The California Medical Assn. has withdrawn its support of AIDS legislation to implement the recommendations of Surgeon General C. Everett Koop in California and now opposes the bill. It is a grave disappointment, coming just as Assembly approval of the legislation had set the stage for negotiations with Gov. George Deukmejian on the final form of the legislation.
AB 87, written by Assemblyman Art Agnos (D-San Francisco) in collaboration with Dr. Koop, is the key proposal to implement in California the recommendations of the federal public-health officers and researchers. The new opposition to the legislation from the medical community centers on confidentiality requirements, among them the need to obtain consent of the person being tested to share the test results with anyone--including other health-care providers. In fact, AB 87 would facilitate, through a simple consent procedure and provision for the establishment of separate confidential records, the sharing of test results with doctors and nurses and others directly involved in the treatment of the person.
Doctors bear a complex responsibility in the AIDS pandemic, and their tension, conflict and bewilderment are understandable. They, like other health-care providers, are at risk to the extent that they come to be exposed to body fluids of infected individuals. They obviously sense the urgency of curbing the spread of a deadly disease for which there is no known cure. Many of them have found persuasive the arguments of those who want to tear down the wall of confidentiality that has been built around those infected with the human immunodeficiency virus (HIV), arguing that existing rules jeopardize the public at large. Implicit in much of the controversy over AB 87 and in many of the attacks on the policy advocated by the surgeon general is that all of these special rules of confidentiality are contrived to protect homosexuals and intravenous drug users, the populations most affected by acquired immune deficiency syndrome.