AIDS destroys trust between doctors, patients


August 25, 1991|By ROGER SIMON

According to the Centers for Disease Control, approximately 6,782 doctors, dentists and other health care workers have AIDS. More than 50,000 others are thought to be infected with the virus that causes AIDS.

New federal guidelines say certain health care workers should voluntarily be tested for the AIDS virus and should voluntarily stop certain procedures and tell their patients if they find they have the virus.

But, as a recent article in the New York Times states, "Many who are infected have decided not to follow the new federal guidelines."

They say "disclosing their infection would panic their patients, close their private practices, force them from their hospital posts and bring a flood of lawsuits."

So they don't tell their colleagues, and they don't tell their patients. And they continue to engage in procedures that could, potentially, pass along the AIDS virus.

This has a lot of people worried, especially since it became known that five patients in Florida apparently contracted the AIDS virus from their dentist.

The relationship between doctor and patient is an extremely close, extremely important one. It must be based on trust.

But some patients now wonder if they can trust their doctor to tell them if he or she has AIDS.

If you were a doctor, would you? Imagine that you have just received the worst news of your life: You have just contracted a 100 percent fatal disease. Further, it carries with it a tremendous social stigma. So what's your next move? Announce to the world you have this disease?

"I could go from being a productive member of society to a street person," an emergency room physician, who has AIDS and is keeping it a secret, told a reporter. "That could happen to me. I could be sick and homeless and rejected by society."

Moreover, statistically speaking, health care workers are more likely to get AIDS from their patients than to give AIDS to their patients. The emergency room physician, for instance, believes he got AIDS from accidentally sticking himself with an infected needle.

So why should he risk the loss of his livelihood and a ton of lawsuits by revealing his condition?

On the other hand, if you went to a doctor or a dentist wouldn't you want to know if they were infected? Don't you think you have a right to know?

Not long ago, Gov. William Donald Schaefer announced he is considering recommending that all doctors and all patients in Maryland be tested for AIDS.

The protest was immediate. While some doctors endorsed the plan, the state medical society blasted it, as did AIDS activists.

They point out that those five patients in Florida are the only known cases of patients who have contracted the AIDS virus from a health care professional.

They also say testing physicians for AIDS is no guarantee because people do not test HIV-positive for three to six months after they are infected. In other words, a doctor could test negative and still have the disease.

Instead, these people argue, health professionals should concentrate on following safe procedures such as using gloves and sterilizing their instruments.

Schaefer remains unconvinced. He admits the chance of getting AIDS from a health care professional may be one in several million, but, he told a reporter, "Do you want to be the one? No you don't. My job is to prevent that one."

The objections listed above, however, tend to obscure the real objection to AIDS testing: It is a massive invasion of privacy. (It would also be very costly and would have to continue for the lifetime of the physician or until a cure for AIDS is found.)

Getting tested for AIDS is not like getting tested for other diseases, because no other disease currently carries the social stigma of AIDS.

When a dentist in Virginia recently began advertising that he and his colleagues were AIDS-free, he was quickly condemned for it.

"I'm stunned a medical professional would try to capitalize and feed hysteria this way," one AIDS activist told a reporter. "It's one of the most unprofessional examples we've seen in the entire AIDS epidemic."

And that's how political this matter has become: Saying you don't have AIDS makes you a target for condemnation.

But not long ago, an interesting thing happened. According to the New York Times, an informal survey was taken at an AMA meeting. And "the vast majority of doctors agreed that they would not seek treatment from an infected doctor."

Dr. Nancy W. Dickey, a trustee of the AMA, said: "Can we ask our patients to do what we're not willing to do?"


If doctors wouldn't go to doctors with AIDS, what are the rest of us supposed to do?

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