S.D. School Board Rejects AIDS Policy

Rejecting the recommendation of federal health officials, the San Diego city school board on Tuesday defeated a proposal that would have allowed most students and employees with AIDS to remain in school.

Three of the five trustees voted against the plan, in spite of last-minute testimony from specialists in AIDS and pediatrics from UC San Diego School of Medicine. The trustees said the fatal syndrome seems insufficiently understood to justify allowing victims in the schools.

“I am not willing to risk the whole for the right of one, two or 10 individuals,” said Trustee Kay Davis. “I am not confident with taking a possible risk. . . . I’m not willing at this point to chance it.”

The vote left the district with no policy at all. Though there are no reported cases of acquired immune deficiency syndrome in the 113,000-student system, the board asked its staff to return in several weeks with an alternative proposal.

That might include a plan for educating AIDS patients at home, Davis said. Trustee John Witt suggested that the board consider offering medical retirement to any employee who comes down with the illness.

AIDS is a fatal syndrome that results from a virus that destroys its victims’ ability to fight off infection. Transmitted through sexual contact and blood products, it has mostly affected homosexual and bisexual men, intravenous drug users and recipients of infected blood products.

The question of whether to allow AIDS patients in public schools has provoked an emotional response nationwide. In New York City, parents kept as many as 18,000 children out of school last month after an unidentified second-grader with AIDS was allowed to attend.

The San Diego proposal, based on the recommendations of the federal Centers for Disease Control, would have allowed the district to consider each case individually. But it would have barred only preschool children and others who might bite or be incontinent.

The UCSD consultants who helped prepare the policy repeatedly stressed that there is no evidence that AIDS can be transmitted through casual contact. They said the virus does not survive outside the body and is not transmitted through saliva or tears.

“We need to deal with what appears to be medically valid,” Dr. Steve Specter, a UCSD specialist in pediatrics and infectious disease, told the board. “We should not let hysteria and concern for what has not been shown dominate our thinking and policies.”

But three trustees remained unconvinced.

Witt predicted that the district will “have difficulty with a policy either way” since county health officials and doctors may be bound to protect victims’ confidentiality, and parents “can be expected to lie” if it seems to be in their child’s interest.

But Witt said he was not persuaded by the argument that schools need not worry because the AIDS virus is passed through sex. “In junior high, experience with sex is not unknown,” he said. “And in some places in senior high school it is a common practice.”

In the end, Witt said, “I think we can’t overlook the feelings of the community.” A small number of outside doctors, parents and other members of the public had testified before the board over the last two weeks, primarily in opposition to the proposed policy.

Board President Larry Lester said he was concerned about what is not known about AIDS.

For example, Lester noted that doctors have been unable to pinpoint the method of transmission in a small percentage of AIDS cases. He also said he worried about the possibility of a child catching the virus through a cut, no matter how slim the chance.

Finally, Lester said he worried that the virus could mutate into a virus that is transmitted in new ways. Specter assured him that there is no scientific evidence that that could happen, but Lester voted against the policy anyway.

“My decision is, if I make a mistake, to err on the side of caution and to see to it that the matter would be considered by the board as (more) information becomes available,” Lester said.

Voting in favor of the policy were board Vice President Susan Davis and Trustee Dorothy Smith. Both argued that the board should accept the experts’ opinion, especially since the policy would allow each case to be judged individually in consultation with doctors.

“I think what I keep coming back to is finding some rational basis for excluding a child from school,” Davis said. “Other than a theoretical or hypothetical one, I don’t think we have a real basis.”

After the vote, Davis said she was disappointed with the board’s action. “You have to respond to it on a real, rational, medical basis,” she said. “Barring that, we’re responding on an emotional one.”

She added, “Our speculation isn’t based on any medical knowledge. Any of us can speculate. But we’re lay individuals. We have to put some faith in the medical community.”

Specter warned that, by choosing to exclude one group, the board is opening the door to excluding others. He suggested the trustees might next find themselves considering excluding the children of AIDS victims, friends of AIDS victims, or other peripheral groups.

“To await negative data is a very long wait,” Specter told the board, referring to members’ desire for harder evidence that the virus cannot be casually transmitted. “You can never get any more absolute than zero.”