Bendradarbiavimo kitam nusikalstant problema vykdant ŽIV prevencijos programas
The problem of cooperation in evil during the implementation of HIV prevention

Summary/Abstract: Cooperation in evil is the participation of more than one person in the same immoral action. So the question of cooperation in evil is widely discussed in connection with ethics of euthanasia, abortion and stem cell research. The question of HIV prevention and the cooperation in evil receives less attention from the bioethicists than other areas of cooperation. However, the issue is very important from both scientific and social points of view, as HIV prevention addresses a huge number of people, especially children and young people, and the implementation of programs is being done not only by health care workers, but also involves social workers, teachers and other specialists. The main goal of the article is to analyze the concept of the cooperation in evil and various forms of such cooperation in the context of HIV prevention. The article pays a specials attention to the harm reduction and its philosophy, which intends to search for alternatives to the prohibition of potentially dangerous lifestyle choices and recognizes that people always will engage in behaviors, which carry risks, such as sex before marriage and drug abuse. The aim of harm reduction is to minimize health risks (the possibility of HIV transmission) associated with the risky behaviors themselves. So HIV prevention, based on the philosophy of harm reduction, uses “safer sex” promotion, needle exchange programs, when nothing is being done in order to prevent risky behavior. The article observes that harm reduction aims at distribution of means, which make ethically questionable behavior possible, and even involves persons in formal cooperation in evil. Formal cooperation in evil is a form of cooperation, when one takes part in the immoral action of another while the same time adopting the evil intention of the principal agent. Such actions, as involving illegal drug dealers in needle exchange programs; methadone programs with the aim of drug substitution or even legalization of narcotic substances are examples of formal cooperation in evil. Formal cooperation is an unethical action and the cooperator shares the same ethical responsibility as the principal agent. The question of political responsibility in the process of decision-making and HIV policy development is also being discussed. Political decisions may influence further tendencies in HIV prevention and propose ethical solutions, thus eliminating the possibility of cooperation in evil in HIV prevention.

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