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This book approaches a variety of social and political issues that have become highly polarized and resistant to compromise by examining them through a population-based public health perspective. The topics included are some of the most contentious: abortion and reproductive rights; end-of-life issues, including the right to die and the treatment of pain; the connection between racism and poor health outcomes for African-Americans; the right of same-sex couples to marry; the toll of gun violence and how to reduce it; domestic violence and how the criminal justice model fails to deal with it effectively; and how tort compensation and punitive damages can further public health goals. People at every point along the political spectrum will find the book enlightening and informative. Written by eight authors, all of whom have cross-disciplinary expertise, this book shifts the focus away from the point of view of rights, politics, or morality and examines the effect of laws and policies from the perspective of public health and welfare.
Recently, I participated in a forum on same-sex marriage. The event was open to members of my law school community, but also in attendance were local citizens, media representatives, as well as audience members and participants from the local area. One question that I'd heard before came up again: “Where's the rights problem? Anyone can marry, including gays and lesbians. The same restriction – marry someone of the opposite sex – applies to everyone equally.”
The standard law professor move at this point would have been to encourage the student to probe a bit more deeply into the notion of equality, asking whether the opposite-sex-only marriage rule duly respects the rights of same-sex couples to form state-sanctioned relationships with the person of their choice. But for some reason, that wasn't the point that occurred to me immediately. Instead, I wondered aloud whether it was good policy to encourage gays and lesbians to marry people of the opposite sex, given the social costs likely to be incurred: The marriage would likely be an unhappy one, possibly ending in divorce (with its documented effect on any children born to the couple); one or both of the parties might be drawn to more emotionally or sexually fulfilling liaisons outside of the marriage; and often such extramarital affairs are conducted in secret, with potentially grave health and emotional consequences for both the unfaithful spouse and his or her uninformed partner.
Until quite recently, one could have accurately stated that the public debate about same-sex marriages was almost entirely focused on rights and morality: Must the law treat same-sex couples the same way it treats their opposite-sex counterparts? What messages, positive or negative, are we sending by allowing gay couples to marry? Are gay unions morally equivalent to straight ones? As anyone who's read a newspaper, watched television, or scanned the internet is well aware, this loud national conversation has played out – at times viciously – in a charged political context. Even the terms of engagement have been a bone of contention. Those favoring marriage rights for same-sex couples have coined the term “marriage equality” to make the point that basic principles of fairness and treating like cases alike compels recognition of same-sex couples' unions, whereas the most virulent opponents place the word marriage into alarmed and ironic quotation marks – homosexual “marriage” – to signal that, in their worldview, such unions can never be true marriages, even if the law deems it otherwise.
This debate is vital and continues at an almost breathless pace. In 2009 alone, only the most fervent of partisans could have kept up with the seemingly endless developments, as the nation (and the world) continued to lurch forward – and backward – on the matter of marriage.