Ronald Bayer

Edited correspondence on the status of homosexuality in DSM‐III

In 1973, after a prolonged period of social agitation and professional conflict, the American Psychiatric Association deleted homosexuality from its official listing of psychiatric disorders (DSM-II). In its place a new classification for homosexuals distressed over their orientation was to be included in DSM-II. Four years later an acrimonious dispute surfaced over the status of homosexuality in the revised APA nomenclature of disorders (DSM-III). The edited correspondence of the participants in this dispute is presented here as a way of revealing the lingering conflict over homosexuality within American psychiatry.

Crime, Punishment, and the Decline of Liberal Optimism

Postwar American liberalism was an optimistic ideology assuming the possibility of resolving the problems of the social order within the context of capitalism. That optimism has now been shattered, with liberals exhibittng great pessimism about the possibility of fashioning policy that can meet the challenge of the times. In this essay, this transformation is traced through an analysis of the shifting perspective of liberalism on crime and punishment. A review of the journals of liberal opinion be tween 1945 and 1975 reveals a growing recognition of the seriousness of urban crime and a profound shift from the rehabilitative ideology to a more punitive response to criminals. The distinction between conservative social thought and the liberal critique of that outlook has thus begun to vanish.

Screening blood: public health and medical uncertainty.

In March 1985, the Food and Drug Administration approved the first of five applications from drug companies to market a blood test kit to detect antibodies to HTLV-III, a virus linked with acquired immunodeficiency syndrome (AIDS). The authors discuss the reliability of the antibody test, the immediate problems it raises concerning notification and confidentiality, and the long-term questions that AIDS-antibody testing poses about mass screening, mandatory reporting of positive results to public health officials, behavioral change, and public health interventions under conditions of medical uncertainty.

Retention Rates among Methadone Patients: An Analysis of the New York Experience 1964–1976

Concern regarding the capacity of methadone maintenance programs to retain patients in treatment for optimal periods has surfaced during recent years. This paper examines the New York City experience from 1964–1976 and reveals a sharp decline in retention rates, each admission cohort being characterized by weaker capacity to retain new admissions. The data suggest that the greatest change has occurred in the first months of treatment and note significant differences among various treatment programs.

Gays and the stigma of bad blood.

On March 4, 1983, the U.S. Public Health Service (PHS) recommended that sexually active homosexuals be discouraged from donating or selling their blood because they are at risk of having acquired immuno-deficiency syndrome (AIDS), which apparently can be transmitted through blood transfusions. The evolution of the PHS policy decision is described, as is the stance of those who opposed the decision as unfair to homosexuals and argued for alternative approaches to preventing the spread of AIDS.

Retention Rates Among Methadone Patients: An Analysis of the New York Experience

In the early 1970’s, the methadone maintenance modality was characterized by its capability to attract and retain addicts in treatment. The results were partciularly impressive since methadone programs essentially relied on voluntary treatment as opposed to the coercive, i.e., criminal justice, retention procedures often used by other modalities. Both the professionals in the field--and the critics--have noted, with increasing concern, the declining retention rates among patients admitted to methadone maintenance programs in recent years.

Public Health and Private Rights: Health, Social and Ethical Perspectives

Before I turn the podium over to my estimable colleagues, Dr. Fineberg and Dr. Vernon, I’d like to set the tone for this morning’s presentations.

Book Reviews : U. S. v. Crime in the Streets, Thomas E. Cronin, Tania Z. Cronin, and Michael E. Milakovich. Pp. 212. Bloomington, Indiana University Press, 1981:

announced that the grave social problems that had at one time provided the social bases for tumultuous conflict had been largely resolved. What remained were technical issues requiring the fine-tuned attention of experts in incremental adjustment. The working class had been integrated into the social order, poverty was only a marginal issue, the &dquo;Negro problem&dquo; was being peacefully and gradually handled through the courts. It did not take long to shatter this myth. The onset of the civil rights struggle revealed the depths of black discontent. The white response to that struggle revealed the depths of racist resistance. In quick succession, America witnessed an explosion of social turmoil-ghetto riots, political assassinations, generational conflict, student unrest. It was under these conditions that urban crime became a national issue. The spectre of disorder amplified the fear of crime. The spectre of urban crime amplified and brought home the fear of social disorder. It is not surprising that conservative social forces threatened by the prospect of chaos and committed to the restoration of order would link the crimes of the black and brown underclass to the more controlled efforts to force the process of social change. Barry Goldwater seized upon these issues as he launched his conservative presidential challenge in 1964. Although defeated in his campaign, his efforts forced American liberals

Book Reviews : The Psychiatric Society, Robert Castel, Francoise Castel, and Anne Lovell. Translated by Arthur Goldhammer. Pp. 358. New York, Columbia University Press, 1982.

The Psychiatric Society, Robert Castel, Francoise Castel, and Anne Lovell. Translated by Arthur Goldhammer. Pp. 358. New York, Columbia University Press, 1982.

24.95

24.95. The spectre of the therapeutic state has haunted the literature on psychiatry and social control in the United States for almost two decades. Beginning with the denunciations by Thomas Szasz in the early 1960s, an important and voluminous genre has been created. Both ideological defenses of an expanded role for psychiatry in society and social practices that reflected the influence of