August 19, 2011
Paul E. Sax, M.D., is director of the HIV Program and Division of Infectious Diseases at Brigham and Women's Hospital in Boston.
The pending HIV legislation is much on my mind these days, for reasons I outlined here. Bottom line is that I don't think it's good for patient care, and we're missing a real opportunity to make things better here in the Bay State.
But yesterday I heard a perspective on the bill I hadn't considered, and it went something like this:
We still need the laws about HIV testing -- and the added protection of privacy -- because of the disgraceful response of the medical community to AIDS when it first burst on the scene in the 1980s.
Examples: The physician who refused to operate on an AIDS patient. The hospitals that tried to avoid having AIDS cases since it would scare other patients away. The thoughtless release of the AIDS diagnosis to employers, family members, friends. And so on.
And I get that -- I understand that doctors, nurses, policy makers, and the rest of the large community that makes up the "medical system" didn't always behave so wonderfully when faced with this new and scary disease. Back in 1989, I heard a director of a Cardiac Intensive Care unit say that having an AIDS patient in his unit was a "waste of resources." That wasn't right then, and it isn't right now.
But here's some items to consider as a counter argument:
And since these dedicated HIV specialists are universally in favor of removing restrictions on HIV testing and the proposed barriers to provider communication, that must be telling us something.
Paul Sax is Clinical Director of Infectious Diseases at Brigham and Women's Hospital. His blog HIV and ID Observations is part of Journal Watch, where he is Editor-in-Chief of Journal Watch AIDS Clinical Care.
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