Posted by Eugene Volokh:
Sperm Banks and Gays:
http://volokh.com/archives/archive_2005_05_15-2005_05_21.shtml#1116248831
[1]The Washington Post ran this story, written by its health reporter,
on May 6:
A new Food and Drug Administration regulation scheduled to go into
effect this month calls on sperm banks to reject anonymous
donations from men who have been sexually active with other men
within five years -- an effort to screen out potential carriers of
the AIDS virus.
With a May 25 implementation day approaching, the long-debated
regulation is being attacked as unscientific and bigoted by some
gay groups that say the new rule stigmatizes gay men.
"This rule is based on bad science because the AIDS epidemic is an
increasingly heterosexual epidemic," said Kevin Cathcart, executive
director of Lambda Legal Defense and Education Fund, which has
asked the FDA to reconsider.
"We also know that sperm banks can test for HIV very well now and
so can screen out any infected donor," he said. "With that in
place, why are gay men being rejected?" . . .
The story goes on -- I don't want to quote the whole thing, because of
copyright reasons (there's a possible argument that quoting the entire
article would be fair use, because I'm criticizing it, but I'd rather
err on the side of caution). But nothing in the rest of the article
says anything about what the FDA's response to this criticism might
be, or about what (if anything) seems to be the conventional wisdom
from objective and reputable sources on who's right here.
The closest the story comes to that is by saying "When the rule was
adopted, acting FDA Commissioner Lester M. Crawford said it was
developed with broad input and 'in all cases, we carefully considered
the comments we received in the proposed rule and made changes in the
final rule when the science supported the change.'" But what exactly
does the science say?
It is pretty obvious -- though perhaps some readers might miss it --
that "This rule is based on bad science because the AIDS epidemic is
an increasingly heterosexual epidemic" is an unsound argument. The
risk that any U.S. male homosexual is infected with HIV are over 10
times (likely considerably over 10 times) the risk that any U.S. male
heterosexual is infected with HIV. (I'm extrapolating from the year
2000 new AIDS infection numbers listed [2]here, with a generous margin
of error; I realize that this isn't the same as current HIV numbers,
but it's close enough to get a confirmation of conventional wisdom,
which is correct here. If anyone has more precise data, please let me
know.) Given this, screening out those who are disproportionately
likely to be at risk -- of course, as well as trying to use other
methods to screen out donors who don't fit within the demographically
most-at-risk categories, but who may have HIV nonetheless -- may well
be sensible. If there's a flaw with the FDA policy, it is not that
AIDS is an increasingly heterosexual epidemic (if it is that) even
though in the U.S. it is still a highly disproportionately male
homosexual epidemic.
But what about the argument that "We also know that sperm banks can
test for HIV very well now and so can screen out any infected donor"
-- "[w]ith that in place, why are gay men being rejected?"? Are HIV
tests certain enough that the sperm banks can efficiently and
completely reliable test sperm, for instance, by freezing the sperm,
testing the donor six months after the donation -- six month seemingly
being the period between infection and [nearly?] certain detectability
-- and using the sperm only if the donor comes up clean? Or is there
some significant possibility of error even then?
In either case, wouldn't that information be useful in an article by a
health reporter, more useful than just giving an advocacy group's take
on the matter (plus a general assurance of safety from the operator of
a sperm bank that accepts sperm from gays), with no sense of what
impartial scientists actually say, and no discussion of any possible
counterarguments?
I should stress that I genuinely have no views on what the science is.
For obvious reasons, I'd love it if sperm banks could 100% reliably
test sperm for HIV. It may well be that Mr. Cathcart's arguments are
completely right.
But it seems to me that readers would like to have more than his
arguments and those of a sperm bank operator that obviously has a
stake in the matter. There should be some science on this out there
somewhere, I take it, and some scientists who can speak to it, no? If
there's a conventional wisdom on the subject that comes from highly
reliable scientific sources, let's hear it. If the conventional wisdom
is that we don't know what the right answer is, let's hear that. In
any event, let's at least hear the specific arguments from the other
side.
I am not trying to make any claims here about media bias. My point is
simply that the story just isn't very useful to a typical casual
reader who's trying to get an objective sense of the matter. Not a
grand journalistic felony, I realize -- but it's the sort of
journalistic misdemeanor (or even infraction, if you prefer) that,
when repeated as often as this one seems to be, makes for unhelpful
newspapers and ill-informed readers.
As always, please let me know if I've missed something important here.
References
1.
http://www.washingtonpost.com/wp-dyn/content/article/2005/05/06/AR2005050600151.html
2. http://www.cdc.gov/hiv/stats/hasrsupp91/table7.htm
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