Wednesday, August 25, 2010

Et cetera

I am back in the big city, again.

After more than a week at the province staying at my mom's place (which seldom happens. Thanks to my reliable internet plug in, I was able to keep my sanity), I am once again back with the hassle of city living. I mean, I love the city life, but I have to be doing things myself again. Although I really don't have problems doing things myself, since I have been doing things myself since I was 15 when I had to leave my parents and live on my own when I went to the University, and eventually getting a job and finally living a bachelor's life, the feel of home and the thought that mom is 'just there' is both an assurance and  a convenience.

It is always nice to be spoiled every once in a while. I never had to do my bed since mom is quick to fix it while I am fixing myself in the shower, and while I am dressing up, breakfast (though I usually wake up early afternoon when at my mom's place) is being served. These are just a few of the conveniences which I have given up when I decided to be on my on my own.Well, I still get those conveniences, except that I have to pay for them monetarily now (talk about the city and capitalism).

Anyway, back to normalcy.

My wound finally healed (after almost a month) and I am ready to be a corporate slave (again). I will be signing my contract this week, and hopefully goes back to the 8-5 routine next week. I am not too excited about it, but I  don't have a choice. I gotta get some funds coming in. =D

I know I also need to decide about my ARV regimen soon. I have been thinking about taking another CD4 test since I was thinking that my previous CD4 count in June must have been at a low 260 because I was on an anti-viral meds for my Zoster, but I realized that if ever there will be changes , it must be just +/- 50, and in any case, is still considered low.

It is also good that J has just gotten back. He can definitely help me make clear decisions. He sent me a message last night saying that he has just gotten back from a two-month vacation. I have to admit that in the past two months, I have been mostly drawing strength and inspiration from J. I have learned to set aside the romantic thoughts, and have settled to maintain a friendly relationship with him, and I am more than fine that it remains that way. Well,  in case it goes beyond that, I will openly entertain it. (**Hopia Baboy, as my friends call it)

So far, things are going well.

I couldn't complain.

Monday, August 23, 2010

On Duty of Disclosure: A Positive's Point of View

Kant' whole ethical philosophy revolves on the whole concept of Duty. The moral act is the act which is done out of our concept of duty, that is Duty as the necessity to act out of respect for the moral laws, regardless of whatever consequences it may bring.

It wouldn't be enough to talk about Kant in one sitting, and as much as I would like to be fair to Kant, the space would only allow me to highlight some of the most important concepts in his Moral Philosophy.

For Kant, the morally important thing is not consequences of our actions but the way we (the agent) think when we make those choices. This is not to say that he has total disregard for consequences only that for him, what determines the morality of an act is/are the principle/s to which it was acted upon.

Kant started his whole philosophy of morals with the concept of a good will. The WILL, according to him is the (only) thing which can be inherently good. It is our power of rational moral choice, and is only present in human beings, which accorded human beings their inherent dignity and humanity the ultimate and unconditional value.

What makes the will good? The will is good when it acts out of duty, not out of inclination. To act out of duty is to act out of respect for the moral law, the moral law which is promulgated by human beings themselves based from their natural capacity to grasp and exercise rationality independent of our inclination or desire of any favorable or good consequences of a possible action.

How do we know the moral law? We use the "Categorical Imperative." The Categorical Imperative is stated as "act only on that maxim (or rules of actions) through which you can at the same time will that it becomes a universal law. Basically it requires the following steps:

1. Before you act, consider the maxim or principle on which you are acting.
2. Generalize that principle.

If, once generalized, it no longer makes any sense because it contradicts itself, then it is wrong to use that maxim as a basis for action.

If the generalized version makes sense, then ask whether you would choose to live in a world where it was followed by everyone. If not, do not act on that maxim.

One good example to illustrate Kant's moral theory is "making false promises."
Maxim: I may make a false promise in order to reap financial gain.
Generalized: Anyone may make a false promise to get something s/he wants.
This is self-contradictory because:
If anyone may make a "false promise," nobody would take a promise seriously; promising becomes meaningless.

Result: I may not act on that maxim.

Another way to articulate Kant's CI is "Always act so as to treat humanity (rational nature) whether in your own person of in the person of another (i.e., other human beings) never simply as a means to an end, but always as an end."

These are just some of the main tenets in Kant's moral theory. Having said these, let us examine the case of "Disclosure."

Scenario: X recently found out that he is HIV positive. Prior to knowing that he is positive, X has engaged in some 'unsafe' sexual practices, and could have possibly infected others. Is X on a duty to disclose to the previous sexual partners he could have possibly infected that he is HIV positive (and ask them to get tested?)

Again, duty is the "necessity" to act out of respect for the moral law. We are put into some concept of duty if and only if we are necessitated to act, out of our concept and respect for the moral law, as promulgated by reason and has satisfied the universality test.

Given the scenario above, we may start formulating our maxim-- I should tell all the previous partners I had of my HIV status so that they can get tested. Let me just emphasize 'should' to underscore the necessity (or the non-necessity) of the action.

Let us now examine the necessity of the action to determine whether we have a duty to do it or not, and eventually if this duty will pass the universality test. We may start with the basic duty of truth telling. We should always at all times tell the truth. That is one principle that can be accepted a universal law without contradiction. However, we may ask, "does not telling or non-disclosure constitute "lying"?"

Withholding some information does not necessarily violate the institution of truth telling. There will be no necessary contradictions with the maxim of truth telling since there will be no truths to be affirmed nor denied when we withhold. But we may still argue that although 'non-disclosure' does not constitute lying and has no contradiction with the principles of truth telling, it may be worthwhile to explore another principle, that is the duty "to save others".

The duty to save others may be properly expressed as "I will save others at all times." This may still be universally expressed as "Everyone will save everybody at all times, provided that he will not use his person or the person of anybody simply as means to an end but an end in itself'.

To illustrate the point, let us take for example the case of a drowning man. If someone is drowning, and I CAN swim, then I am put into a duty to save that man. To NOT save that person will be morally impermissible since we are treating the drowning person's life and humanity with less regard.

On the other hand, if someone is drowning, and I CANNOT swim, then, I am NOT put in any duty to save the drowning person since I will be using "my person" as a means to an end, and that is to save someone else's. This leads me to the point that "Ought" implies "Can". We are only put into some sort of Duty when we CAN.

Given the illustration, we can finally express the duty of "saving others" as "We will save others as much as we CAN, at all times."

Relating this to the previous point of disclosure, we may try and express the maxim as such "I will tell people truths that I know to save others as much as I can." Or to be more specific, "I will tell my previous sexual partners who I could have possibly infected as much as I CAN so that they can have themselves tested and stop the spread of infection".

Let us now examine that maxim.

First, are we violating any principles in the application of that maxim? It seems plausible to tell previous sexual partners about our serostatus. We can surely and easily tell our previous sexual partners that we have recently been diagnosed HIV positive, but we have to ask, is it necessary to do so? Moreso, are we using any person as a means to achieve our end, and that is to save our previous sexual partners, and their future sexual partner by having tested, and hopefully practice 'safer' sex in the future?

Although I CAN by principle tell my previous sexual partners about my serostatus, it is important to consider if I will be using my own person by doing that. I may put my own person and my own agency into jeopardy by disclosure. Although my intention by telling other previous sexual partners is to save them by making them know, so that they can also possibly save others they may have possibly infected, and so on ad infinitum, so as to stop the spread of the infection, I am putting myself and my agency into some danger, therefore making myself merely as a means to some end, and that is to stop the future infection.

It may be argued, however, that we may be ‘endangering’ others’ lives, thus making them mere means instead of an end in itself should we not disclose. We may put them into some serious health risk should we not tell them. Still, we are also putting others they will have unsafe sexual contacts into possible risk of infection.

I understand that it is important to stop future infection. At the same time, I understand that knowledge of one's serostatus is a good start to realizing that end. However, I also need to consider in this case the possibility of my agency being undermined should I go for that possibility. How can I be certain that by telling my previous sexual partners of my serostatus, I am guaranteeing that they will only act in such a way that they will only be engaging in safer sexual practices? I still remain hopeful, though.

So does this put me in a "duty to disclose?"

I will go back to my previous example of a drowning man. Although this may sound like an extreme example, it might be worth to try and see the parallelism. If we are all in the same boat, and we all do not know how to swim, it is no question that I do not have duty whatsoever to save others in the boat. To try and save others is not the prudent thing to do as I will be undermining my person, thus endangering my agency of the possibility to 'save others' in ways I can. Say if I die in my attempt to save another drowning person, I won’t be able to try and save an old lady crossing the street, or an impoverished kid who do not have something to eat. The point is, there are ways where 'saving others' can be fulfilled, and that is saving others in the way I can without possibly endangering my agency and my capacity to save others.

Applying the parallelism to the case of (non)disclosure, by disclosing my serostatus to previous sexual partners, I may be jeopardizing myself of the possible 'normal' life. Others may find out. To say the worst, I may suffer stigma and incarceration thereby making me unable to function 'normally', thus undermining my further duty of fighting (and possibly stopping) the spread of infection. That may sound an exaggeration, but remains a possibility.

Still following the parallelism, should I NOT disclose the information, I can still fulfill the ends of trying to fight the spread of infection (in the ways I CAN). I CAN definitely engage in safer sexual practices, which is one way. I can also go and start educating people about HIV/AIDS. And these acts, although directed towards the same end, that is to stop the spread of infection, does not necessarily endanger my person and my agency, thus, not violating the principle of Universality as discussed.

I recognize that everyone has the responsibility and is in a duty to fight the spread of HIV/AIDS. This is not questionable. This is something that can be accepted as a Universal law. It should be added however that "fighting in a way we CAN without endangering your person or the person of another" simply to achieve this end.

This responsibility and duty is also not retroactive. When I still didn’t know how to swim, I didn't have the duty to save anyone in a drowning boat. I cannot be faulted for not having been able to save anybody. But say I finally learn to swim, and the same drowning boat incident happen, I cannot escape my duty to save others. To NOT save anybody would be morally impermissible.

The same is the case of knowing my serostatus. I cannot be faulted for not being able to save those who I could have possibly infected "when I still didn't know." Disclosing my serostatus, although may not change the fact that I may or may have infected them, may possibly have them know their own status and could help a lot in stopping the spread of the virus. At the same time, I still cannot guarantee that by disclosure, I am completely not using my person as a means to achieving the end, that is to stop the spread of infection. It can, but the odds that I may be are still very apparent, though.

However, I am not sparing myself of the duty and my responsibility to stop the spread of the Virus. Now that I know my serostatus, to endanger other people by doing the same irresponsible act of unsafe sexual practices would be equally morally impermissible.

Finally, I can no longer save those who have drowned. But I CAN save (some of) those who will. And this is what I will do.

Sunday, August 22, 2010

(Ethical) Issues on Disclosure

Maybe I am over-thinking it. Maybe I am also just too engrossed with the philosophical concept of justice and responsibility.

When I found out about my HIV status, some friends who I told I am positive suggested that I tell the previous contacts (who I could have possibly infected when I still didn't know my status) to get tested. They even told me to get a dummy SIM card and send those people anonymous messages. I decided NOT, and I remain with my position.

Today, a friend has met a pozzie online, and he volunteered to be the 'third' party to tell the HIV pozzie's (lets call him R****) previous contact  (lets call him A****) to get tested. Again, I may be wrong, but I remain.

(Friend): As a third party, protecting R****'s anonymity, I contacted A**** with R****'s message for him to get tested
(ME): Uhuh
(Friend): And R****'s message was very non-judgmental, no guilt no 'kawawa' drama
(Friend): A**** ignored my message - this morning A**** thought he was chatting with a new guy in Taguig and invited him over for sex - but he was actually chatting with R**** who wanted to get his CP for the health department.
(ME): R**** shouldn't be giving A****'s number no matter how good is the intention
(ME): I do not agree with what he's (A****'s) doing
(Friend): Then you are lucky to live in the Philippines
(Friend): (Smiley)
(ME): I respect A****'s, or anyone else's privacy, and at the same time, I give the responsibility to him to check on his health
(ME): R**** may be concerned, but doesn't have the right to disclose to anyone, not even the health department what "could" be A****'s (possible) status
(Friend): I told R**** that in the states, the Health Dept has full time employees who spend their entire career tracing spreaders of HIV.
(ME): He could get into trouble.
(Friend): Are you telling me that the health department here does not ask for the names of who you've had sex with?
(ME): No, they don't and they can't.
(ME): I mean theres a law against explicitly disclosing someone else's (possible) status
(Friend): It's a mandatory question in the states
(ME): Not here
(ME): Which is good i guess
(ME): I mean, you are putting someone else's privacy into jeopardy
(Friend): Life is more important than privacy
(ME): Privacy could mean 'a certain quality of life'
(ME): Its not just 'life' we have to consider, but the quality of life

(Friend): If Guy A is tested, and his test is positive, then Guy A commits a crime every time he has unprotected sex in the future
(ME): That's up to guy A and his partner
(ME): A responsible partner wouldn't have unprotected sex
(ME): So its not just guy A, but a consent from guy B
(ME): No crime is committed.

(Friend): Right now in Germany a female rock star is on trial for knowing she had HIV and giving it to 3 different male partners
(ME): Yes, that's true.
(ME): If you know that you are positive and you deliberately act so as to infect someone, that could be ASSAULT
(Friend): Under German law, she is required to notify the partner of her HIV status
(Friend): In the states, attempted murder
(ME): Yes, you are required to tell, if you know that you will be infecting the partner
(ME): That is, by 'deliberately' not protecting
(ME): But if it's not putting the partner into grave danger, say you've taken protection, then that's not assault
(Friend): A**** apparently likes to fuck younger men without condoms
(ME): A responsible HIV positive wouldn't wanna get fucked without condoms
(ME): No matter how the partner wants it
(ME): Now if the partner insists fucking a positive guy without rubber after the positive person refuses, no assault there
(Friend): Are you going to go to law school?
(ME): I hope I am. Why? (Smiley)
(Friend): (Smiley)
(ME): Hehehe
(ME): One doesn't have to be in the law school to make sense of some principles and postulates
(Friend): Because you are arguing how many lawyers can dance on the head of a pin
(ME): (Wink)

(Friend): My postulate is this: 1. If someone says you have a 50/50 chance of being the guy who infected him with HIV, then you have two obligations 1. to be tested and 2. No matter what the result, negative or positive, you must use condoms on all future acts of penetration.
(ME): I take number 2
(ME): That's the responsible choice

(Friend): Did you notice in his (A****) profile, the number of young men he has his arm around?
(Friend): He has a moral obligation to others to be tested
(ME): Should we judge him as to how many men he has?
(ME): What he should do is to protect himself
(ME): And the partners
(ME): Say he gets tested, and he tested positive
(ME): What do we do then? Shall we stop him for f**king others?
(Friend): And to hell with the past ?
(ME): What about the past?

(Friend): You should never work in infectious disease control
(ME): If you ask me, am I responsible for the guys I could have possibly infected when I didn't know I have IT, I'd say "NO!"
(ME): I am responsible for my future contacts
(ME): Not with the past. Things happened because of our choices
(ME): There were times I wasn't responsible that's why I had it
(ME): But at the same time, I didn't tell the former partners to be not responsible
(ME): As far as I know, at the point of contact, I was safe and I wanna take the risk by doing it 'unsafe' with them
(Friend): You need to read And The Band Played On
(ME): So I cannot be held responsible for them in the same way that they shouldn't be responsible for me
(ME): If there are people I am responsible to, that's the future partners am gonna do it with
(ME): I have to make sure i do it safely so as not to endanger them
(Friend): I can see this debate is not going anywhere
(Friend): You need to read And The Band Played On
(ME): Hmmm!
(ME): My only point is that you cannot be responsible from that which you didn't WILL.

(Friend): I don't see it as a philosophical argument - I see it as a public health issue, and the health of the public body is more important than the rights of the individual
(ME): Don't you think the public needs to protect themselves among anyone or anybody else?
(ME): Would a responsible public engage in unsafe sex?
(Friend): You're making it a philosophical question
(ME): Would you like some authority to impose on its people how they should be doing things, including that personal act of having sex?
(ME): They can only influence and advocate
(Friend): A disease that kills is NOT a philosophical question
(ME): In the end, the individual is responsible for himself
(Friend): Oh Jesus I give up!
(ME): I am sorry. I couldn't just accept it.

(ME): Would you like me to jeopardize my own privacy
(ME): Or if for example it is you,  your privacy jeopardized? Would you like it?
(ME): Try putting yourself in the position of all the positive
(Friend): Whatever, bye
(ME): I am sorry.

This is the actual transcipt, except that some spellings have been auto corrected. The names were also changed for privacy's sake.

Saturday, August 21, 2010

Am I the Same Boy

I am currently in Yahoo Messenger with (one of the few) friends who know I am Positive. As I write now, I have thoughts of how some things can remain almost the same over time while others can change in a blink of an eye.

I have been in my mom's place for a visit for a few days now and today, a friend from high school decided to visit me and and we went to another friend's house. My friend's house still looked almost the same. The same vibe. The same warm welcome from his parents. The same neighborhood. Almost the same 5 or 10 years ago.

We then took a walk by the school where I spent most of my formative years. I remember the classroom I was in. The oval and the acacia tree where we used to hang out after school is still standing strong. The leaning wall is still the same wall and hasn't fallen yet. The sound of the jeepneys are pretty much the same, although a little louder now.

Some things don't change much over time.

On the other hand, while talking to this friend, I also realized that there are some thing that can change at a blink of an eye or a snap of a finger.

I have been living my life as I know it. It has been going well, smooth and manageable, until suddenly I found out that I am HIV Positive. I wouldn't exagerate, though. It is not as if the next day I wake up, my life suddenly became that of a dying man who has been sick and can barely manage to do things. I am still able to do what I have to, with a little discomfort and self-limitation. But the point is that, realization comes that there are things that I do which I cannot and should not do while, while there are those that I have to and should do to be able to go on.

I know I should not indulge too much in an overnight drinking party, drowning myself with alcohol and swim in fumes of cigarettes. I know I should be taking time to properly rest. I know I have to keep my body healthy. And the list goes on.

Am I the same Boy?

Sunday, August 15, 2010

Catching Up, and Lots of It

I haven't updated my blog for a while now. No, this isn't one of those spontaneous hiatus i do every once in a while. Neither it is because I've ran out of things to write. Rather, it is because of the discomfort of having been only able to do things single-handedly-- and I mean literally with one hand, that had me take writing (or typing, whatever you wanna call it) at a bay.

Now I am back, though still with only one able hand while the other is recuperating. I am getting better, nonetheless.

So, how do I start (again)?

Well, the past weeks have been good, I must say.

First, I have reconciled with my past. Although I really didn't have to deal with post break up anxiety after my relationship of more than a year ended in April, things weren't all good. BF and I weren't in speaking terms for a while until his birthday. Though I won't say everything is fixed now, it is good that we have started to be at ease and are able talk to each other without either antagonism or indifference.

Last week, I went to see him to get some of the things I left with him in the condo. I felt it was not as homey as before, but at least I felt at ease. We then decided to go out that night to a party of a friend, and here are a few things I realized.

BF is a special guy and will always have a special space in my heart. I may (choose to) cease to care at times, but I know that wouldn't last. I will always have a soft spot for this guy I love(d). Afterall, he is a great guy. He is a great guy in the same way that (I'd like to think)I am as well, and we are both great as individuals, only that it is not always great when we're together. Again, two great individuals do not always make a good couple. The fallacy of composition stands.

Still, another thing I realized is that is that although I would say I have long time accepted that we are no longer together and it is better this way, it (still) feels awkward whenever I am asked by friends about 'US'. I mean, at the same party we were in, we were asked how long have we been together, and I, although (still) not very comfortable, said "we are no longer together." I tried to disperse the situation with nonchalance, but I know at the back of my mind were a lot of thoughts. It could have been just the pressure from the assumption the relationships ought to last, well, at least ours. Or it could also be just me over thinking it. I could have just taken it as 'a plain statement of a fact' as I usually do with other truths I tell people, but I know this truth is one things I have to learn to take casually. It shouldn't be a big deal, afterall.

Moving on,I have finally decided to take on a new job last week. After going freelance since I left my last job in November last year, I decided to accept a regular job and go back to the corporate jungle. This isn't exactly my dream job, but for the meantime, I'll try and wing it.

Lastly, I finally went home. Just before I get enslaved in the corners of my new office, I decided to hit the road and head home to spend some time with my family.I know it is not a herculean task. A two to three hour commuting doesn't sound a task at all. I also know I should have done this a long time ago, and as often as I should have, but always failed. Despite my failure, it is good to know that it is always a home and a family waiting for me. I know I am loved.

I am staying at my mom's for the meantime. Although it pains me to see her worry upon and everytime she sees the wound on my left hand, I'll take the time and this chance to be the son to her, the brother to my siblings, and the uncle to my niece. Its gonna be a good happy vacation at home, I know.

Things are falling into places, and I am somehow pleased. Its also good that to know that by the time I am back in the city, a special person will have already been there. J will come back from his vacation soon. This is the one thing I look forward to at the moment.

Til I write again.

Sunday, August 8, 2010

A Bad Infection

It has been two weeks now since I had this wound in my finger. It is still fresh and I have seen no improvements at all aside from the fact that I can now withstand a day without a pain killer.

It has been two weeks now as well that I have been doing things single-handedly, with my left hand barely able to hold a fork when I eat. It gets frustrating at times.

I already stopped my medication today, though. I planned on visiting my doctor to have it checked again, but I was thinking she might just go on and prescribe a new set of medication, and I wouldn't want that.

I don't want my body dependent so much on medicines. Aside from the medicines being very expensive and difficult to maintain as they are to be taken on schedule, I am still hoping that my body is still able to respond to and fight some of the infections. But this one looks like a really bad infection. Still, I am hopeful.

I am crossing my fingers (**pun intended)

Sunday, August 1, 2010

Party Popper

Last night was (ex)boyfriend's birthday. It's his 40th, and I know it is an important day for him. Despite not being able to talk since went separate ways, our silence and distance seem to have put things into places. So with my dose of antibiotic and pain killers, I decided to go despite my swollen and sometimes throbbing finger.

It was nice to see him after a long time. I have to admit that after all these times and after all that happened, he will always be a special person for me and that he will always have a special place in my heart. I am talking about this now not in a romantic tone, though. LOL.

It was equally nice to see some of our common friends as well. And just when everyone started to grab their drinks, I had to be content to merely looking at them as they savor the taste and smell of alcohol.

I haven't drank in a while now. The last time I drank was during my birthday, and after some time of not drinking, either you get too excited to drink or you manage to be content to the mere thought but actually drinking.

I put my temperament into the test as much as I can, trying not to hold a glass or a bottle, until I realized I couldn't take it anymore. So I called on the waiter to serve me a glass of cosmo.

I slowly sipped into my glass, and (whoah, did I say it was potent?) then another, until I downed my first. Just when I was about to get another one, I felt the gauze on my finger becoming a bit warm and moist.

It was blood coming from my open wound. What a big party popper!

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