AIDS Confidentiality Law Must Be Eased, Medical Assn. Leader Says

The president of the Los Angeles County Medical Assn. on Friday called for the easing of the state’s 18-month-old AIDS-related confidentiality laws, saying that the present code may leave people in danger.

Dr. Jack E. McCleary said the Legislature should loosen confidentiality laws to allow physicians to inform the sexual partners of people who test positive for antibodies to the AIDS virus that they might be in mortal danger.

Under current laws, physicians who provide such information could face up to one year in jail and a $10,000 fine--”even when the information might save that person’s life,” McCleary said. Doctors now counsel such patients to inform their sexual partners, but, McCleary asked, how should a physician respond to a recalcitrant patient?

‘Horrible Dilemma’

“These are unusual circumstances but it puts the physician in a horrible dilemma,” McCleary said. He stressed that his views have not been endorsed by the 10,000-member county medical group.

McCleary’s view represents one of several aimed at revising California’s AIDS confidentiality laws, perhaps the strictest in the nation. In the coming year, the state Legislature is expected to take up bills that would allow antibody test results to be included in a patient’s medical record. Under the current law, reporting such information is prohibited in order to protect a person’s confidentiality.

The insurance industry is also expected to press efforts to rewrite laws that prohibit companies from using the antibody test to determine an individual’s insurability.

According to medical experts, a person who tests positive for antibodies is believed to have a 25% to 30% chance of developing full-fledged AIDS and perhaps a roughly equal chance of developing other AIDS-related maladies. All people who test positive are believed capable of transmitting the disease through sexual contact.

‘Remained Silent’

Interviewed in his Sherman Oaks office, McCleary, a dermatologist, said he feels that the medical establishment “remained silent” about the confidentiality issue during the campaign to defeat Proposition 64, the proposal conceived by political extremist Lyndon H. LaRouche Jr. and denounced by public health authorities.

“If the medical community seemed divided, it would have given him some ammunition and created some doubt in the voting public,” he said. “Now I think it’s time to speak up and take some action on some very bad laws.”

In a column to be published in the county medical association’s bulletin, McCleary advances the hypothesis of “a married female who is antibody positive,” but, against her doctor’s wishes, refuses to tell her husband. She is determined “to get pregnant as soon as possible so she would ‘leave someone’ with her husband. She refused to believe the child would be infected or that she would infect her husband.”

McCleary said, however, that he knows of no such instances in which an infected person failed to share the information with a spouse or steady sexual partner.

Aide Rejects Idea

Larry Bush, a legislative aide to state Assemblyman Art Agnos (D-San Francisco), who developed the AIDS confidentiality laws, rejected such scenarios. Bush said he feels that such a law enabling physicians to inform spouses or other endangered third parties is unnecessary.

“We’ve never had a case where there was a recalcitrant spouse,” he said.

Bush agreed that several aspects of the AIDS confidentiality laws should be reviewed. The original law was pushed through, in part, to ensure a confidential blood-screening method to protect a blood supply that had previously been contaminated with the virus.

A bill to smooth out rough areas in the original law, which had the support of the California Medical Assn., was vetoed last spring by Gov. George Deukmejian. That measure, a version of which is expected to be reintroduced next year, would have allowed antibody test results to be placed in a separate section of a patient’s medical record, such as a sealed envelope.

Bush said Deukmejian objected to provisions in the bill concerning AIDS-related job discrimination as “unnecessary.”