The reasons for such denials, according to medical ethicists, revolve around rigid schedules that the taking of such drugs require. If, because of alcoholism or other addictions, a patient is thought unlikely to maintain a proper schedule, these doctors refuse to prescribe the costly and most potent anti-AIDS treatments. Such doctors, say the ethicists, may find themselves in a briar patch of legal and ethical quandaries. Do they, in fact, have a right to deny anybody life-prolonging medicine? Warren D. Adkins, an ACT-UP supporter, says the withholding by doctors of such drugs is "a vicious criminal act" far worse than anything else today's doctors might do. "They have no right," says Adkins, "to decide who lives and who dies. Every person, no matter his or her addictive status, should be allowed an equal chance with the new drugs."

Others say that the protease inhibitors, because they are so expensive, must be distributed with extra care because there are so many who need them who can be trusted to take them according to the proper routine. "The answer," replies Adkins, "is not in denying life-saving drugs to our fellow human beings, but in raising a unrelenting stink to bring down the damned prices of these drugs, making them affordable to whoever needs them."

Adkins burst into an angry monologue insisting that "this is the wealthiest nation on earth. To defend ourselves from real enemies, lets realize they're not all overseas. AIDS, happening right here, is World War III, the most insidious internal enemy we've ever faced. The Pentagon spends billions on huge bombers we're not even using. How about some money for people who really need it here in the states, living American citizens who will otherwise die? Lets spend some of that bomber money on getting them the right drugs,OK? That would spell real protection, not the phony-baloney protection too many military big wigs are willing to tax us to death for."

Still, drug costs in a few locales as New York state, where provisions have been made to supply AIDS patients with the protease inhibitors, seem not to be problematic. It is the doctors themselves, in spite of the state's patient- payments, who stand in the way of fair drug distribution procedures. In many locales, however, expenses spell paramount difficulties for patients. Several states provide no monies,period, for the inhibitors and other states set aside only a small fraction of what's needed to keep a growing number of patients alive.

Dr. Charles Carpenter, chair of the National Institutes of Health's guideline panel for the use of AIDS drugs, appears to side with such critics as Adkins, stating, "I don't think we have a right to exclude anyone as a general rule....I've been astonished by how many people, including those who are using IV drugs, have been able to stick to the regimen. I don't think we can tell a good or a bad patient in advance."