The Third Great Plague: A Discussion of Syphilis for Everyday PeopleStokes, John H. (John Hinchman)
History
The Third Great Plague: A Discussion of Syphilis for Everyday People
Stokes, John H. (John Hinchman)
Syphilis
+Reporting of Syphilis to Health Officers.+--The question of reporting
syphilis to health officers as a contagious disease is a good one to
raise in a meeting when a stormy session is desired. Upon this question
wide differences of opinion exist all over the world. The right of a
sick person to privacy, always deserving of consideration, becomes acute
when it touches not only his physical but his social, economic, and
moral welfare. It becomes a matter of importance to the state also when
the prospect that his secret will not be kept leads him to conceal his
disease and to avoid good public aid in favor of bad private care. It is
a question whether the amount gained by collecting a few statistics as
to the actual presence of the disease will be offset by the harm done in
driving to cover persons who will not be reported. Modified forms of
reporting sexual diseases, without name or address, for example, can be
employed without betraying a patient's identity, thus doing away with
some of the objections, and they have been in force in such cities as
New York for some time. Vermont has recently adopted a compulsory
reporting system, with the almost ludicrous result that by the figures
her population shows 0.5 per cent syphilis, when the truth probably
stands nearer 10 per cent. Much of the difficulty with reporting systems
goes back to the lack of an educated public or professional sentiment
behind them. For this reason they may be fairly placed in the category
of premature legislative experiments, and should be postponed until a
more favorable time. That this view has the sanction of students of such
problems is borne out by the recent comment of Hugh Cabot on this issue,
and by the decision of the British Royal Commission which, after careful
deliberation, decided not to recommend to the Government at the present
time any form of reporting for sexual disease. The West Australian law
recognizes the wisdom of providing the patient having sexual disease
with every safeguard for his secret provided he conforms to the
requirement of the law in the continuance of his treatment. German
sentiment is strongly against reporting, and no provision is made for it
in the civil population. On the other hand, the very complete programs
of the Scandinavian countries provide for reporting cases without names.
It is, therefore, apparent, in view of this conflict of opinion, that we
can afford to watch the experience of our neighbors a little longer
before committing ourselves to the risk of arousing antagonism over a
detail whose importance in the scheme of attack on syphilis is at best
secondary to the fundamental principles of efficient treatment and
diagnosis. There is no apparent reason why we should not be satisfied,
for the present, at least, with drawing to our aid everything which can
give us the confidence and the willing cooeperation of those we want to
reach. Physicians who work with large numbers of these patients realize
Public-domain text, read in full here on John Shaqi.
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