Local Michigan county wants to force meds on HIV criminal suspect

[TonyRedux]

from what i'm reading i expect more of this in the future, but i wonder how they can ensure this without incarcerating him?

http://www.americanindependent.com/208474/local-michigan-county-wants-to-force-meds-on-hiv-criminal-suspect

Local Michigan county wants to force meds on HIV criminal suspect

By Todd Heywood

Tuesday, January 10, 2012 at 9:55 am

Sangeeta Ghosh, assistant corporate counsel for Kent County, Mich., says should the 51-year-old man charged in two cases of failing to disclose his HIV-positive status to sexual partners make bail, the county is prepared to ask a court to force him to take antiretroviral medications.

“The county is taking steps that if he gets out, we will file a civil matter to make sure he takes his medications,” Ghosh told The American Independent.

Ghosh was speaking of the Comstock Park man who turned himself in to Grand Rapids police Dec. 22, alleging he attempted to infect hundreds of people with HIV through unprotected sex and sharing needles. He was placed in a psychiatric hold for two days, and on Dec. 24, he was arraigned on the first of two charges of failing to disclose his status to a sex partner. Several days later, prosecutors added a second charge of failing to disclose. He is currently in Ypsilanti undergoing a psychiatric evaluation to determine if he can stand trial. He is being held on a $100,000 bond.

TAI does not identify the names of those charged with HIV disclosure laws unless both the accused and the accuser are named in court documents, or one or both provide TAI permission to publish their names.

The case, media releases and subsequent reporting have resulted in what experts have told TAI were “sensationalist” reports in the wider media.

But this is the first time county officials have indicated plans on how to deal with the man if he is released on bond.

The announcement, however, has HIV advocates worried.

“Forcing anyone to take treatment is a slippery slope,” said Sean Strub, co-chair of the Global Network of People with AIDS, North America (GNP+), in an email. “This person’s most important health issue seems to be his mental health, not his viral status. Forcing anti-retroviral treatment on anyone is a slippery slope. Once the camel’s nose gets inside that tent, even in such a rare and bizarre circumstance as this peculiar case, it is not such a huge step to mandatory testing and treatment for an ever-expanding number of people with HIV.”

While the advent of antiretroviral medications in the mid-1990s resulted in a staggering revival of persons living with AIDS and s sharp decrease in AIDS-related deaths, the drugs themselves are quite toxic and cause a host of side effects. In addition, scientists are not in agreement as to when is the appropriate point in clinical progression to begin treatment, resulting in many mixed messages to patients.

Michigan does have a part of the state health code that allows health officials to declare a person a health threat to others (HTTO). HTTOs are a civil action and can amount to anything from counseling to forced civil confinement for as long as six months. TAI reported in December that many people thought the law was being abused when it was revealed that any HIV-positive person who was diagnosed with a sexually transmitted infection was immediately issued an HTTO. In other instances, women who became pregnant were issued HTTO orders and HIV-positive people who were named in partner services programs were also targeted for HTTO orders. The state, which oversees the HTTO list, denies pregnant women were targeted but said the STI and partner services programs were appropriate uses of the state’s name-based HIV list.

“[The suspect] does not have an airborne disease spread through casual contact; he has a disease that, regardless of treatment, is not easily transmitted. Even without treatment, the primary routes of infection — unprotected anal or vaginal sex — result in HIV transmission roughly one percent or less of the time,” said Catherine Hanssens, executive director of the Center for HIV Law and Policy. “So the threat of mandatory treatment is not a reflection of any danger [the suspect] poses, but of Ms.Ghosh’s dangerous misapprehension of both HIV transmission and the law governing the very limited circumstances under which treatment of an individual can be mandated.”

Photo: Kent County, Mich. logo (www.accesskent.com)

[Hotload84]

An interesting case. When an individual is incarcerated, the state acts in loco parentis, and in that capacity the state can order the individual to take medications, just as one's parent can order his or her underage child to do the same. When an individual has been charged and is being held awaiting trial, again, the state acts in loco parentis, so it's easy for me to see how the state can mandate that the prisoner take the meds. The state's interest is not only the well-being of the prisoner, it is also acting in the best interest of the guards and other prisoners with whom the poz prisoner may come in contact. Similarly, if the accused makes bail, as a condition of being released, the state can request the Court order the accused to take the meds.

The comment by Sean Strub of Global Network is nevertheless perceptive, and parses the issue nicely: whereas the accused is seemingly mentally troubled, and presumably that mental condition should be treated, is it also appropriate to treat him as a potential Typhoid Mary who's medical treatment becomes a matter for public oversight? Tough call, no matter what the outcome.

A more challenging