AEGiS-AP: Medical AIDS Rule Causes Split Many Groups Reject Limits

Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.

Medical AIDS Rule Causes Split Many Groups Reject Limits

The Associated Press; Tuesday, November 5, 1991

ATLANTA - Many medical groups -- but not the nation's largest -- on Monday assailed the federal government's attempt to list which medical procedures pose a risk to patients when performed by doctors with AIDS.

The American Dental Association, the American College of Surgeons, the American College of Physicians and the American Academy of Orthopedic Surgeons were among groups telling the Centers for Disease Control that there isn't sufficient scientific evidence to determine which medical procedures are "exposure-prone" and which aren't.

The CDC called Monday's meeting to fine-tune its guidelines recommending that AIDS-infected doctors refrain from "exposure-prone" procedures except with the consent of the patient and outside experts.

The guidelines could mean the end of practice for an indeterminate number of infected physicians, surgeons and dentists. The CDC's guidelines, even without the force of law, often become the standard of practice for hospitals, local regulators and insurance companies.

Many medical groups said there isn't sufficient evidence to determine what is risky on the basis of the only reported case of transmission -- among five patients of an infected Florida dentist, Dr. David Acer, of Stuart, who died of AIDS-related illness.

"No procedure, other than dental extraction, has ever been shown to transmit HIV (AIDS virus) infection to a patient," said LaMar McGinnes of the American College of Surgeons. He called for "further research rather than the formulation of Draconian social policy."

The nation's largest medical group, the American Medical Association, stood virtually alone in agreement with the CDC on Monday -- and even the AMA recommended defining just one procedure, Caesarean deliveries of newborns, as "exposure-prone."

Dr. Nancy Dickey, a trustee of the AMA, said the medical profession must act now, before any more cases of doctor-to-patient transmission are found.

"It's important we not be seen as self-serving individuals who want to wait for the first 20 cases," she said. "We may have to make some assumptions."

Copyright 1991/The Associated Press. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Permissions Desk, The Associated Press, 50 Rockefeller Plaza, New York, NY 10020.
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