Abstract:
When Mary Selecky, a long-time county health official in Washington state, is named by Governor Gary Locke to be acting state health commissioner, she finds herself in the midst of a pitched battle related to the public health treatment of those infected with the virus that causes AIDS. Public health officials are convinced the control of the disease demands a heightened reporting requirement, as with other sexually-transmitted illnesses. Advocacy organizations concerned about the treatment of AIDS victims, including stigmatization and potential loss of employment or insurance, are dubious whether privacy can be guaranteed in a new reporting regime. Selecky must decide on her policy recommendation to the State Board of Health, the body that will decide. In doing so, she has to weigh the concerns of her public health peers, the potential threat to the public, the varying views of county health officials, the political role of advocacy organizations and the impact of the entire affair on her own career and reputation, as well as that of the Governor.
