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The Battle Against AIDS

May 23, 1988

In an Op-Ed Page column (May 3), Dr. Neil Schram relates a surgeon's approach to the difficulty in obtaining AIDS antibody testing on his elective surgery patients. The surgeon " . . . Requires all of his patients to donate at least one unit of blood for themselves. Thus the hospital blood bank does the pre-test counseling and obtains the consent. Presumably the surgeon will be notified if the test is positive so that he can take extra precautions. . . ."

While this approach is novel, it is also illegal in the state of California for a blood bank to notify a donor of the results of his AIDS test, even if it is positive, unless more than 60 days have elapsed since the blood donation. This law was enacted to discourage donations from people worried about AIDS. If you are worried about AIDS, you should not donate. Alternative test sites were established for such persons.

In the case of a patient donating blood for himself (autologous donation) the blood bank, with a proper informed consent statement, could notify the patient. However, it is strictly illegal for anyone to notify a physician about a patient's AIDS antibody test, unless there is written consent from the patient.

At the Community Blood Bank of North County, we have all patients who donate blood for themselves sign a consent statement permitting health-care workers to be notified of any abnormal laboratory results. However, our blood bank attorney believes that this consent statement, obtained prior to the actual blood donation, is probably insufficient permission to notify a surgeon or any other health-care worker of an AIDS antibody test result. The penalty for release of results without the patient's permission could be as severe as a $10,000 fine plus a year in the county jail.

Finally, physicians should be reminded that the AIDS antibody test is not perfect. In Los Angeles, false negative results occur in about one in every 50,000 donations. Consequently, it is dangerous to encourage people worried about their AIDS antibody status to donate blood for the community.

JERRY KOLINS, M.D.

Medical Director

Community Blood Bank

of North County

Escondido

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