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Tuesday, November 15, 2005

A Modest Proposal (That doesn't involve eating babies).

Not to be unkind to Jonathon Swift or his humanitarian efforts but I prefer other sources of nutrition. What I want to discuss, instead, is a deal between those of us on the left side of the political fence and those on the right side.

Recently we were notified (see also here) that a vaccine has been developed for cervical cancer. The vaccine protects against infection with several strains of Human Papillomavirus, or HPV, that cause cervical cancer and genital warts. The potential for this vaccine is, indeed, substantial. As the New York Times explains:

If widely used, the vaccine could save many lives. Worldwide, there are about 500,000 new cases of cervical cancer a year, and 290,000 deaths. Most of the cases and most of the deaths occur in poorer countries where women do not have regular Pap tests, which can detect cancers or precancerous cells early enough for them to be cured. In the United States, where Pap tests are common, 10,400 new cases are expected in 2005, and 3,700 deaths.

"The potential, particularly in the undeveloped world, particularly if they can overcome the logistics and get the vaccine to those women, could be enormous," said Dr. Deborah Saslow, director of breast and gynecological cancer at the American Cancer Society. The vaccine could prevent at least 70 percent of the deaths from cervical cancer, Dr. Saslow added.

So, this vaccine is very promising. Medical professionals have been recommending making the treatment mandatory, and administering it before females become sexually active- which is at around age 15 in the United States (that's the median age, actually). However, this recommendation has been meeting with disapproval from some Christian group who are worried about the message this sends:

At the ACIP [Advisory Committee on Immunization Practices of the Centers for Disease Control] meeting last week, panel members heard presentations about the pros and cons of vaccinating girls at various ages. A survey of 294 pediatricians presented at the meeting found that more than half were worried that parents of female patients might refuse the vaccine, and 11 percent of the doctors said they thought vaccinating against a sexually transmitted disease "may encourage risky sexual behavior in my adolescent patients."

Conservative groups say they welcome the vaccine as an important public health tool but oppose making it mandatory.

"Some people have raised the issue of whether this vaccine may be sending an overall message to teen-agers that, 'We expect you to be sexually active,' " said Reginald Finger, a doctor trained in public health who served as a medical analyst for Focus on the Family before being appointed to the ACIP in 2003.

"There are people who sense that it could cause people to feel like sexual behaviors are safer if they are vaccinated and may lead to more sexual behavior because they feel safe," said Finger, emphasizing he does not endorse that position and is withholding judgment until the issue comes before the vaccine policy panel for a formal recommendation.

In other words, we shouldn't use a vaccine that appears almost one hundred percent effective because it might encourage sexual activity. Now, I have to admit, I find this argument highly questionable. Primarily, I just don't think the possible risk of contracting HPV is really holding adolescents back right now anyway, so eliminating that threat is unlikely to make a meaningful difference. Besides, compared to the risk of contracting HIV the possible, long-term, risks of HPV will seem speculative to most young adults. Yet, despite my skepticism of this conservative position, my role today is to act as a uniter, not a divider. This is where my "modest proposal" comes in.

We know (Miller et al. 2002) that female participation in organized sports and other athletic pursuits reduces the likelihood of participation in risky sexual practices. We, similarly, know (Whaley 2001) that over the long-term reductions in male/female inequality result in lower rates of sexual assault which, you know, is bad. The sexual assault is bad, I mean- reducing sexual assault is good. Finally we know that the new HPV vaccine is highly effective in preventing a disease that kills thousands of Americans every year. So, knowing all this, let's make a deal.

Conservatives: you will let us wacky liberals use a validated technology to save thousands of lives. We, in return, will allow you to set up programs encouraging women to participate in organized and team sports, so as to reap the benefit of lower rates of risky sexual behavior. In combination these two policies should allow us to save lives without experiencing a rise in dangerous sexual behavior. Hell, we might even see a decline! Since we're in a good mood, we'll even let you enhance programs to reduce gender inequality which should reduce rape- perhaps the riskiest sexual behavior of them all.

I know, I know, this may seem a little crazy- I mean, we're just letting you go wild with this agenda, but we have to be willing to make concessions if we're going to be a part of the political process. Still, this is no wilder an idea than Midnight Basketball leagues and, let's face it, this approach is bound to work better than the abstinence only crap you've been pushing so far.

So how about it? We get to vaccinate kids against a life-threatening illness, you get a program that reduces promiscuity, and women get safer lives- physically, emotionally, and sexually.

Sounds good to me.


Miller, Kathleen E., Grace M. Barnes, Merrill J. Melnick, Donald F. Sabo, & Michael P. Farrell. (2002). "Gender and racial/ethnic differences in predicting adolescent sexual risk: Athletic participation vs. exercise." Journal of Health and Social Behavior. 43(4). 436-450.

Whaley, Rachel Bridges. (2001). "The Paradoxical Relationship between Gender Inequality and Rape: Toward a Refined Theory." Gender and Society. 15(4). 531-555.


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