An Unhealthy Generosity

Imagine you were the head of a family and a sick vagrant knocked on your door one night asking to be taken in. Though you would feel sorry for him and might try to direct him to a professional health care facility, you would probably consider yourself justified in refusing him shelter in your home, especially if he wanted to move in for a long time. You would be motivated by a sense of responsibility towards your family, whom the infectious guest could involuntarily endanger.

On the other hand, if your own child became sick with a contagious disease, turning her out into the street would not be an option. Your family would learn to deal with the risks of her presence safely or (if necessary) hospitalize her.

From an impersonal, universal perspective this sounds unfair and selfish. Why is one person worthy of care that another is denied? Isn't it all just accidental? Well, yes. A family (or a state) is, like everything human, finite entity whose attention and resources can only be expended on a limited number of people.

Once one has taken responsibility for the people among whom one happens (more or less accidentally) to be situated, the perimeter of one's care can only be extended so far. This is especially true if the dependents one proposes to take on automatically pose a threat to one's current dependents.

This scenario isn't nice. In fact, it sounds cold-blooded. But if someone disregarded the welfare of her family by adopting dangerous or infectious homeless strangers, her commitment to abstract fairness and compassion would require a corresponding callousness to her already existing dependents. We might well call this single-minded idealism cold-blooded-- a selfish sentimentality, if you will.

The Clinton administration needs to be reminded of this unpleasant reality. Like the hypothetical head of the family, the government's primary responsibility is to safeguard the welfare of its citizens. According to the Declaration of Independence, this is why "governments are instituted among men."

A quick review of that document would also remind us of something we tend to forget in this age of federal mega-bureaucracy: namely, that the government is our creation for our needs, not an independent entity that should follow its own opinion in matters that affect us. The state, like the hypothetical head of the family, has no right to purchase its own clear conscience and good public image at the price of sacrificing the interests of those to whom it is primarily answerable.

These being a democratic government's proper priorities, the Administration--and the citizens from whom it derives its legitimate powers--should feel no shame about immigration laws that take into account the immigrant's potential to be a public health threat. Instead, the Department of Health and Human Services (HHS) has drastically reduced the list of medical conditions restricting immigration, ruling that only infectious tuberculosis is enough of a threat to warrant refusing entry to an infected immigrant. Other infectious diseases, including AIDS, syphilis and leprosy, no longer count.

Secretary of Health and Human Services Donna Shalala, the former University of Wisconsin president who was a vocal advocate of campus speech codes, is apparently working her usual guilt trip magic over in Washington, D.C. Common sense, medical knowledge, and the government's primary responsibility to its own people are all disregarded for fear that words like "discrimination," "ethnocentrism," and "insensitivity" will be thrown like bricks at the already battered image of our golden-boy president.

The HHS offers as its rationale the fact that AIDS and other such diseases are not transmitted by casual contact the way tuberculosis is. In order to assert this, however, the department must implicitly define casual contact in a narrow and unrealistic way that is more appropriate to describe the situation of visitors than of proposed long-term residents.

It is true that cannot catch AIDS, for example, by sitting next to an AIDS sufferer on a bus or by using a pay phone he had used. Yet if infected people enter a community for an extended stay, routine contact between them and the uninfected community will certainly include sexual activity, and intravenous drugs may well become another regular medium of interaction between the AIDS carriers and the uninfected community. The same is true of other infectious diseases which are not as instantaneously infectious as tuberculosis but which pose just as great a threat once the carriers' interaction with their healthy neighbors becomes long-term and intimate.

The claim that the government must prioritize the sufferings of its own citizens over those of outsiders need not be founded on or lead to racism and ethnocentrism. Rather, it is legitimized by the limited nature of our nation's resources and the existence of prior responsibilities, the neglect of which would undermine the justification of our government as a government of the people.