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AMA seeking liberal policies on AIDS testing


CHICAGO -- The question of whether doctors must get written consent from a patient to test for acquired immune deficiency syndrome, or whether a spoken reply is enough, is prompting debate among health care professionals nationwide.

The American Medical Association's board of trustees wants to make it easier for doctors to test patients for the deadly disease, arguing that early detection makes it possible to prescribe treatment to prolong a patient's life and could prevent its unknowing spread to others.

The AMA board also said that spoken consent would make it easier to test health workers who were at risk.

During the AMA convention in Chicago later this month, trustees will seek passage of a resolution calling for the liberalization of testing policies, said Dr. Robert McAfee, vice chairman of the AMA board and a surgeon in Portland, Maine. Resolutions passed by the AMA body often become laws in many states, he added.

But critics of the AMA proposal say that because an AIDS diagnosis is a death sentence, there must be greater control over the circumstances in which testing takes place.

Dr. Neil Schram, a Los Angeles internist and chairman of the AIDS task force of the San Francisco-based Physicians for Human Rights, said that despite heightened awareness of AIDS, he believed it was in the best interests of both parties to document that a patient understood the significance of the results.

"It's too easy to give verbal consent. What if the patient does not understand?" he said. "This issue is not about getting verbal consent, but about getting any consent at all."

Dr. Richard McDonald, medical director of the North Side's Brown Memorial Clinic, which serves people with AIDS, said that in his private practice in Chicago, he conducted all of his AIDS tests and was the only professional in his office to know the identity of a patient given a test for the virus that causes AIDS.

"Testing must be done anonymously," or it puts patients at risk of discrimination, he said.

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