Pragmatism beats preaching in battle against society's ills


If there's anything we can agree on in America, it is that we have problems. We can even agree on what some of the problems are. Two examples come to mind: teen-age pregnancy and drug abuse.

No arguments, right? But watch how quickly you can start one. All you have to do is begin discussing possible solutions for these social ills.

That's when it can get ugly. We seem to break down into two camps that, as the football announcers say, plain don't like each other. That's another problem.

One group preaches abstinence. Nancy Reagan personified that argument with her just-say-no campaign against drug use. You can combat AIDS the same way. Also, teen-age pregnancy. There's a long list of applicable sins, from murder to overeating. Certainly, you have to like the simplicity involved. It's neat, it's clean. And it has a corollary.

The argument continues that, with our current welfare system, we actually encourage single mothers to have babies. Maybe, some on the radical end say, we should turn off the welfare spigot. If the government just says no, perhaps some potential single mothers will, too.

The other side says, in effect, grow up. We can call this the just-face-reality line. People use drugs. People have sex. Given those truths, what do we do about them?

Here's their answer. If using dirty needles can lead to AIDS, make sure addicts have clean needles. And if teen-agers insist on having sex -- and they do, with alarming frequency -- make condoms or Norplant available, where teen-agers congregate. Like at school. If it won't stop kids from having sex, it may stop some of them from getting pregnant.

Into the middle of this discussion steps Dr. Joycelyn Elders, our new surgeon general. Boy, does she ever.

If there's anything she wants, it's for the debate to be joined. It could get loud.

She was on "Nightline" the other night. When Ted Koppel asked her to identify the biggest health problem facing our country, she said it was children having children. Dan Quayle might have said the same thing.

Her solutions are slightly different.

She believes in sex education. She wants to talk about sex. She wants to talk about it a lot. She wants kids to know the consequences of sex, and she wants them to know how to avoid the consequences -- and that includes using condoms, which she would be happy to give to anyone who wants one.

You may know of her famous quote: "We have had driver's ed for our kids. We've taught them what to do in the front seat of the car but not what to do in the back seat of the car."

Her opponents, and there are many, say that such discussions put ideas into kids' heads. Maybe they haven't seen the study showing that, in 1990, 32 percent of ninth-grade females had sex. Or that, in the same year, nearly 10 percent of all females 15 to 17 years old in Baltimore had a baby.

Obviously, these kids already have an idea. They need a clue. What do we do about it?

Mayor Kurt Schmoke is asking the same question with his task force on drugs. He wants to give methadone to heroin addicts. He wants a needle exchange. He wants to stop locking up drug users, who are overloading our prisons, and get them help instead. He thinks we should concentrate our law enforcement efforts on drug dealers, who are responsible for so much of the crime in our cities.

Schmoke has called for a national debate. Elders, I'm sure, would approve.

She wants to use her position as surgeon general in much the same way C. Everett Koop did. Koop relentlessly attacked cigarette smoking and the tobacco industry, making it clear that this was a national health problem requiring national solutions.

You can make the same argument in terms of teen-age pregnancy. According to Elders, more than half the black men in prison were born to teen-age mothers. Is there any greater factor contributing to the cycle of poverty than children having children? Mustn't something be done?

You say welfare is a primary factor in this equation. Maybe it is. Most people have come around to the idea that the welfare system must be overhauled.

Most people would like to see a time, too, when ninth graders weren't having sex. Elders certainly would. She has no objection to preaching abstinence. Her objection is the suggestion that preaching abstinence is a policy. Meanwhile, she says, you have to try to make sure these children aren't making babies.

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