Path: utzoo!utgpu!jarvis.csri.toronto.edu!mailrus!tut.cis.ohio-state.edu!gem.mps.ohio-state.edu!usc!ucla-cs!KMILLER%BROWNVM.BITNET@oac.ucla.edu
From: KMILLER%BROWNVM.BITNET@oac.ucla.edu (Ken Miller)
Newsgroups: sci.med.aids
Subject: Re: Health Care Workers and AIDS
Message-ID: <27675@shemp.CS.UCLA.EDU>
Date: 2 Oct 89 20:12:05 GMT
Sender: news@CS.UCLA.EDU
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Approved: aids@cs.ucla.edu
Archive-number: 1289

Steven L. Karon reacted to the story of a Dr. Day's leaving a certain
aspect of medical practice (in part) because of being unable to gain
information about the HIV status of patients.   Steve argued that
such information should be kept hidden from medical care workers and
bid Dr. Day farewell from the profession by writing:

> It is my opinion that Dr. Day is not
>fufilling  her duties as a doctor if she is not willing to help someone that
>may put her in some risk, and therefore bid her a fare goodbye from her
>profession.

In the same message Steven wrote:

>  It seems that by giving health workers knowledge about hiv infected patients
>would result in Health workers, doctors and nurses not giving the same amount
>of care that they would if these people were not infected. In the case of
>doctors this leads to a breaking of their hippocratic oaths, ...

I don't think that I could disagree more.  What confuses me is the attitude
that AIDS is a "special" disease, which must be treated differently
than any other disease.  This attitude leads to the mystique that
AIDS is something that must be kept secret and whispered about.
AIDS then becomes a matter of shame and embarassment.

I know that the issue is complex, but I will make two points that I
hope will stimulate discussion.  First - I believe that heath care
workers have the right to know the medical status of ANY patient,
especially when that status might put them at risk.  Knowing that
someone is HIV positive doesn't lead medical works to deny care - it
simply gives them the knowledge that they need to care for patients
while protecting themselves and others.  It is an unfortunate fact
that quite a few medical workers have been infected by HIV as a
result of their work.  We should recognize that medical workers
as a group have accepted the danger of caring for the sick as part of
their calling.  We have a right to ask them to care for HIV patients.
It does not follow that we have a right to keep them from knowing
if a patient has HIV.

Second - The continued emphasis on secrecy with HIV results inhibits
efforts to stop the AIDS epidemic, and will ultimately cost lives.
The standard technique in halting the spread of STD's and similar
diseases is by testing and contact tracing.  In all but a few
states this cannot be done because the law forbids it.  Ironically,
less serious diseases (like gonorrhea) are routinely traced this way,
helping to control infections.  It is often claimed that HIV-status
must be kept secret because of the "stigma" associated with the
disease.  But doesn't the emphasis on secrecy actually produce
the stigma?

In short, wouldn't the interests of AIDS patients, HIV-carriers,
medical care workers, and those yet-to-be-infected with the virus
best be served by a system in which HIV status was available to
health care workers - with strong laws against workplace and
insurance discrimination in place?

It might even keep Dr. Day in practice helping to prolong the lives of
HIV+ individuals.