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This concluding chapter explores the implications of the PVV view in two major areas. First, as a philosophic tool, the PVV view can be used to assess and enhance both theoretical and applied accounts: the examples here are principlist bioethics, as in Principles of Biomedical Ethics by Tom Beauchamp and James Childress; theorizing about capabilities, as in the work of Amartya Sen and Martha Nussbaum; and liberal individualism. Second, the PVV view can be used as a tool in policy analysis: it can show how some historical policies have overemphasized vectorhood and underemphasized victimhood (for example, the isolation of lepers on Molokai, Hawaii; the quarantine of Chinese for plague in San Francisco; and “Typhoid Mary” and “Patient Zero”); others have overemphasized victimhood and underemphasized vectorhood (for example, the critique of the Tuskeegee syphilis experiments and the HPV immunization campaign). In some, the balance is controversial (HIV/AIDS containment in Cuba; isolation of MRSA patients in modern hospitals); and in some, it appears well-balanced (Canada's exit policy for people with active tuberculosis).

Chapter 7 traces the AIDS crisis into the 1990s. It begins with the 1987 release of Randy Shilts’s And the Band Played On and his portrayal of Dugas as the origin of the epidemic in America. My analysis confirms long-standing assertions that Gäetan Dugas was not the first American with AIDS. Shilts’s editor has confirmed that Shilts manipulated the “Patient Zero” narrative to garner media publicity. Via this publicity, flight attendants were now implicated in the larger social and political battles over AIDS, gay sexual practices, and workplace rights. Over time, the airlines ultimately helped to defuse this hysteria. In 1988 United Airlines stopped grounding flight attendants with AIDS, and, by 1993, American Airlines had become the United States’ first self-proclaimed “gay-friendly” airline.

Shilts and book editor Michael Denneny make controversial decisions about how to get And the Band Played On properly promoted and reviewed. The New York Post’s screaming headline about “Patient Zero” sets in motion worldwide publicity for the concept that one man, Gaetan Dugas, was responsible for spreading AIDS in North America. Shilts’s review of Dr. William Darrow’s cluster study of gay men in Los Angeles proves faulty, although mainstream journalism quickly goes with the “Patient Zero” concept and Shilts is quickly cast as a national expert on HIV-AIDS. Shilts unveils his “AIDS was allowed to happen” posit. A subsequent review of Shilts’s work is mostly critical, particularly from LGBT sources who fault Shilts for allegedly scapegoating Dugas.

Chapter 6 examines the early AIDS crisis. Flight attendants experienced how AIDS was both a medical and a political crisis. The demonization of steward Gäetan Dugas, known as “Patient Zero,” illustrates the ways that flight attendants became embroiled in pitched social battles over AIDS. This chapter details the facts of Dugas’s life and the state of the “Patient Zero” myth circa 1984, before journalist Randy Shilts circulated the myth more widely. I also chronicle the plight of another flight attendant with AIDS, Gär Traynor, whose response to his diagnosis ultimately offered a legal basis for overcoming AIDS-phobia. In a key 1984 legal victory, Traynor became one of the first people with AIDS to win the right to return to work.

Timing played a key role in all of Shilts’s success, and failures. His reporting and books on cutting-edge issues in the emerging gay liberation movement withstood strong push back on his work while establishing himself as an openly gay reporter in mainstream journalism. Shilts unapologetically approached his reporting as he had approached his earlier life – that information granted power and understanding and journalists played a key role in conveying that information. Important questions remain about whether Shilts helped or hindered the understanding of AIDS in the context of the gay community, with serious reservations raised about his use of the “Patient Zero” posit. He was praised, however, for advocacy for gay rights via Conduct Unbecoming.

Shilts begins work on And the Band Played On for St. Martin’s Press – despite an initial struggle to find a publisher for the work. Shilts tackles the complexity of writing about an ongoing infectious disease pandemic with an unknown ending. Shilts unveils his thesis that AIDS succeeded because of government neglect, gay leaders public relations concerns, and news media reluctance to cover gay-related issues. Shilts employs “new journalism” techniques to tell the story of AIDS including reconstructed dialogue and internal thoughts. Shilts learns of the existence of a gay man infected with HIV still sexually active. Shilts uncovers and misinterprets the first “cluster study” on KS victims in southern California. Initial criticism of Shilts for “Patient Zero” concept raised.