change the fact that I already have it.

(Then I went on with my kilometric messages)

[Me] : Is that a mockery?
[Him] : No, sorry if you felt that way.


Good start gone Kaput!


Big sigh!

Wednesday, September 15, 2010

(Un)Fit to Work

Its my second day with my new job.

After a long break from the corporate set up, I decided to take on a new job. It is not necessarily my dream job.  But I think it is a good job, nonetheless. By good job, I only mean a 'very' attractive compensation package, a 'normal' working schedule, and less toxic than my previous (I assume). Though I had hesitations about taking it as I am afraid and might get bored and would look for a more challenges, I decided to take on the new job anyway. I was more concerned about earning more and getting less stressed this time.

Just when I am all set on my new job, I was called by the company HR earlier today and advised me to re-take my blood test as I was found to have low platelets count. I haven't gotten a "Fit to Work" certificate and would require a second test. I was like "futch!" (that's fuck + bitch = futch) I wouldn't want my job jeopardized because of this. At the same time, the bigger worry I have is having to disclose my sero-status.

I had my medical exam last weekend, and I never remember being asked about my sero-status. I remember being asked about "other known diseases", which I answered "None" to. Honestly, I didn't know how to respond properly to the question. Everything seemed like a blur at that point.

I know there are some legislation in the Philippines about discrimination among people with HIV/AIDS and related disabilities. Of course, there is Republic Act 8504 which states that "The State shall extend to every person suspected or known to be infected with HIV/AIDS full protection of his/her human rights and civil liberties. Towards this end...discrimination, in all its forms and subtleties, against individuals with HIV or persons perceived or suspected of having HIV shall be considered inimical to individual and national interest".

For a while I thought of disclosing, but fear sat in and have decided to come up with 'mental' justification for my answer. I convinced myself that the question is not really about my sero-status. Whether that is acceptable or not, I thought that the whole point of medical exams is (simply) to determine fitness to work, and I thought my sero-status doesn't really make me unable to perform essential functions of the job, and as long as I am able to perform my job well, then there wouldn't be a necessity to disclose, well, at least at the moment.

Of course, I have also considered the possibility of me being required to take some time off work for some reason such as (another) infection or complication or when I require medical appointments, or experience (some) side effects should I decide to take some medications soon. I know I cannot compromise these things as they are more serious than a day's worth of my salary. But until then, my viral secret remains.

Anyway, I am going to have my blood sample taken and tested again for a complete blood count (and not HIV) on Saturday. I am not sure if my platelets count will go any better in a few day's time. I remain hopeful. However, in case results prove to be otherwise and further probing on the cause of my low platelet count be done, I am already psyching myself up for a possible discussion of my sero-status.

I know disclosure is just the apparent issue at the moment. I know there is more. I know I have to check on my health again very soon, but I'll take things one by one.



Monday, August 23, 2010

On Duty of Disclosure: A Positive's Point of View

Kant' whole ethical philosophy revolves on the whole concept of Duty. The moral act is the act which is done out of our concept of duty, that is Duty as the necessity to act out of respect for the moral laws, regardless of whatever consequences it may bring.

It wouldn't be enough to talk about Kant in one sitting, and as much as I would like to be fair to Kant, the space would only allow me to highlight some of the most important concepts in his Moral Philosophy.

For Kant, the morally important thing is not consequences of our actions but the way we (the agent) think when we make those choices. This is not to say that he has total disregard for consequences only that for him, what determines the morality of an act is/are the principle/s to which it was acted upon.

Kant started his whole philosophy of morals with the concept of a good will. The WILL, according to him is the (only) thing which can be inherently good. It is our power of rational moral choice, and is only present in human beings, which accorded human beings their inherent dignity and humanity the ultimate and unconditional value.

What makes the will good? The will is good when it acts out of duty, not out of inclination. To act out of duty is to act out of respect for the moral law, the moral law which is promulgated by human beings themselves based from their natural capacity to grasp and exercise rationality independent of our inclination or desire of any favorable or good consequences of a possible action.

How do we know the moral law? We use the "Categorical Imperative." The Categorical Imperative is stated as "act only on that maxim (or rules of actions) through which you can at the same time will that it becomes a universal law. Basically it requires the following steps:

1. Before you act, consider the maxim or principle on which you are acting.
2. Generalize that principle.

PERFORM TEST ONE.
If, once generalized, it no longer makes any sense because it contradicts itself, then it is wrong to use that maxim as a basis for action.

IF NECESSARY PERFORM TEST TWO (aka Reversibility)
If the generalized version makes sense, then ask whether you would choose to live in a world where it was followed by everyone. If not, do not act on that maxim.

One good example to illustrate Kant's moral theory is "making false promises."
Maxim: I may make a false promise in order to reap financial gain.
Generalized: Anyone may make a false promise to get something s/he wants.
This is self-contradictory because:
If anyone may make a "false promise," nobody would take a promise seriously; promising becomes meaningless.

Result: I may not act on that maxim.

Another way to articulate Kant's CI is "Always act so as to treat humanity (rational nature) whether in your own person of in the person of another (i.e., other human beings) never simply as a means to an end, but always as an end."

These are just some of the main tenets in Kant's moral theory. Having said these, let us examine the case of "Disclosure."

Scenario: X recently found out that he is HIV positive. Prior to knowing that he is positive, X has engaged in some 'unsafe' sexual practices, and could have possibly infected others. Is X on a duty to disclose to the previous sexual partners he could have possibly infected that he is HIV positive (and ask them to get tested?)

Again, duty is the "necessity" to act out of respect for the moral law. We are put into some concept of duty if and only if we are necessitated to act, out of our concept and respect for the moral law, as promulgated by reason and has satisfied the universality test.

Given the scenario above, we may start formulating our maxim-- I should tell all the previous partners I had of my HIV status so that they can get tested. Let me just emphasize 'should' to underscore the necessity (or the non-necessity) of the action.

Let us now examine the necessity of the action to determine whether we have a duty to do it or not, and eventually if this duty will pass the universality test. We may start with the basic duty of truth telling. We should always at all times tell the truth. That is one principle that can be accepted a universal law without contradiction. However, we may ask, "does not telling or non-disclosure constitute "lying"?"

Withholding some information does not necessarily violate the institution of truth telling. There will be no necessary contradictions with the maxim of truth telling since there will be no truths to be affirmed nor denied when we withhold. But we may still argue that although 'non-disclosure' does not constitute lying and has no contradiction with the principles of truth telling, it may be worthwhile to explore another principle, that is the duty "to save others".

The duty to save others may be properly expressed as "I will save others at all times." This may still be universally expressed as "Everyone will save everybody at all times, provided that he will not use his person or the person of anybody simply as means to an end but an end in itself'.

To illustrate the point, let us take for example the case of a drowning man. If someone is drowning, and I CAN swim, then I am put into a duty to save that man. To NOT save that person will be morally impermissible since we are treating the drowning person's life and humanity with less regard.

On the other hand, if someone is drowning, and I CANNOT swim, then, I am NOT put in any duty to save the drowning person since I will be using "my person" as a means to an end, and that is to save someone else's. This leads me to the point that "Ought" implies "Can". We are only put into some sort of Duty when we CAN.

Given the illustration, we can finally express the duty of "saving others" as "We will save others as much as we CAN, at all times."

Relating this to the previous point of disclosure, we may try and express the maxim as such "I will tell people truths that I know to save others as much as I can." Or to be more specific, "I will tell my previous sexual partners who I could have possibly infected as much as I CAN so that they can have themselves tested and stop the spread of infection".

Let us now examine that maxim.

First, are we violating any principles in the application of that maxim? It seems plausible to tell previous sexual partners about our serostatus. We can surely and easily tell our previous sexual partners that we have recently been diagnosed HIV positive, but we have to ask, is it necessary to do so? Moreso, are we using any person as a means to achieve our end, and that is to save our previous sexual partners, and their future sexual partner by having tested, and hopefully practice 'safer' sex in the future?

Although I CAN by principle tell my previous sexual partners about my serostatus, it is important to consider if I will be using my own person by doing that. I may put my own person and my own agency into jeopardy by disclosure. Although my intention by telling other previous sexual partners is to save them by making them know, so that they can also possibly save others they may have possibly infected, and so on ad infinitum, so as to stop the spread of the infection, I am putting myself and my agency into some danger, therefore making myself merely as a means to some end, and that is to stop the future infection.

It may be argued, however, that we may be ‘endangering’ others’ lives, thus making them mere means instead of an end in itself should we not disclose. We may put them into some serious health risk should we not tell them. Still, we are also putting others they will have unsafe sexual contacts into possible risk of infection.

I understand that it is important to stop future infection. At the same time, I understand that knowledge of one's serostatus is a good start to realizing that end. However, I also need to consider in this case the possibility of my agency being undermined should I go for that possibility. How can I be certain that by telling my previous sexual partners of my serostatus, I am guaranteeing that they will only act in such a way that they will only be engaging in safer sexual practices? I still remain hopeful, though.

So does this put me in a "duty to disclose?"

I will go back to my previous example of a drowning man. Although this may sound like an extreme example, it might be worth to try and see the parallelism. If we are all in the same boat, and we all do not know how to swim, it is no question that I do not have duty whatsoever to save others in the boat. To try and save others is not the prudent thing to do as I will be undermining my person, thus endangering my agency of the possibility to 'save others' in ways I can. Say if I die in my attempt to save another drowning person, I won’t be able to try and save an old lady crossing the street, or an impoverished kid who do not have something to eat. The point is, there are ways where 'saving others' can be fulfilled, and that is saving others in the way I can without possibly endangering my agency and my capacity to save others.

Applying the parallelism to the case of (non)disclosure, by disclosing my serostatus to previous sexual partners, I may be jeopardizing myself of the possible 'normal' life. Others may find out. To say the worst, I may suffer stigma and incarceration thereby making me unable to function 'normally', thus undermining my further duty of fighting (and possibly stopping) the spread of infection. That may sound an exaggeration, but remains a possibility.

Still following the parallelism, should I NOT disclose the information, I can still fulfill the ends of trying to fight the spread of infection (in the ways I CAN). I CAN definitely engage in safer sexual practices, which is one way. I can also go and start educating people about HIV/AIDS. And these acts, although directed towards the same end, that is to stop the spread of infection, does not necessarily endanger my person and my agency, thus, not violating the principle of Universality as discussed.

I recognize that everyone has the responsibility and is in a duty to fight the spread of HIV/AIDS. This is not questionable. This is something that can be accepted as a Universal law. It should be added however that "fighting in a way we CAN without endangering your person or the person of another" simply to achieve this end.

This responsibility and duty is also not retroactive. When I still didn’t know how to swim, I didn't have the duty to save anyone in a drowning boat. I cannot be faulted for not having been able to save anybody. But say I finally learn to swim, and the same drowning boat incident happen, I cannot escape my duty to save others. To NOT save anybody would be morally impermissible.

The same is the case of knowing my serostatus. I cannot be faulted for not being able to save those who I could have possibly infected "when I still didn't know." Disclosing my serostatus, although may not change the fact that I may or may have infected them, may possibly have them know their own status and could help a lot in stopping the spread of the virus. At the same time, I still cannot guarantee that by disclosure, I am completely not using my person as a means to achieving the end, that is to stop the spread of infection. It can, but the odds that I may be are still very apparent, though.

However, I am not sparing myself of the duty and my responsibility to stop the spread of the Virus. Now that I know my serostatus, to endanger other people by doing the same irresponsible act of unsafe sexual practices would be equally morally impermissible.

Finally, I can no longer save those who have drowned. But I CAN save (some of) those who will. And this is what I will do.

Sunday, August 22, 2010

(Ethical) Issues on Disclosure

Maybe I am over-thinking it. Maybe I am also just too engrossed with the philosophical concept of justice and responsibility.

When I found out about my HIV status, some friends who I told I am positive suggested that I tell the previous contacts (who I could have possibly infected when I still didn't know my status) to get tested. They even told me to get a dummy SIM card and send those people anonymous messages. I decided NOT, and I remain with my position.

Today, a friend has met a pozzie online, and he volunteered to be the 'third' party to tell the HIV pozzie's (lets call him R****) previous contact  (lets call him A****) to get tested. Again, I may be wrong, but I remain.


(Friend): As a third party, protecting R****'s anonymity, I contacted A**** with R****'s message for him to get tested
(ME): Uhuh
(Friend): And R****'s message was very non-judgmental, no guilt no 'kawawa' drama
(Friend): A**** ignored my message - this morning A**** thought he was chatting with a new guy in Taguig and invited him over for sex - but he was actually chatting with R**** who wanted to get his CP for the health department.
(ME): R**** shouldn't be giving A****'s number no matter how good is the intention
(ME): I do not agree with what he's (A****'s) doing
(Friend): Then you are lucky to live in the Philippines
(Friend): (Smiley)
(ME): I respect A****'s, or anyone else's privacy, and at the same time, I give the responsibility to him to check on his health
(ME): R**** may be concerned, but doesn't have the right to disclose to anyone, not even the health department what "could" be A****'s (possible) status
(Friend): I told R**** that in the states, the Health Dept has full time employees who spend their entire career tracing spreaders of HIV.
(ME): He could get into trouble.
(Friend): Are you telling me that the health department here does not ask for the names of who you've had sex with?
(ME): No, they don't and they can't.
(ME): I mean theres a law against explicitly disclosing someone else's (possible) status
(Friend): It's a mandatory question in the states
(ME): Not here
(ME): Which is good i guess
(ME): I mean, you are putting someone else's privacy into jeopardy
(Friend): Life is more important than privacy
(ME): Privacy could mean 'a certain quality of life'
(ME): Its not just 'life' we have to consider, but the quality of life

(Friend): If Guy A is tested, and his test is positive, then Guy A commits a crime every time he has unprotected sex in the future
(ME): That's up to guy A and his partner
(ME): A responsible partner wouldn't have unprotected sex
(ME): So its not just guy A, but a consent from guy B
(ME): No crime is committed.

(Friend): Right now in Germany a female rock star is on trial for knowing she had HIV and giving it to 3 different male partners
(ME): Yes, that's true.
(ME): If you know that you are positive and you deliberately act so as to infect someone, that could be ASSAULT
(Friend): Under German law, she is required to notify the partner of her HIV status
(Friend): In the states, attempted murder
(ME): Yes, you are required to tell, if you know that you will be infecting the partner
(ME): That is, by 'deliberately' not protecting
(ME): But if it's not putting the partner into grave danger, say you've taken protection, then that's not assault
(Friend): A**** apparently likes to fuck younger men without condoms
(ME): A responsible HIV positive wouldn't wanna get fucked without condoms
(ME): No matter how the partner wants it
(ME): Now if the partner insists fucking a positive guy without rubber after the positive person refuses, no assault there
(Friend): Are you going to go to law school?
(ME): I hope I am. Why? (Smiley)
(Friend): (Smiley)
(ME): Hehehe
(ME): One doesn't have to be in the law school to make sense of some principles and postulates
(Friend): Because you are arguing how many lawyers can dance on the head of a pin
(ME): (Wink)

(Friend): My postulate is this: 1. If someone says you have a 50/50 chance of being the guy who infected him with HIV, then you have two obligations 1. to be tested and 2. No matter what the result, negative or positive, you must use condoms on all future acts of penetration.
(ME): I take number 2
(ME): That's the responsible choice

(Friend): Did you notice in his (A****) profile, the number of young men he has his arm around?
(Friend): He has a moral obligation to others to be tested
(ME): Should we judge him as to how many men he has?
(ME): What he should do is to protect himself
(ME): And the partners
(ME): Say he gets tested, and he tested positive
(ME): What do we do then? Shall we stop him for f**king others?
(Friend): And to hell with the past ?
(ME): What about the past?

(Friend): You should never work in infectious disease control
(ME): If you ask me, am I responsible for the guys I could have possibly infected when I didn't know I have IT, I'd say "NO!"
(ME): I am responsible for my future contacts
(ME): Not with the past. Things happened because of our choices
(ME): There were times I wasn't responsible that's why I had it
(ME): But at the same time, I didn't tell the former partners to be not responsible
(ME): As far as I know, at the point of contact, I was safe and I wanna take the risk by doing it 'unsafe' with them
(Friend): You need to read And The Band Played On
(ME): So I cannot be held responsible for them in the same way that they shouldn't be responsible for me
(ME): If there are people I am responsible to, that's the future partners am gonna do it with
(ME): I have to make sure i do it safely so as not to endanger them
(Friend): I can see this debate is not going anywhere
(Friend): You need to read And The Band Played On
(ME): Hmmm!
(ME): My only point is that you cannot be responsible from that which you didn't WILL.

(Friend): I don't see it as a philosophical argument - I see it as a public health issue, and the health of the public body is more important than the rights of the individual
(ME): Don't you think the public needs to protect themselves among anyone or anybody else?
(ME): Would a responsible public engage in unsafe sex?
(Friend): You're making it a philosophical question
(ME): Would you like some authority to impose on its people how they should be doing things, including that personal act of having sex?
(ME): They can only influence and advocate
(Friend): A disease that kills is NOT a philosophical question
(ME): In the end, the individual is responsible for himself
(Friend): Oh Jesus I give up!
(ME): I am sorry. I couldn't just accept it.

(ME): Would you like me to jeopardize my own privacy
(ME): Or if for example it is you,  your privacy jeopardized? Would you like it?
(ME): Try putting yourself in the position of all the positive
(Friend): Whatever, bye
(ME): I am sorry.

**PS:
This is the actual transcipt, except that some spellings have been auto corrected. The names were also changed for privacy's sake.

Friday, June 25, 2010

Unlikely Disclosure

I was out to see J today. Today will be the last time I'll be seeing him for the next two months. He is going for a two-month vacation in Spain. Although the thought of (temporary) separation saddens me, I picked myself up and met with him anyway.

We just went for the usual coffee talk and said our temporary 'goodbyes'.

J and I have been seeing each other for a while now since we reconnected, and I have always been vocal about my interest in him. He takes the compliments and would reciprocate at times. i really cannot speak as to how he feels, but I know I like him and I am hopeful that he would be mine. But then again, I am trying to keep my promise of not getting between his relationship with his boyfriend. I remain content to us being friends for a while, and just enjoy whatever we have at the moment.

I also have to admit that in the past few days, I have been being drawn closer and more comfortable to him. But at the same time, I am also afraid with the comfortabilty we have now. We have been telling each other more 'personal' truths than before, and I am afraid i wouldn't know how to tell him one truth about me, and that is my HIV status.

I wanted to tell him about my status since I first saw him again back in April. Although I remained firm-- no matter how my friend K told me that I should tell the people I could have infected when I still do not know that I am positive-- that I am not responsible for them, I always felt that J is an exemption and that he needs to know. J and I had sex back in October, and I was thinking I could have been already infected then since my last test prior to my "Indeterminate" result in November was in July when I turned negative, and I could have possibly infected him.

Although I still maintain that I am not responsible for the possible infections that the "irresponsible" sexual activities I engaged myself in the past as I myself do not know my status, I felt different for J. Maybe its the attachment that is making me feel obliged to tell him. it could also be because I see a real person in him, sincere and loving, and that I cannot be unfair by keeping it now that I know. But fears are holding me back.

Finally, I took th courage and told him.

It started from exchanges of "not-so-good" text messages the night after we had our last meeting. For what reason, I'd rather keep that between us. One after the other, and I decided it wasn't a good time to talk and tell him. I have gone frustrated and exasperated with the message sent and recieved, until I decided to end it all there-- not to see him again, not even to hear from me again, with one last plea-- that he get tested.

Some moments of silence and I told him in a very relaxed message that I am HIV positive and that I might have possibly infected him. I then gave my final goodbye. It was hard, but I had to do it.

J sent a somehow confused reply. I went on to clarify. More messages and we finally decided to talk it out in details when he comes back from his vacation.

Things have started to get pacified. The earlier bitter exchanges have turned out to be words of comfort.

I am not sure really as to what this unlikely disclosure might be. But more than being afraid, I am now very much relieved.

Saturday, February 27, 2010

Skype[d] my Worries Away

I have just finished a Skype session with one, if not the closest friend I have.

I have known L since 1999. We were best bud in college. I haven't seen her for a while now. She is currently based in Norway finishing her Phd and haven't seen her since January 2009. We remained in touch despite the physical separation though.

L is the crybaby, while I am the 'tough' guy in the group. L cries a lot, but I know she is strong. I've seen her gone through some painful moments in the past, including a death of a very special friend, but she managed to stand up and remain. I know she can handle tough times. I may see her cry again, but I am assured she can manage. And so I decided to be weak in her presence.

I have managed to at least be 'more normal' than my previous state and is now able to think level headed (or at least I would like to think.) The typical 'tough' guy that I was decided to L about my current reality, with the disclaimer that its as if our conversation never happened soon as we finished. Although I am confident that she wouldn't even dare tell anybody about it, I just had to tell her that to assure that I am not incriminating myself. She agreed on the condition.

I slowly typed into the message tab of Skype: "I am HIV positive."' I don't know why I couldn't say it verbally and needed to write it instead. That could be the part of me still in denial despite the countless conditioning that I have already accepted that fact. Anyway, i tried to keep my message plain and flat, devoid of any emotions.

I looked at her in the webcam soon as i pressed the 'enter' key on my laptop. She looked calm. Not the typical L I know. I have seen her freak out before (in public) upon reading a note sent to her by a friend. I was pleased by what I saw.

She then started to assure me that everything is gonna be fine, that nothing is going to change, and that she will always be there. I tried to compose myself and look as if everything is OK. I was at the same time holding my tears. I am the 'tough' guy, afterall.

We ended the conversation with best wishes and a few reminders. Then my tears fell soon as I hit the 'close window' icon.

Suddenly, all  my hesitations and worries for the moment were gone. I am appeased.

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