Schaler, J.A. (1988, December 24). 'AIDS and the medical fundamentalists.'
The Washington Post, Letters to the Editor, p. A14.

President Reagan is correct when he states that morality and medicine teach the same lesson ["AIDS and the Medical Fundamentalists," Dec. 17]. The fallacious categorization of certain phenomena as disease is a means by which doctors have been practicing both moralism and paternalism, if not prejudice and coercion, in the name of medicine for years.

In 1785, Benjamin Rush, father of American psychiatry and signer of the Declaration of Independence, asserted that alcoholism was a disease. Seven years later he claimed to have discovered the disease of "Negritude." (He erroneously called the disease of vitiligo the spontaneous cure of the "disease" he believed all Negroes suffered from.)

In 1973 the American Psychiatric Association declassified homosexuality as a disease. This was not a scientific decision. It was a political decision. Today, we know there is a relationship between homosexuality and the disease we call AIDS. This does not mean that homosexuality is a disease. Public outrage brought psychiatrists to their senses.

It is inaccurate to say that a behavior, such as drinking alcohol, is caused by genetic or biochemical differences. That a correlation may exist is uncontested. That the differences account for the behavior is another matter.

Anytime a behavior is considered a disease, a moral judgment is made in the name of practicing medicine. Mental illness, a contradiction in terms, is no exception.

JEFFREY A. SCHALER
Silver Spring