Ronald Bayer – författare

Today, AIDS has been indelibly etched in our consciousness. Yet it was less than twenty years ago that doctors confronted a sudden avalanche of strange, inexplicable, seemingly untreatable conditions that signaled the arrival of a devastating new disease. Bewildered, unprepared, and pushed to the limit of their diagnostic abilities, a select group of courageous physicians nevertheless persevered. This unique collective memoir tells their story. Based on interviews with nearly eighty doctors whose lives and careers have centered on the AIDS epidemic from the early 1980s to the present, this candid, emotionally textured account details the palpable anxiety in the medical profession as it experienced a rapid succession of cases for which there was no clinical history. The physicians interviewed chronicle the roller coaster experiences of hope and despair, as they applied newly developed, often unsuccessful therapies. Yet these physicians who chose to embrace the challenge confronted more than just the sense of therapeutic helplessness in dealing with a disease they could not conquer. They also faced the tough choices inherent in treating a controversial, sexually and intravenously transmitted illness as many colleagues simply walked away. Many describe being gripped by a sense of mission: by the moral imperative to treat the disempowered and despised. Nearly all describe a common purpose, an esprit de corps that bound them together in a terrible yet exhilarating war against an invisible enemy. This extraordinary oral history forms a landmark effort in the understanding of the AIDS crisis. Carefully collected and eloquently told, the doctors'' narratives reveal the tenacity and unquenchable optimism that has paved the way for taming a 20th-century plague.

Since public health seeks to protect the health of populations, it inevitably confronts a range of ethical challenges having to do primarily with the friction between individual freedoms and what might be perceived as governmental paternalism. This volume brings together twenty-five articles by leading thinkers in the field, writing on topics that concern both classic and novel problems. They open up new terrain in each area, including tobacco and drug control, infectious disease, environmental and occupational health, the effect of new genetics on the publics health, and the impact of social inequalities on patterns of morbidity and mortality. The volume editors offer a context for discussion with introductory essays for each of the books five sections.

Shattered Dreams? is an oral history of how physicians and nurses in South Africa struggled to ride the tiger of the world''s most catastrophic AIDS epidemic. Based on interviews-not only from the great urban centers of Johannesburg, Cape Town and Durban-but from provincial centers and rural villages, this book captures the experience of health care workers as they confronted indifference from colleagues, opposition from superiors, unexpected resistance from the country''s political leaders, and material scarcity that was both the legacy of Apartheid and a consequence of the global power of the international pharmaceutical industry.

Today, AIDS has been indelibly etched in our consciousness. Yet it was less than twenty years ago that doctors confronted a sudden avalanche of strange, inexplicable, seemingly untreatable conditions that signaled the arrival of a devastating new disease. Bewildered, unprepared, and pushed to the limit of their diagnostic abilities, a select group of courageous physicians nevertheless persevered. This unique collective memoir tells their story. Based on interviews with nearly eighty doctors whose lives and careers have centered on the AIDS epidemic from the early 1980s to the present, this candid, emotionally textured account details the palpable anxiety in the medical profession as it experienced a rapid succession of cases for which there was no clinical history. The physicians interviewed chronicle the roller coaster experiences of hope and despair, as they applied newly developed, often unsuccessful therapies. Yet these physicians who chose to embrace the challenge confronted more than just the sense of therapeutic helplessness in dealing with a disease they could not conquer. They also faced the tough choices inherent in treating a controversial, sexually and intravenously transmitted illness as many colleagues simply walked away. Many describe being gripped by a sense of mission: by the moral imperative to treat the disempowered and despised. Nearly all describe a common purpose, an esprit de corps that bound them together in a terrible yet exhilarating war against an invisible enemy. This extraordinary oral history forms a landmark effort in the understanding of the AIDS crisis. Carefully collected and eloquently told, the doctors' narratives reveal the tenacity and unquenchable optimism that has paved the way for taming a 20th-century plague.

On April 27th, 1994, the people of South Africa voted in their first democratic election, bringing down the curtain on 46 years of Apartheid. But, at the very moment of transition, the seeds of a grave epidemic had already been sown. AIDS has indelibly marked the era since the Apartheid's end, exacting an enormous toll on South Africa's Black community. Since the epidemic's onset, more thean 1,000,000 men, women and children have died.Shattered Dreams? is an oral history of how physicians and nurses in South Africa struggled to ride the tiger of the world's most catastrophic AIDS epidemic. Based on interviews - not only from the great urban centres of Johannesburg, Cape Town and Durban - but from provincial centres and rural villages, this book captures the experience of health care workers as they confronted indifference from colleagues, opposition from superiors, unexpected resistance from the country's political leaders, and material scarcity that was both the legacy of Apartheid and a consequence of the global power of the international pharmaceutical industry.In 2003, after years of bitter debate and persistent agitation on the part of treatment activists, the national government committed itself to making anti-retroviral drugs available to those whose lives hung in the balance. Now that a halting rollout of drug treatment has begun, it is more crucial than ever to capture the experiences of those who, as caregivers, have been witness to the unfolding South African epidemic and who are now able to provide these new medications to a small but growing number of their patients.

Shattered Dreams? is an oral history of how physicians and nurses in South Africa struggled to ride the tiger of the world''s most catastrophic AIDS epidemic. Based on interviews-not only from the great urban centers of Johannesburg, Cape Town and Durban-but from provincial centers and rural villages, this book captures the experience of health care workers as they confronted indifference from colleagues, opposition from superiors, unexpected resistance from the country''s political leaders, and material scarcity that was both the legacy of Apartheid and a consequence of the global power of the international pharmaceutical industry.

Since public health seeks to protect the health of populations, it inevitably confronts a range of ethical challenges having to do primarily with the friction between individual freedoms and what might be perceived as governmental paternalism. This volume brings together twenty-five articles by leading thinkers in the field, writing on topics that concern both classic and novel problems. They open up new terrain in each area, including tobacco and drug control, infectious disease, environmental and occupational health, the effect of new genetics on the publics health, and the impact of social inequalities on patterns of morbidity and mortality. The volume editors offer a context for discussion with introductory essays for each of the books five sections.

This is the first history of public health surveillance in the United States to span more than a century of conflict and controversy. The practice of reporting the names of those with disease to health authorities inevitably poses questions about the interplay between the imperative to control threats to the public's health and legal and ethical concerns about privacy. Authors Amy L. Fairchild, Ronald Bayer, and James Colgrove situate the tension inherent in public health surveillance in a broad social and political context and show how the changing meaning and significance of privacy have marked the politics and practice of surveillance since the end of the nineteenth century.

This is the first history of public health surveillance in the United States to span more than a century of conflict and controversy. The practice of reporting the names of those with disease to health authorities inevitably poses questions about the interplay between the imperative to control threats to the public''s health and legal and ethical concerns about privacy. Authors Amy L. Fairchild, Ronald Bayer, and James Colgrove situate the tension inherent in public health surveillance in a broad social and political context and show how the changing meaning and significance of privacy have marked the politics and practice of surveillance since the end of the nineteenth century.

Tobacco, among the most popular consumer products of the twentieth century, is under attack. Once a behavior that knew no social bounds, cigarette smoking has been transformed into an activity that reflects sharp differences in social status. Unfiltered tells the story of how anti-smoking advocates, public health professionals, bureaucrats, and tobacco corporations have clashed over smoking regulation. The nations discussed in this book--Australia, Canada, Denmark, France, Germany, Japan, the United Kingdom, and the United States--restrict tobacco advertising, tax tobacco products, and limit where smoking is permitted. Each is also struggling to shape a tobacco policy that ensures corporate accountability, protects individual liberty, and asserts the state's public health power. Unfiltered offers a comparative perspective on legal, political, and social conflicts over tobacco control. The book makes a unique contribution to our understanding of how scientific evidence, global health advocacy, individual risk assessments, and governmental interests intersect in the crafting of tobacco policy. It features national case studies and cross-cultural essays by experts in health policy, law, political science, history, and sociology. The lessons in Unfiltered are crucial to all who seek to understand and influence tobacco policy and reduce tobacco-related mortality worldwide.

In 1973, after several years of bitter dispute, the Board of Trustees of the American Psychiatric Association decided to remove homosexuality from its official list of mental diseases. Infuriated by the Board's action, a substantial number of dissident psychiatrists charged the association's leadership with capitulating to the pressures of Gay Liberation groups, and forced the board to submit its decision to a referendum of the full APA membership. Ronald Bayer presents a political analysis of the psychiatric battle involved, from the first confrontations organized by gay demonstrators at psychiatric conventions to the referendum initiated by orthodox psychiatrists. The result is a fascinating view of the individuals who led the debate and the fundamental questions that engaged them: social and cultural values, the definition of disease, and the nature of sexuality. Available for the first time in paperback, the book includes a new afterword by the author.

In the era of the Internet and Oprah, in which formerly taboo information is readily available or freely confided, secrecy and privacy have in many ways given way to an onslaught of confession. Yet for those who are HIV positive, decisions about disclosure of their diagnosis force them to confront intimate, fundamental, and rarely discussed questions about truth, lies, sex, and trust. Drawing from interviews with over seventy gay men and women, intravenous drug users, sex workers, bisexual men, and heterosexual men and women, the authors provide a detailed portrait of moral, social, and psychological decision making. The interviews convey the complex emotions of love, lust, longing, hope, despair, and fear that shape individual dilemmas about whether to disclose to, deceive, or trust others concerning this disease. Some of those interviewed revealed their diagnosis widely; others told no one. Some struggled and ultimately told their partners; others spoke in codes or half-truths. One woman discovered her husband's diagnosis in a diary; when confronted, he denied it.Each year in the United States, 40,000 new cases of HIV arise, yet approximately one-third of the 900,000 Americans who are infected do not know it. As treatments have improved, unsafe sexual behavior has increased and efforts at prevention have stalled. Many of those infected continue to fear and experience rejection and discrimination. Addressing broad debates about the nature of secrecy, morality, and silence, this book explores public policy questions in the light of the nuanced, private decisions that are shaping the course of an epidemic and have broader indications for all.

In the era of the Internet and Oprah, in which formerly taboo information is readily available or freely confided, secrecy and privacy have in many ways given way to an onslaught of confession. Yet for those who are HIV positive, decisions about disclosure of their diagnosis force them to confront intimate, fundamental, and rarely discussed questions about truth, lies, sex, and trust. Drawing from interviews with over seventy gay men and women, intravenous drug users, sex workers, bisexual men, and heterosexual men and women, the authors provide a detailed portrait of moral, social, and psychological decision making. The interviews convey the complex emotions of love, lust, longing, hope, despair, and fear that shape individual dilemmas about whether to disclose to, deceive, or trust others concerning this disease. Some of those interviewed revealed their diagnosis widely; others told no one. Some struggled and ultimately told their partners; others spoke in codes or half-truths. One woman discovered her husband's diagnosis in a diary; when confronted, he denied it.Each year in the United States, 40,000 new cases of HIV arise, yet approximately one-third of the 900,000 Americans who are infected do not know it. As treatments have improved, unsafe sexual behavior has increased and efforts at prevention have stalled. Many of those infected continue to fear and experience rejection and discrimination. Addressing broad debates about the nature of secrecy, morality, and silence, this book explores public policy questions in the light of the nuanced, private decisions that are shaping the course of an epidemic and have broader indications for all.

In this timely, penetrating analysis, Ronald Bayer examines the legal and political implications of creating and implementing an effective and rational nationwide health policy that balances public safety with private freedom.

I Several years ago, when the Carter administration announced that it would support congressional action to end the public fund­ ing of abortions, the President was asked at a press conference whether he thought that such a policy was unfair; he responded, "Life is unfair." His remarks provoked a storm of controversy. For other than those who, for principled reasons, opposed abor­ tion on any grounds, it seemed that the President''s comments were cruel, violating what was thought to be an American com­ mitment to providing equal access to health services to all citi­ zens, regardless of their capacity to pay. Those sentiments had, in fact, been reflected in public opinion polls that had, for at least three decades, indicated that Americans supported the propo­ sition that the government should guarantee health care to all. Ultimately, those beliefs had been translated into the oft-ex­ 1 pressed political demand for a one-class system of health care. This commitment to equality is rather remarkable. American society evidences a striking willingness to tolerate vast inequal­ ities with regard to income and wealth. While it guarantees ed­ ucation to all children, there is not even a pretense that the children of the wealthy and the children of the poor ought to get precisely the same kind of schooling. While some commitment ''Hazel Erskine. "The Polls: Health Insurance," Public Opinion Quarterly, XXXIX (Spring, 1975), 128-143.

I Several years ago, when the Carter administration announced that it would support congressional action to end the public fund­ ing of abortions, the President was asked at a press conference whether he thought that such a policy was unfair; he responded, "Life is unfair." His remarks provoked a storm of controversy. For other than those who, for principled reasons, opposed abor­ tion on any grounds, it seemed that the President's comments were cruel, violating what was thought to be an American com­ mitment to providing equal access to health services to all citi­ zens, regardless of their capacity to pay. Those sentiments had, in fact, been reflected in public opinion polls that had, for at least three decades, indicated that Americans supported the propo­ sition that the government should guarantee health care to all. Ultimately, those beliefs had been translated into the oft-ex­ 1 pressed political demand for a one-class system of health care. This commitment to equality is rather remarkable. American society evidences a striking willingness to tolerate vast inequal­ ities with regard to income and wealth. While it guarantees ed­ ucation to all children, there is not even a pretense that the children of the wealthy and the children of the poor ought to get precisely the same kind of schooling. While some commitment 'Hazel Erskine. "The Polls: Health Insurance," Public Opinion Quarterly, XXXIX (Spring, 1975), 128-143.

This open access book offers the first in-depth study of the history and current debates surrounding electronic cigarettes comparing the UK, US and Australia. Since their introduction, e-cigarettes have been the subject of much public, media and regulatory attention, with discussion centring on whether these devices encourage or discourage smoking. This study delves into the history of policymaking and institutions in three countries which have taken different approaches to the regulation of e-cigarettes. In the UK, the tradition of harm reduction through nicotine has helped form a response which has endorsed e-cigarettes, though not without considerable controversy. In contrast, the US has a cessation-only anti-tobacco agenda, and Australia has effectively banned e-cigarettes. This book argues that each country frames the long-term use of nicotine differently and prioritises the health of different groups within the population of smokers or non-smokers, set against a broad backdropof national responses to addiction. By taking this comparative approach, the authors explore the relationship between history, evidence and policy in public health more widely.