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Tuesday 14 April 2009

Canada: Soul searching over meaning of Aziga murder verdict continues

This weekend, some of Canada's major newspapers ran editorials and commentaries about the broader issue of HIV disclosure prior to sex that may risk transmission.

The most enlightened, entitled 'HIV/AIDS is just one risk of sexual activity' by Iain Hunter of The Times Colonist (BC capital, Victoria's, local paper), argues that criminal prosecutions divert attention from the fact that everyone needs to practice safer sex and not trust their partners with such life-changing decisions. He concludes:

But the law does seem to put an extraordinary burden entirely on one of two people engaged in a pursuit that both of them know is risky and always has been.

The criminal law isn't sophisticated enough to take account of human passion. It isn't often consulted while clothing drops to the floor.

It doesn't recognize that we're all, now, living with HIV/AIDS.

These days, none of us should believe everything we're told.

Another remarkably enlightened editorial came from The National Post, published last Wednesday after I had written my last posting on the subject. Entitled A fraudster, not a murderer, Barbara Kay argued that although Mr Aziga was morally "despicable" he should not have been charged with, nor found guilty of, murder.
Will all Canadian women sleep easier knowing Aziga no longer prowls the streets in search of prey? No, because "society" was never in danger from Aziga or the afore-mentioned other miscreants. None were rapists: Their victims were women who paid a disproportionately high price for their naivete.


Aziga's moral crime was fraud with depraved indifference to human life, not murder, for which there must be intent. Two of Aziga's 11 relevant sexual partners died of AIDS-related cancers. But four emerged virus-free. People with murder on their minds do not choose to play Russian roulette with their targets.

The sexual aspect is a red herring in this case. The crime is, or should be, knowingly passing a life-threatening infection to an innocent person by any means. The vehicle -penis, needle, amniotic sac-- should be immaterial.

Let the punishment fit the crime, and let all who commit the crime be equally punished.

Others were far less positive, including 'Guilty as charged' in The Calgary Herald
The conviction should send a strong message to HIV-infected people that playing Russian roulette with a partner's sexual health could end very badly and that the person carrying the virus will be held responsible if and when it does. This is a public-health issue and that means the greater good of the public comes before individual considerations.
and an editorial in The Milton Canadian Champion, which concluded: "The end result of what Aziga did was no different than if he’d shot these women."

However, potentially most damaging was Margaret Wente's article in Saturday's Globe & Mail (which describes itself as "Canada's National Newspaper") that focused exclusively on gay men, even though the vast majority of prosecutions are a result of heterosexual sex.

The article cleverly pulls apart anti-criminalisation arguments by being selective about what we actually say; choosing to quote the most radical or (at least legally) lesser informed anti-prosecution advocates; and finding gay men (including doctors and men living with HIV) who support prosections to quote in the piece.

Peter Troyer, a 37-year-old Toronto man who is himself HIV-positive, has no doubt about where he stands. "It is absolutely reasonable to have a law," he says. "He exposed people to a potentially dangerous virus without their consent. I wouldn't want to live in a society that didn't punish this behaviour at the highest level."


Brian Cornelson, a primary care physician at St. Michael's Hospital in Toronto, has been treating HIV-AIDS patients for 17 years. "What I tell my patients is that people who are positive have 100-per-cent responsibility to not infect others, and people who are negative have 100-per-cent responsibility not to infect themselves. If everybody took that stance, we wouldn't have any HIV transmission."

He too believes the position of the activist establishment is flat-out irresponsible. "They've put the stigmatization issue in front of the transmission issue," he says. "For me, as a gay man and a physician, this is particularly dismaying."


But the idea of giving anyone a pass because they're victims makes many people deeply angry. Michael Leshner is one of them. Mr. Leshner, a long-time activist, and his partner were the first gay couple in Canada to be legally married. "The ads give people with HIV-AIDS a moral pass to infect," he says. "Whenever you define a person or a group as victims, the danger is that you excuse away their conduct. It's as if they have no responsibility to themselves or others."

The Globe & Mail had previously published an extremely damning editorial which misrepresented the Canadian HIV/AIDS Legal Network's stance on prosecutions (and on the Aziga case, in particular). They submitted an op-ed on the subject which was declined “because of limited space”. I have lots of space, and so I'm publishing it here, to at least try to balance some of the harm done by writers like Wente.

More light, less heat: it’s time for rational discussion and guidelines about criminal prosecutions for not disclosing HIV

Recently, a Hamilton man with HIV was convicted of first-degree murder. Two women, with whom he had unprotected sex without disclosing his HIV status, were infected; the prosecution argued their subsequent deaths from cancer were linked to their HIV infection.

There is a well-known adage that “bad facts make bad law” — and, seemingly, for simplistic reasoning. In its editorial on the Hamilton case (“Murder, not policy”, April 7), The Globe and Mail fell prey, as did many commentators, to this syndrome, letting the discomfiting facts of this particular proceeding obscure a careful exploration of when it might, and might not, be legitimate to prosecute someone for not disclosing HIV-positive status. In the interests of a rational debate of this difficult issue, we offer the following observations.

It has been suggested that questioning the expansive use of the criminal law, in response to individual prosecutions for HIV exposure amounts to excusing the behaviour of a particular accused. By this same logic, anyone who questions how Canada’s anti-terrorism legislation functions is condoning a given act of terrorism. Both suggestions are fatuous and do a disservice by foreclosing reasoned discussion of how the law should be serving society.

It is similarly intellectually sloppy, but rhetorically convenient, to equate not disclosing HIV status with rape, simply because the same charge is laid as a result of how aggravated sexual assault is currently defined in the Criminal Code. But unprotected sexual intercourse between two autonomous, willing adults, which often carries risks, is dramatically different than violent or coerced sex, which inherently denies the autonomy of one of the parties. To simplistically equate the two does nothing to advance an effective response to either violence against women or HIV exposure.

Over the past decade, there has been an increase in both the frequency and severity of charges against individuals with HIV for not disclosing, for various reasons, their status to a sexual partner. Prosecutors have pursued serious assault charges even in circumstances where the risk of HIV transmission, already statistically small in any single sexual encounter, has been lowered further by responsibly practising safer sex. In light of this “criminalization creep,” it is all the more urgent to address legitimate questions about where, as a matter of public policy, we should draw the lines.

In the “heat of the moment,” do legal requirements influence people’s disclosure or risk behaviour? They may, for some people in some circumstances. But there is no clear evidence to support this claim, and some evidence to rebut it. Surely those who would extend the power of the state to jail people for otherwise consensual sex should point to at least some evidence if they argue that criminal prosecutions can function as HIV prevention policy in this way?

Do criminal charges for non-disclosure of HIV-status help or hinder women attempting to protect themselves, in particular women in abusive relationships or who are economically or
socially dependent on male partners? What about women living with HIV in such circumstances? Would criminally prosecuting them for not disclosing their HIV-positive status serve the interests of justice?

What specific sexual acts pose a legally “significant risk” of HIV transmission, the threshold established by the Supreme Court as requiring disclosure? Using condoms, engaging in lower-risk sexual activities such as oral sex and individual factors such as the viral load of the HIV-positive partner, reduce dramatically the possibility of HIV transmission, leading a few courts to find that criminal charges are not appropriate in these circumstances. But this remains an unsettled aspect of the law, inviting police and prosecutors to keep pushing the boundaries of the law outward to criminalize more and more people, even those who act responsibly.

Finally, if the criminal law is to serve its proper function, we ought to be questioning its broader public health impacts. Why do some individuals living with HIV not disclose their status to sexual partners in certain circumstances? Stigma is one very real major factor, despite cavalier dismissals by some commentators. To the extent that widespread media coverage of criminal prosecutions reinforces an image of people with HIV as potential criminals, it exacerbates the stigma surrounding HIV and certainly does harm. Are people more reluctant to be tested (believing ignorance is their friend) and do they withhold information about their risk behaviours from counsellors (as this information could be used against them in a criminal proceeding)? Do we encourage a false sense of security among people who believe themselves to be HIV-negative, who want to believe that a legal requirement of disclosure means they needn’t worry about their partner’s HIV status?

Contrary to what has been suggested in some commentary (including in The Globe and Mail’s editorial), we have not taken a position on whether the man recently convicted in Hamilton should have been charged with murder, nor on his guilt or innocence. What we have consistently advocated for is a reasoned evaluation and policy debate with respect to the broader questions raised by using criminal charges in cases of HIV non-disclosure.

One step would be to develop prosecutorial guidelines to guide individual police officers and prosecutors, including indicating when prosecution is not warranted. No one is suggesting that we forgive and forget behaviour that has caused harm. But the criminal law is “society’s ultimate weapon.” Not only is studying, evaluating and critiquing the application of the criminal law appropriate, it is absolutely necessary to ensure it is used sensibly and fairly.

Alison Symington is senior policy analyst and Richard Elliott is executive director with the Canadian HIV/AIDS Legal Network.

Update: Although the Globe and Mail didn't publish the above op-ed, they did publish this letter by Eric Mykhalovskiy who is a member of the Ontario Working Group on Criminal Law and HIV Exposure, on April 9th.

HIV legal policy needs debate

The Globe and Mail should support the call for a national dialogue on the criminalization of HIV-nondisclosure (Murder, Not Policy - editorial, April 7). Criminalizing nondisclosure may create the appearance the state is doing something concrete about sexual transmission of HIV. But there are difficult issues at stake, far more complex than those arising out of the Johnson Aziga case.

A few places to start: how to set parameters for a criminal law, given new research showing the possibility of transmitting HIV is dramatically reduced when treatments are used; how to update criminal justice to reflect that HIV is no longer the immediate death sentence it was when the legal obligation to disclose HIV was set; how to make sense of sentences for HIV nondisclosure that have been up to 10 times longer than those for other sexual assault convictions; and, yes, how to consider what the broad and long-term impact of criminalization will be on public-health strategies for HIV prevention.

Canadian Institutes of Health Research New Investigator, York University


Anonymous said...

Great POst as always.
In the National Post Podcast Barbars Kay squares off with Alison Symington of in it Ms Kay asks why we have not held mothers accountable for teh same actions in MTC TRansmission to which Ms Symington responds that it is not in the interest of a newborn to remove it from a mother which was countered with, We remove childern every day from abusive situations. Ms Kay makes a very valid point on the application of the law. Ms Symington needs to look inward if she somehow feels that an unborn child should not be protected by the law.


Internet Badass said...

What makes anyone think that if the intentional spread of HIV was not a criminal act that people with HIV would not be more stigmatized? I have HIV and I wonder what people's reactions to my illness would be if they thought I could just go around spreading it without any consequences?

Anonymous said...

It's time the Canadian legal system actually took the time to craft a law that correctly clarified this area for all parties: police, prosecutors, judges, and those 'involved' in the sexual act.

California has a law that specifically clarifies that you can be charged with 'HIV related assault' if:
1) it involved anal/vaginal sex (oral sex is not included)
2) know your status
3) do not wear a condom
4) fail to disclose
5) have 'intent' to infect

They have actually went through the process of clearly defining how HIV affects the criminal code.

The bottom line is that all of the articles on this subject rarely include a clear, concise discussion about
1) consensual relationships - if something is consnsual, the knowledge or lack of knowledge of HIV status should be held a responsibilty of both parties - otherwise, the law unfairly focuses on only those who have taken the care to learn their status. So anyone having sex should always assume their body is theirs to protect
2) Condom usage and type of sex. If the discussion can't at least start with an assumption that protected sex, is 'good enough' to protect participants and that some sex acts are signficantly more risky than others, then the conversation is meaningless - so is kissing going to be classified as 'assault'? Of course not

So the focus should be on
1) unprotected sex
2) non concensual sex

and if people can't get past number 2, at least clarify #1 - because if protected sex still requires HIV disclosure, then their is an absurd focus on responsibility on only those who have knowledge of their HIV status which accounts for a fraction of sexually active individuals


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