Originally posted 13th December 2009
Occam's razor and the debate about condoms in Africa
A case for the ethical use of condoms to combat the spread of HIV/AIDS
In 2009 Pope Benedict made some remarks on his first visit to Africa that outraged health agencies trying to halt the spread of HIV and Aids. “. . . [S]peaking to journalists on his flight, he said “the condition was a tragedy that cannot be overcome by money alone, that cannot be overcome through the distribution of condoms, which even aggravates the problems.’" (The Guardian 17 Mar 2009)
The passage of time has allowed human feelings to subside, I suppose, if we discount those who died because of the pope’s pontifical pronouncements. However, something might still be learned from the exchange. Here is an analogy that I hope brings home some of the contending impulses that get in the way of thought and action.
Imagine that you are just walking along, minding your own business, and suddenly you notice a crowd of gawkers around a huge building that is being engulfed by flames. All of us would agree that the most humane response would be to call the fire department and help get those in harm’s way to safety as quickly as possible with the least risk to yourself and anyone else close to the flames.
But when you begin to take any action – shout to people in the building so that they might be able to find a way out, ring the fire alarm, grab a bucket – various bystanders try to stop you.
One group shouts that one floor of the building has been taken over by crack heads and that it’s better to let them burn than possibly influence their kids, and turn them towards the path to addiction.
Some preachers declaim that prostitutes live in part of the building and they spread venereal disease and, besides, the injunction in their holy books says that they should be punished by death. The fire itself is their god’s wrath.
Another man says that his wife is on one of the upper floors, but that she has been unfaithful. It makes no difference to him whether she lives or dies. He is cheered on by a larger group of men who do not believe that men should put themselves in danger trying to rescue any women.
A group of women blockade any help because their husbands are in the building. Each and everyone of the men is HIV infected. They say that the fire is the hand of God saving them from certain infection.
Some priests claim certain knowledge that the fire was set by an arsonist doing either God’s or the devil’s work. They shout that the only possible solution is to avoid fires in the first place, that it’s immoral to intervene in a situation where the laws of nature have been violated, and that dousing the flames with water will not work in cases like this anyway.
A group of social workers stand to one side shaking their heads. They are not without compassion, but they say they are helpless. And besides, this situation could have been avoided entirely if the basic needs of the folks in the burning building had been addressed earlier, if they had been educated, fed, trained in fire prevention, and given classes in self esteem.
Meanwhile the fire engulfs the building floor after floor. More and more people die. The professional firefighters cannot do what they know how to do. They know how to suppress the flames with water or chemicals. They can handle catastrophic fires and reduce the loss of human life. But they cannot do their job.
Each group has seemingly sound reasons (or justifications) for blocking the intervention by the firefighters. One points to tons of studies that prove that proximity to drug addicts increases the risk of addiction. The group that is content to let prostitutes die shouts age-old taboos about sex and virginity to justify themselves. The man whose unfaithful wife is going to be burned feels justified because his honor will be satisfied. The women whose husbands are HIV infected feel that finally nature has set about to reset the balance of power between the sexes. The priests use myth about being possessed by the devil to justify their claim that water will not put out these flames. The social workers feel that their profession might finally be recognized for the possible benefit for all mankind when finally the fire has taken its toll and they can sift through the ashes.
We cannot allow considerations from other disciplines, practices, myths, cultures, religions, or magic to cloud the thread of the argument. Promoting the use of condoms is an ethical and necessary step towards preventing the spread of HIV, and that the conversation about the use of condoms to stem the spread of HIV in Africa has to be kept simple and direct. Only unencumbered language will allow us to arrive at both a sound conclusion and an effective strategy to stop AIDS. That has to be the goal – reduce the rate of HIV infection among poorer African populations.
Here is a modern gloss of Occam’s razor: any good baseball coach teaches young players to keep their eye on the ball. It is that simple – there is only the ball flying through space, only you with a bat, or your glove, can stop its trajectory. When you hear people screaming at you from the stands, “if you catch it, you’ll be no better than the devil, you’ll go to hell, there’s a spell on that ball, it carries drug addiction and disease,” what do you do? Eliminate the noise as best you can.
Occam’s Razor: entia non sunt multiplicanda praeter necessitatem, "entities must not be multiplied beyond necessity." It is also expressed this way: Numquam ponenda est pluralitas sine necessitate, "Plurality ought never be posited without necessity".
HIV/AIDS is a medical problem. Whatever else might be handled separately.