Students Out, Teachers ‘If’ in S.D. Schools AIDS Policy

The San Diego school board voted narrowly Tuesday to ban all students with AIDS from city schools but to evaluate each employee with AIDS separately because it would be illegal to automatically ban them from work.

Rejecting medical opinion that the fatal syndrome cannot be transmitted through casual contact, the trustees voted, 3-2, to teach students with AIDS in their homes by a visiting teacher or over the telephone.

But they agreed unanimously to consider school workers individually and in consultation with doctors. The board had been advised that it could be illegal or prohibitively expensive to retire, fire or transfer all employees with AIDS.

AIDS--acquired immune deficiency syndrome--results from a virus that destroys its victims’ ability to fight off infection. Transmitted through sexual contact and blood products, it has affected primarily homosexual and bisexual men, hemophiliacs and intravenous drug abusers.

There are no reported cases in the San Diego schools. But Supt. Tom Payzant proposed a month ago that the board decide how it would handle a case. On medical consultants’ advice, he proposed allowing most students and workers to remain in school.

On Oct. 8, the board rejected Payzant’s plan by a vote of 3-2. While Trustees Larry Lester, John Witt and Kay Davis doubted researchers’ understanding of the disease, Trustees Susan Davis and Dorothy Smith argued that the board should defer to medical authorities.

On Tuesday, Payzant presented an alternative proposal. Under that plan, all students with AIDS would be kept out of school. But Payzant reiterated his original recommendation on employees, saying the district had no choice but to consider them case by case.

On the question of students, the board split along the old lines.

“It has been shown that this policy excludes children for a reason that is not based on the best medical knowledge . . . ,” said Smith, voting with Susan Davis against exclusion. “This policy is not based on any criterion that has to do with medical knowledge.”

But the trustees voted together on the question of employees. Having AIDS would not be a justifiable cause for firing a worker, district officials had told them, and retiring the employees on medical disability could prove very expensive.

The district may not be able to enforce either policy, board members acknowledge. AIDS victims may choose not to report their disease to the district, and health officials are legally bound not to reveal cases without patients’ approval.

The trustees also unanimously approved a proposal by Smith that the district staff prepare materials on “AIDS awareness” for students and others, and a proposal by Payzant for a task force to keep abreast of research and medical findings about AIDS.

Even that plan became controversial.

Witt and Lester expressed concern that the task force be “balanced”--that is, that it would include medical authorities with varying views about AIDS, the methods of transmitting it and the survivability of the virus, Lester said.

But Susan Davis countered that task force members should be specialists, with good credentials. And Payzant said to Witt, “My intention with the task force, John, is to try to get a task force that is apolitical.”

He added, “I don’t intend to go out and try to find a physician who is on this side of the issue and a physician who is on that side of the issue, if that’s the kind of balance you’re talking about.”

Dr. Alan McCutcheon, a UC San Diego specialist in infectious disease who has advised the board that there is no evidence of transmission through casual contact, told Witt and Lester that he has seen little difference of opinion.

“I think there is general agreement among reasonably well-informed people on what the evidence is and what it means,” McCutcheon told the board Tuesday.

During hearings on the proposed AIDS policies over the last month, colleagues of McCutcheon’s from UCSD repeatedly pointed out that there have been no instances of transmission through casual contact in their four years of studying the disease.

They said the virus can be transmitted only through blood and sexual contact. Though it has been found in saliva and tears, they said it was in light concentrations and proved so fragile that it died almost immediately outside the body.

But several other doctors--not AIDS researchers, but one who specialized in sexual dysfunction and another who said he had treated AIDS patients in San Francisco--appeared before the board and testified that they doubted the researchers’ conclusions.

They argued that AIDS researchers had been proven wrong in the past and might be proven wrong again. Supporters of excluding students have cited those doctors’ testimony as evidence of a difference of opinion within the medical community.