Dannemeyer Wants Doctor, Patient AIDS Tests

WASHINGTON —  Amid a growing debate over the rights of patients to know if their doctors have AIDS, an Orange County congressman introduced legislation Wednesday that would require states to test certain health-care professionals for infection by the virus that causes the disease.

The bill by Rep. William E. Dannemeyer (R-Fullerton), a longtime critic of the way public health authorities have responded to the AIDS epidemic, would also give doctors, dentists and other health-care providers the right to order involuntary AIDS testing of patients.

Dannemeyer’s bill is named after Kimberly Bergalis, a dying, 23-year-old Florida woman who apparently contracted AIDS from her infected dentist who has since died of the disease.

“Every patient has the absolute right to know what harm can befall him or her from a health-care worker,” said Dr. Sanford F. Kuvin, a vice chairman of the National Foundation for Infectious Diseases, who said he is acting as a medical adviser to Bergalis.

“On balance,” said Dannemeyer, “we have treated AIDS as a civil rights issue and not as a public health issue.”

A strident critic of gay activism, Dannemeyer has been strongly criticized by gay groups for his AIDS-related proposals, which include mandatory, confidential reporting to public health authorities of those who test positive for the AIDS virus.

“The Congress of the United States had better get with it,” said Rep. Robert K. Dornan (R-Garden Grove), who appeared with Dannemeyer at a Capitol Hill press conference. “This is a health problem, not a public relations problem.”

Dannemeyer and Kuvin said that Bergalis and her family strongly endorse his legislation.

The measure, however, is sure to draw intense criticism from public health officials, AIDS activists and gay rights organizations. They contend there is little or no scientific basis for limiting the work of infected health-care workers because of the remote risk of transmitting the human immunodeficiency virus, which causes AIDS.

In addition, they are concerned that imposing restrictions on health professionals could contribute to the creation of two classes of patient care--one for the uninfected and another for those who are infected.

The issue has sparked a nationwide debate over the rights of patients to know the HIV status of their doctors and dentists and the rights of infected health-care workers to keep their status private. The American Medical Assn.’s policy-making body debated the question Wednesday during the organization’s convention in Chicago. On a voice vote, delegates rejected calls for mandatory testing of health-care workers but endorsed regular voluntary testing of those whose practice puts them at risk of contracting AIDS.

Meanwhile, a recent Newsweek poll found that 90% of a sample of 618 adults believe that all health-care workers should be required to tell patients if they are infected with HIV.

Despite the apparent popular concern, prospects for the Dannemeyer measure on Capitol Hill are uncertain at best. Dannemeyer is the ranking Republican on the health and environment subcommittee of the House Committee on Energy and Commerce, which will have jurisdiction over the measure. However, the panel is chaired by Rep. Henry A. Waxman (D-Los Angeles), who has been a champion of of the civil rights of those infected with HIV.

Waxman was not immediately available for comment. A Dannemeyer aide, however, said Waxman is likely to schedule a hearing on the issue of health-care providers who are infected with HIV, although not on the Dannemeyer bill itself.

The legislation would require the secretary of health and human services to publish a list of communicable diseases, including AIDS and hepatitis B, that pose a risk and for which certain health-care providers must be tested.

The secretary would be required to identify those medical and dental procedures that might lead to infection with any of those diseases if performed by an infected doctor, dentist or other health-care worker, and to identify those health-care workers who should be tested.

States that accept federal assistance for AIDS care would be required to periodically test those health-care providers. If any tested positive, they would be barred from performing invasive procedures without the specific, written consent of their patients.

The bill would also require states to give doctors who perform invasive procedures the right to test their patients for infection for specific diseases, including AIDS. The bill would require doctors to have a reasonable basis to believe that a patient might be infected and to have the patient’s permission to perform the invasive procedure.