Doctor's death from AIDS creates shock, fear But some defend his right to privacy

December 04, 1990|By Gerri Kobren Jean Marbella and Diane Winston of The Sun's staff contributed to this article.

When the surgeon removed the lump from Debra Judy's breast in 1987 and told her it was benign, she and her husband were very relieved.

But now the Taneytown couple is worried -- and very angry.

Mrs. Judy's surgeon was Dr. Rudolph Almaraz, who died of AIDS on Nov. 16, at age 41. They're afraid he might have infected her.

"It was bad enough thinking I might have cancer," says Mrs. Judy, 29. "Now that it's possible that I might have AIDS. . . . This should not be."

But another patient, who asked that her name not be used, defended the doctor, saying she would have continued going to him even if she knew he had AIDS.

"It's not a concern at all. I've been hospitalized enough," said the woman, who was operated on by the doctor in February, "that I know the precautions hospitals take. When he did surgery, he always wore gloves and a mask.

"I knew he had a lot of important, powerful patients; he was the top of his field," the woman continued. "But I think he was equally concerned about his patients who weren't important, powerful people. Before surgery, he would spend some time with you, and after surgery in the recovery room. He was very considerate and caring."

The woman criticized The Sun for "causing unnecessary reaction among his patients" by revealing the nature of Dr. Almaraz's death.

"When you're talking about someone's health, especially AIDS, you should have some more consideration," said the woman, who had been operated on by Dr. Almaraz. "Cancer is frightening enough; breast cancer is frightening enough."

Like other patients -- who may number about 1,800, by one estimate -- these two were shocked to learn from news reports that Dr. Almaraz had AIDS. Johns Hopkins Hospital mailed letters to his surgical patients yesterday offering free AIDS tests and counseling.

On the issue of physician disclosure, doctors and gay activists said they understand why Dr. Almaraz might have kept his illness a secret.

"There is so much AIDS hysteria, physicians may just as well close down their practices if they have AIDS and tell their patients," said Stephen Glassman, a member of the Baltimore Mayor's Task Force on Gay and Lesbian Issues.

"The bottom line is that everyone is entitled to [privacy] about his health-care status," said Andrew Barasda, executive director of HERO, an AIDS service organization. "The whole area of increased discrimination because of one's health status might be so overwhelming that no one would treat anybody."

Experts continually say there is little chance that doctors with LTC AIDS will infect their patients. Yet questions of safety and ethics remain.

"It's an immensely complicated ethical situation," said Dr. Fred A. Gill, a Chevy Chase physician who is chairman of the state medical society's AIDS committee. "As an expert on AIDS, I think there is little or no risk of transmission from a surgeon to a patient."

Dr. Helen B. McAllister, who recently quit her post on the Governor's Advisory Council on AIDS, was a little more cautious.

"If I were the physician with the antibody, I would have a great deal of hesitation operating where there would be a great deal of blood," said Dr. McAllister, who is retiring as health officer for the Prince George's County Health Department.

Dr. Dana Simpler, a physician in private practice in East Baltimore, said she believes public health officials should be authorized to contact partners or other at-risk persons whenever a case of AIDS is reported. That, she said, is how other infectious diseases like tuberculosis and syphilis are handled.

"There is no aggressive public health effort to control this epidemic," she said. "I think it's because there's such a fear of litigation over the issue of privacy, because they fear the person with AIDS will be discriminated against. I think the gay rights groups have fought for the individual's rights, but not really for the rights of the uninfected. I think it's a political hot potato."

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