State Senate Passes AIDS Disclosure Bill

Amid assertions that the threat of AIDS to society outweighs the rights of victims to confidentiality, the Senate on Thursday passed controversial legislation that would allow wider disclosure of the results of AIDS virus testing without an individual’s consent.

The bill, narrowly approved over charges that it represented a “panic approach” to the lethal disease, constituted a major departure from privacy laws that prohibit a physician or other health care professional from disclosing test results without a patient’s written consent. Those privacy laws, passed two years ago, were pushed by the medical community to encourage voluntary testing for the AIDS virus.

Initial Cold Shoulder

A 21-11 vote, the exact simple majority required of the 40-member Senate, sent the proposal by Sen. John Doolittle (R-Citrus Heights) to the Assembly, where Speaker Willie Brown Jr. (D-San Francisco) gave it an initial cold shoulder but stopped short of predicting its failure.

Noting that similar legislation has not been proposed in the Assembly, Brown told a reporter, “It’s been a Doolittle issue for a long time and I think it probably will stay a Doolittle issue.”

Doolittle, a rock-hard political conservative and author of an anti-AIDS package that has received bipartisan support in a Legislature increasingly apprehensive about AIDS, charged that in enacting strict confidentiality protections for those who are tested for the AIDS virus, the Legislature had “gone overboard.”

“We have ignored another civil liberty--the right to life of the potential victim,” he asserted.

Without any debate, the Senate also approved on a 26-2 vote and sent to the Assembly another Doolittle bill that would require mandatory AIDS virus testing for anyone convicted of prostitution or other sex crimes.

A positive test would be included in an individual’s criminal history. Prostitutes testing positive would face felony charges if convicted again of engaging in prostitution. Sex criminals who test positive would face increased penalties for future sex offenses--an addition of up to three years in prison for the crimes.

Opposed to Legislation

Groups opposing the legislation have objected that a prostitute’s clients would not be subject to similar treatment. The American Civil Liberties Union also objected to mandatory testing, arguing in part that the AIDS antibody test is not totally reliable.

The test indicates whether the patient is infected with the AIDS virus. Not all who test positive have developed the disease, but those who test positive are considered infectious to others.

AIDS, or acquired immune deficiency syndrome, destroys the body’s immune system, leaving it powerless against certain cancers and other infections. It is commonly transmitted through anal and vaginal sexual intercourse, through the sharing of unsterilized hypodermic needles and by mother to fetus during pregnancy.

In this country, AIDS primarily has afflicted homosexual and bisexual men, intravenous drug users and their sexual partners. As of Monday, 37,386 Americans had contracted AIDS, of whom 21,621 had died.

Under the law now, a physician or other health care professional may not divulge the results of a positive AIDS test to others without the patient’s consent. Proponents of the bill said this has prevented doctors from advising another physician, nurse and other health workers that they are dealing with a patient infected with the AIDS virus.

Fear of Disclosure

Health groups, including the California Medical Assn. and the federal Centers for Disease Control, have regarded confidentiality of test results as crucial to stopping the spread of the disease. They fear that the chance of public disclosure--which carries the threat of job and insurance loss--will discourage the people most likely to carry the AIDS virus from being tested.

The CMA and other medical groups favor a minor easing of confidentiality laws so a physician will know if a patient he is treating has tested positive for the AIDS virus. However, the state’s top AIDS experts and health groups oppose the Doolittle bill, saying it goes too far in requiring that names be reported to county health officers and allowing test results to be included in medical records made available to hospitals and insurance companies.

‘Very Bad Bill’

“It’s a very bad bill that would damage our efforts to combat AIDS in California,” said Assemblyman Art Agnos (D-San Francisco), author of the confidentiality laws. “That’s why every public health group is against it.”

The Doolittle bill would allow the physician to disclose the test information to other licensed medical people “to facilitate continued or additional treatment of the infected patient,” to certain medical researchers and county public health officers, who would protect the patient’s name “as is practicable” and release it to staff members only on a “bona fide” need basis.

“Medical personnel are out there on the front line and are at risk,” Doolittle told the Senate. “They need to know if the patient has AIDS. Why do they need to know? They have concern about their own health. There is a lot of fear out there.”

Health officers were included as recipients of the information “for purposes of controlling the spread” of AIDS. Health officers already collect the names of gonorrhea and syphilis patients.

But opponents charged that the bill maintained only “minimal” confidentiality protections and warned that fear that their names would be disclosed would discourage people from being tested voluntarily.

“Public health officers have been pretty good about keeping gonorrhea and syphilis confidential, but this is going to be different,” said Dr. Mervyn Silverman, an AIDS expert and former health official in San Francisco. “Once you make those names widely available, it’s going to get out.”

Silverman also said reporting names would waste money needed for AIDS treatment and research and inundate county health officers with useless information. “There’s this mistaken idea that if you know the names you can do something about it,” he said.

Sen. Ed Davis (R-Valencia), in remarks he said were aimed at some Democrats, termed the Doolittle effort modest and warned that unless such measures were adopted by the Legislature radical ballot initiatives would be approved by voters.

Warning on LaRouche

“You are going to have the Lyndon LaRouches of the world writing your legislation,” Davis said, “and the people will support them.”

Supporters of political extremist LaRouche placed an anti-AIDS proposition before the voters last year and it was defeated. They are now seeking to put a similar initiative on the 1988 ballot.

Brown, under whom Assembly members have taken a more moderate approach to dealing with AIDS legislation than has Doolittle, said he was concerned about what would be done with the results of the AIDS testing information, regardless of how it was obtained.

“Do you provide treatment, counseling, directions?” he asked. “If it is going to be used for the purposes of isolating people and going back to a leper colony, then we’ve got to be very, very careful. The rules on AIDS shouldn’t be any different than any other issue that has to do with confidentiality.”

Carl Ingram reported from Sacramento and Kevin Roderick reported from Los Angeles. Times staff writer Paul Jacobs contributed to this story.