Conscience and depressive disorders.
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Adolescent gay and bisexual males face a higher risk of infection with HIV than most other young people because of their behaviors and because HIV prevention programs have failed to address their unique concerns. Ironically, current efforts to heighten public awareness about the AIDS pandemic may be nullifying the potential for gay, lesbian, and bisexual young persons at high risk to form the support networks needed to modify their behavior. The personal and group empowerment of gay, lesbian, and bisexual young people is a necessary prerequisite to their ability to make healthy behavioral choices around HIV and other health issues. This paper proposes a comprehensive health education model for HIV prevention for gay, lesbian, and bisexual adolescents. Current health education efforts would be augmented by broader self and group empowerment training that would develop self-esteem, social skills, support networks, and access to risk reduction materials. An integrated system of care involving school-based programs, multi-service youth agencies, and self-help groups would be in a position to deliver appropriate educational, mental health, medical, and social support services. Such a system of care presents gay, lesbian, and bisexual youth with their best chance to reduce their risk of infection with HIV and develop into emotionally healthy individuals.
As the fifth national bioethics commission has concluded its work and a sixth is currently underway, it is time to step back and consider appropriate measures of success. This paper argues that standard measures of commissions' influence fail to fully assess their role as public forums. From the perspective of democratic theory, a critical dimension of this role is public engagement: the ability of a commission to address the concerns of the general public, to learn how average citizens resolve moral issues in healthcare, and to monitor public opinion on the topics addressed in the commission. Such a public forum role is supported by the critical literature within bioethics, which has deemed some commissions successful, supported more generally by the history of bioethics as a reform discourse that has brought socially important values into the medical domain, and supported more generally still by the example of the great social issues commissions of the 1960s.
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