AN OPEN LETTER TO OUR UNIONS.

White Ribbon, Volume 27, Issue 314, 18 August 1921, Page 5

AN OPEN LETTER TO OUR UNIONS.

Dear White Ribbon Sisters. — You have heard much lately about the Government’s intention to introduce legislation dealing with the control of Venerea! Disease. All rightthinking women would welcome measures calculated to help the sufferer* themselves and to prevent them spreading the disease. Are the measures jn the proposed Social Hygiene Bill likely to accomplish these ends? In other examination of suspects. Now, upon right lines? The main features of the proposed Rill are: (1) Compulsory notification of Venereal Disease; (2) Compulsory treatment; (3) Compulsory examination of suspects. Now. puon the surface, compulsory nnt-.fication seems a fair thins. All other infectious diseases are notifiable. Why not this? As compulsory notification would not accomplish much unless followed by compulsory treatment, these two may be taken together. The reasons against compulsory notification lie deep below the surface, and must be sought for. In the first place, these diseases are unlike all others, in this, that no patient Is ashamed to seek treatment for scarlet fever or any similar disease, but to suffer from Venereal Disease usually implies a moral lapse in one’s self or one’s loved ones, and on this account they are carefully hidden. Threi. !acts cannot be too strongly stressed, and must ever be borne in inind in estimating the value of any legislation for the stamping out of Venereal Disease: (1) The absolute nevessity of treating the disease in its very early stage. as then only is there any hope of cure; (2) the utter impossibility of getting the patient in this stage unless he voluntarily presents himself for treatment; (3) the strong probability that patient* would not come voluntarily If they were to be notified and compelled to continue trtftlment. Both expert opinion and practical ex perience are against all forms of compulsion. The British Medical Women’s Federation says:—"Notification, which might be followed by compulsory treatment, would entail the risk of a certain amount of publicity, visits from an official who would be known by sight, proceedings in Police Courts,

etc., and would in consequence deter patients from seeking treatment in the early stage of the disease, when it is mast important, and so lead to concealment of early cases. Patients would only seek advice when driven by pain and illness, when in most cases the disease has become Incurable." The BritLsh Medical Association has pronounced against compulsion, and the many experts examined before the Royal Commission were almost unanimous against compulsory measures, and the Commission itself pronounced against th°m The Italian Minister or Health, speaking to a European Conf* rence upon this subject, said that any legislation to be effective must have no trace of compulsion in it. He was asked would hr allow a diseased woman to leave a hospital while still in the infective store, and he replied. "Yes, because for one so lost I should gain a hundred whom compulsory dc. tention would deter from coming." Free, confidential, and voluntary treatment encourages the patient to seek medical help early; compulsory treatment deters him from coming until he is so bad that there is no hope of cure. The matron of a Salvation Army Rescue Home testified that at the first effrrt to detain the girls they w’ould seek to escape, but if they were left nhsoluteley free to go or stay, they rarely attempted to leave until permission was given. Now’, as to actual experience. Weft Australia has legislation along the lines proposed in the Social Hygiene Bill, and the Women's Societies are sup porting Archbishop Riley and his Vigilance Committee in calling upon the Government to rescind these compulsory clauses for the following reasons: (1) It Is operating mainly against women (2) it Introduces the compulsory medical examination of women; (3) it exposes any woman to malicious denunciation by men of had character. A question asked in Parliament of West Australia produced the statement from the Public Health Commissioner that he had only exercised his powers of forcing patients to lx* examined in 40 cases, and all of these happened to be women. In five cases the women w’ore declared free from the disease. Commenting upon a statement made by women's societies that these five women were unjustly accused, the Public Health Commls-

sioner stated: "In five cases it was impossible micrascopically to pr< i-e definitely that infection was present. These people say —which 1s quite un justified that five women were accused unjustly. The truth is that in all five of these cases the private life of the individual was such as to suggest the probable presence of Venereal Disease, though this could not. hacteriologically, be proved.” This last sentence is very illuminating. because it bears out the contention so often urged that this Bill aims to give control over women of the unfor tunate class. It also shows that the Public Health Commissioner is not satistted with the tests made. Here 1* a disease the most difficult to detect, where even blood tests may not give accurate information, and yet thi* Bill provides that any person, however unskilled. may give evidence that he Im* lieves another person Is suffering from Venereal Disease, and the accused must submit to medical examination. A lady lecturer in this Dominion drew’ a harrowing picture of a girl she had seen selling confectionery. and who she was sure was diseased, and "if this Bill had !m*cu in force I could have reported her." How did she know the disease was present? Without criminal intent, mistakes would be made. But In Victoria (upon Ihe authority of the Minister of Health) there had been cases of malicious accusation by had men. As to the penalty clause, we ask, "Is it likely thnt a penalty of £IOO will deter such men win n by this means they can probably obtain the prey they hnve hem stalk ingr In Western Australia there were 1400 notification in 1919. and 10:tR last year. It w’as stated by a M.P. that 1000 of these came from the Public Hospital, thus leaving only 33 not!flea tions from doctors in private practice. This forces us to accept one of three conclusions: (1) Venereal Diseases are not very prevalent; (2) patients will not consult doctors for fear of being notified; (3) doctors are not notifying. Prohably all are t r ue in part, but as 1000 cases were in hospital, it seems that the balance of probabilities L* In favour of failure to report. But, you say, a do<lor falling to notify is liable to n penalty. So he Is, but it <s an axiom that not the severity but the certainty of the punishment deters. If a thou

wind escape for every one who yets caught. they are prepared to take the infinitesimal risk of discovery. Now. who is to inform against the doctor if he fails to notify? Will the patient inform? If not, who is to do it? Doc tors have declared that they will not notify cases of Venereal Disease that come to them for treatment. One doctor remarked. "If T am fined, the pa I ient will pay the fine.*' Precisely, a wealthy patient would pay the fine sooner than risk publicity. Thus we have class legislation The wealthy would escape, the poor and friendless would alone he notified. If a patient refuses to continue treatment he must he compelled. Who is to compel? W hy. In the last resource he would fall into the hands of the police. Flener. who studied this subject thoroughly in all European caim tries, is entirely opposed to any system of compulsion, as he says: "It continues the hurtful association ri venereal disease with the police, which must Im* completely uprooted <f persons : ll of Venereal Disease are to sfek treatment as rtadily as those r/Mn measles or mumps,.” We must always bear in mind that Venereal Disease is the result of promiscuous sexual intercourse. Education is the only hop-; of erad eating it, gnu that is a slow process. Scientific sex instruction should be »,dven in our schools. To conhnt thf disease, free, voluntary, confidential treatment is urged. Ir. S’drey, v here this treatment is obtainable, su.ferers gr in large nuni!>ers to the clirics. while In Victoria, when- they are compelled to continue treatment, comparatively few seek aid in the -arly stages of the disease. if the Coveminert Is In earnest in corr hating these diseases, let them estab’ish mere of these clinics; let then raise fhe age of consent, and protec". both sexes. We .re in accord with the opinions expressed by (he British Medical Womens Federation in their pronouncement upon this question as follows: "In concluding we desire once more (o eniphas.se our conviction of the necessity of the more serious consideration of f he whole problem and the avoidance of hasty and panic legislation. The problem is one of far-reach-ng complexity: its consideration involves many complicated socta* ques-

tions, the reformation of social condl tions, and of the moral habits of so ciety. A remedy which does not in elude consideration of these will fall in its attempt, and probably draw new social evils in its train." We urge that free, secret, efficient treatment for all patients suffering fiorn venereal disease should he pro vidod by the State, and that every area should immediately take st« ps to provide adequate treatment, and we reiter ate the importance of avoiding ary legislation that may have the effect of deterring patients from seeking advice at the earliest possible momi n', We are, yours very faithfully, RACHEL DON. T resident; PRISCA CRABB. Vice-President; CHRISTINA HENDERSON. Corresponding Secretary; NELLIE BENDERY, Treasurer; NELLIE I*ERYMAN, Editor "White Riblion.”