Nearly one third of all primary-care physicians do not feel they have a responsibility to treat people with AIDS -- a view, disclosed in a survey released today, which the American Medical Association says flouts basic principles governing the role of doctors in society.
The survey results, published in the Journal of the American Medical Association, traced the doctors' position in part to bias against the groups hardest hit by the disease -- specifically, to homosexuals and intravenous drug users.
More than a third of those answering the nationwide survey of 2,004 internists and general and family practitioners said they would feel "nervous" among homosexuals and view homosexuality as "a threat to many of our basic social institutions."
"I think there is an attitude among many physicians that they're absolutely free to take whoever they want as patients," commented Dr. Robert Conley of the AMA. ". . . But there are limitations, and that principle does not extend to give cover to discrimination."
Since its inception, the AMA has said that a physician's responsibility during an epidemic is to treat the sick without regard for the risk.
"To say, 'My helping you would be too costly for me, therefore I won't help' is a complete abrogation of the relationship between medicine and society," Albert R. Jonsen, a medical ethicist and professor of medicine at the University of Washington, said yesterday.
The survey, by researchers at the University of California, San Francisco, focused on so-called primary care physicians, a group likely to be called upon increasingly to treat patients infected with the AIDS virus as the epidemic expands beyond the reach of traditional AIDS specialists.
Thirty two percent of the doctors surveyed did not agree with the statement that they had a responsibility to treat people with AIDS. Fifty percent said they would not work with AIDS patients if given a choice. The survey traced their reluctance not only to fear of catching the disease but to attitudes toward many people who have it.
Relatively few -- 29 percent of those polled -- said they derive more intellectual stimulation from the practice of medicine as a result of caring for infected patients a finding that one of the authors found especially disconcerting.