Let's test YOU!

March 05, 1992

It's a funny thing about AIDS legislation: Most of the HIV-related bills in the General Assembly stem from one group's desire to have another group tested for the infection. Patients want testing for doctors; doctors want patients tested. Funeral directors want HIV-infected bodies identified as such. Rape victims want rapists tested. And, as one wag put it, if rapists had a lobby, they would probably want a law requiring their victims to be tested. Notice that no group ever seems to think they should be tested.

Part of the dilemma lies in the nature of the legislative game. Legislators are elected to respond to public concerns, and the public is extremely concerned about the spread of AIDS. But diseases don't respond to laws, and it is easy for well-intentioned legislation to do more harm than good -- or at least to cause headaches and expense without providing any significant protection.

A good example is the bill Gov. William Donald Schaefer supports that would require testing of patients and physicians before invasive, exposure-prone procedures are performed. There is still a heated national debate on what procedures should fall under this category. A second, more serious problem is the cost of the bill, which would fall more heavily on individuals than on the state. For example, it is generally conceded that dental procedures would be classified as invasive, since they cause bleeding. If HIV tests were required, Marylanders could be looking at an extra $50 to $100 in medical costs each year simply to get routine dental care. That wouldn't qualify as raising taxes, but it sure hits the pocketbook.

As for funeral directors, their concern is understandable, since embalming procedures could place them at risk of infection. But the legislation they want is redundant, since new federal guidelines would require them, as well as people in any other field who could come into contact with infected blood, to practice universal precautions such as wearing gloves and other protective garb.

That, in the end, is the only sane way to deal with the AIDS threat. As the epidemic spreads beyond the populations where risk has been highest in the past, there is no way to make sure every HIV-carrier is properly identified. Moreover, HIV is not the only blood-borne infection worth worrying about, and legislation dealing only with HIV ignores the dangers of virulent forms of hepatitis. Marylanders, like people everywhere, have to come to terms with the fact that laws cannot eliminate risk, and that consistent and reasonable precautions are the best way to manage it.

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