VENEREAL DISEASE

Otago Witness, Issue 3593, 23 January 1923, Page 8

VENEREAL DISEASE

IMPORTANCE OF COMPULSORY NOTIFICATION. WELLINGTON, January 17. “Education as a Factor in the Control of Venereal Disease” was the subject of a paper/read by Dr E. Sydney Morris, Director of Public Health, Tasmania, which was read before the hygiene section of the Science Congress. In Dr Morris’s opinion legislation was really a subsidiary factor in the control of venereal disease. The good effects issuing from the law were duo more to the consequent public education and facilities for treatment which did not require legislation, than to any inherent virtue in the law itself. Dr J. S. Elliott, in opening the discussion on Dr (Morris’s paper, said he would like to say a few words to counteract any tendency likely to throw unwarranted discredit on the effects which might accrue from notification as one of the partial remedies for the eradication of venereal disease. Dr Morris, in discussing the question, which bristled with difficulties, had glossed over the difficulties inseparable from every method of combating venereal disease, with the notable exception of acting as a special pleader to unduly emphasise the difficulties in the way of legislative control by means of conditional notification. Education and facilities for treatment had their own special difficulties which should fairly have equal prominence with the legislative difficulties. “I had the privilege,” said Dr Elliott, “of being a member of the committee of tne New Zealand Board of Health which recently investigated very exhaustively the question of venereal disease. This committee made numerous proposals, including education and increased facilities for treatment, and among other recommendations included provisional notification. Therefore we do not come into the category of those who, to quote Dr Morris, rely entirely on legislation, contending that it is capable of controlling the source of these diseases. Dr Morris, in his desire to give prominence to education and facilities for treatment, had staled that notification legislation had had the good effect of educating the public and facilitating treatment. The logical conclusion, which Dr Morris fails to see, could only be that anything which led to good results must of necessity be good in itself. If Dr Morris had realised this at, the beginning of his thesis he wotdd not have proceeded to stir up prejudice and opposition against notification. In any case this work could not have been a congenial one for the Director of Public Health, for notification was essential in the control of all contagious diseases, and venereal disease from the public health point of view could not logically be treated differently from such less important diseases as scarlet fever and diphtheria. His objection to notification was really an attack on a section of the medical profession. These doctors, the anthor had said, were too careless in their methods or too lazy to attend to the duty of notification, or they feared that they

might be subject to the abuse of recalcitrant, patients—i.e., of vile people who thought they were free to remain infective and a danger to the community, but the cup of humiliation is not yet- full, for Dr Morris prophesies that this decline in the public spirit, or shall I sav the honesty of the medical profession, will continue until the law of notification becomes a dead letter. This . is, I think, as great an error as his prognostication that if the best treatment is given free and no questions are asked of the patients, the vast majority of the patients • would proceed with tile treatment and be guided by their medical advisers. The weight cf evidence is against Dr Morris, for in our venereal disease clinics in New Zealand we have the conditions postulated by him, and venereal disease medical officers find that the majority of the patients do not proceed with the treatment, and these doctors all favour notification of recalcitrant patients.” Dr Elliott quoted figures to show the percentage of cases attending the climes at the four centres till they were non-infective, and in no single instance was the percentage of those who remained under treatment very large. Dr Wilkins, Director of the Division of the School of Hygiene, was the next speaker. He said ho was not in a position to express a definite opinion on the matter of non-notification, but he would say he was in agreement with Dr Morris in regard to the question of education. It was a difficult thing to deal with, as there was a tremendous number of points requiring attention. He held very strongly to the view that we would have to begin on general lines and to begin early, and to deal in a frank and straightforward manner with the child. He thought it should be treated rather as an educational matter than a medical one. Dr Harvey Sutton (president of the section) said he felt sure Dr Morris’s attitude was simply due to considerable pessimism, as the basis of the medical profession in Tasmania was not on all fours with that in other cities of the commonwealth and particularly in New Zealand. Personally he could not see how the principle of dealing with infectious disease could be given up ; n regard to syphilis, and he instanced the opposition which occurred in regard to the notification of pulmonary tuberculosis some years ago. No doubt the general consensus of opinion was in favour of notification, and it needed a very thorough trial before one got to the stage at which apparently Dr Morris had reached. In his opinion it was questionable whether education on sex matters given by an outside person would not give prominence to a subject which was undesirable. He gave instances of what was being done at the present time in Australia, notably by the Church of England, which through the medium of its bishops ad a booklet which consisted of instructions to parents on the best methods of imparting this knowledge to their children, and also the preparation of three sets of lectures by the secondary school authorities in many of the larger schools. Those two measures seemed to have been well accepted, and practically no complaints had been heard from the parents on the steps taken with a view to imparting knowledge to their children. In conclusion, Dr Sutton said that to a great extent he agreed with Dr Morris about the question of education, but on the other hand he agreed with everything Dr Elliott had said in regard to the importance of compulsory notification.