public morality in the emergence of AIDS as a nationalnproblem.nMoral discourse in the United States tends to be framednin terms of interest, purpose, and preference — that is,nstructurally. But phenomena like the AIDS epidemic arenlikely to refocus our understanding of public morality in atnleast two respects: One, they will shift the center of gravitynfrom moral codes to moral decision-making and the policiesnthus entailed. The appeals to normative structures are onlynone aspect of moral coding. The other is reformulating thenprocesses by which moral behavior gets defined. And this isna consequence of policymaking in issues like AIDS.nWhat we have, then, is a clear distinction between thendevelopment of social science and the manufacture ofnpublic policy. This distinction does not imply a contradictionnbetween the two, but that the realms of discourse arendistinct and that social science cannot simply be invoked innthe name of policy. In short-run terms, wide condomndisbursement would probably help contain an AIDS epidemicnthat threatens to kill more people than any diseasenexcept heart attacks and cancer. At the same time, thencultural imperative upholding such a short-term policynmaintains that homosexuality is a legitimate alternativenlife-style, the criticism of which is homophobic or just plainnneurotic (in direct contrast to earlier psychoanalytical traditions,nin which homosexuality was held to be a neuroticnaffliction).nThe attitudes toward heart disease and acquired immunendeficiency syndrome are radically different. There is nonvociferous demand for building massive numbers of Jarvik:7nartificial heart units. Rather, the call is for change innpersonal life-style: abstinence, no smoking, cutting down onnthe intake of caffeine and carbohydrates, less stressful modesnThe avoidance of the brute fact that nine out of 10nvictims of AIDS are homosexuals (the Hgure would beneven higher if the so-called bisexuals were included) isntypical of people who want clear-cut policies even asnthey move to obscure clear-cut evidence. . . . The policynof treating AIDS has turned into a metaphysicalndisposition to develop a way to disregard social consensus,nUmit the scientific information base, and confusenmoral premises.n24 I CHRONICLESnof life. But in the case of AIDS, calls for abstinence arenmostly met with derision and contempt. What we are facednhere with, then, is the power of a social movement, rathernthan the worthiness or worthlessness of public policy.nThus we come upon the limits of policy rather than thensimple disenthrallment with policy. The cry to do somethingnboils down to individuals doing something (i.e., as innthe case of heart patients being urged to desist from smokingncigarettes), as opposed to the cry that the society donsomething, as in the case of AIDS patients who are urged tondemand social supports that would not entail a change innpersonal behavior. The current thrust, the impulse, ofnpolicy is most often for governments to correct imbalancesnamong populations; but in the case of AIDS, in the absencenof consensus at least the issue of policies designed tonnneliminate a specific contagion or illness should be treatednwithin a larger context of scientific, political, and moralnconsiderations. That panoply of concerns is what the socialnscientific study of public policy is about.nThere is a specific lesson in all of this for those whosenchief concerns are the scientific study and practical implementationnof public policy. To be successful, policymakingnneeds either of the two requirements: a broad-based publicnconsensus on issues under consideration or a narrow-basednelite consensus on issues about which the general public isneither unconcerned or incapable of being intelligentlyninformed.nWhere there is a wide dissensus and equally broadrangingndiscussion, there policymaking becomes extremelyndifficult and is often reduced to piecemeal or ad hocnconsiderations. The limits of policymaking, therefore, cannbe seen quite clearly in the controversy over what should bendone about AIDS. For the moment, and many moments toncome, there is very little agreement on the need for exactninformation, hardly any consensus on the implications ofnthe medical aspects of AIDS, and virtually no agreement onnthe moral basis of public behavior. When and if such a set ofnagreements is forthcoming (as is perhaps more likely in thenmatter of AIDS) and the medical aspects of the problemnoverwhelm common ideological proclivities, then policiesnwill become possible. In the meantime, the demand fornpolicy serves to acerbate rather than alleviate partisannconsiderations.nIn his recent introduction to The Art and Craft of PolicynAnalysis, Aaron Wildavsky notes that under what he callsn”elite polarization,” policy analysis should become chastenednand attempt to move from a one-sided emphasis onnpolicymaking to a search for the source of preferences andnmovements. Such a salutary sociology of knowledge approachnis heartily to be endorsed and should be urged tonmove even further, to indicate that under conditions of massnpolarization the potential for even this limited achievementnmay be hard to establish. At the moment, wisdom dictatesnthat AIDS public policy has been preempted by the neednfor social and behavioral science. This is perhaps anothernway of saying that knowledge should be a guide for action,nbut in the absence of any consensus on the truth about annillness, demands for policy or action become as dangerous, ifnnot more so, than assertions or admissions of learnednignorance.nOur age tends to insist upon firm linkages betweenndescriptive and prescriptive patterns of behavior. And whilenthis may be admirable, we must not lose sight that there is ancausal disjunction between the two. Accurate descriptionnmust precede prescription, if we are not to fall prey to thensort of fanaticisms and myth-making scientists often accusenothers of basing their actions upon. It is this tentativeness atnthe empirical level, no less than dissensus at the ethical level,nthat should serve as a limit to those who would leap to policynrecommendations without delay. If the wish is father to thenact, then too we should recognize that the fact is mother tonthe wish. Such homiletics may not lead us to instantnsolutions for such dread diseases as AIDS, but at least theynwill hold in check any approach that can only create moreninsoluble problems by demands for immediate, and morenperfect policies.n