Polite critics of the AIDS amendments sponsored by Rep. William Dannemeyer in the House and Jesse Helms in the Senate call them unworkable, unwise, unfair attempts to deal with a difficult situation.
I call them bad laws that needlessly invade the privacy of health-care workers and patients, stigmatizing those infected with HIV, the AIDS virus, in the process.It's a shame both the Senate and the House have been cowed into seriously considering these proposals because of a single, unproven case of HIV transmission from health-care worker to patient.
Despite the odds against such an occurrence, the hysteria surrounding the tragedy of Kimberly Bergalis is very real and the question is no longer whether we will have new legal protections, but what their substance will be.
The Helms and Dannemeyer amendments would allow doctors to test patients and require health-care workers to disclose their HIV status, measures that would result in widespread testing of health-care workers as well as patients.
But disclosure won't work: Why would workers facing a death penalty be persuaded by a $10,000 fine or 10 years in jail?
Violations of privacy and questions of necessity notwithstanding, the biggest trouble with testing is that it's unreliable and expensive.
Our union, which has been in the forefront of AIDS education for many years, recently estimated the cost of testing all health-care workers potentially involved in invasive procedures four times a year at $1.5 billion to $3 billion, a hefty add-on to our out-of-control national health-care tab.
No, the answer isn't mandatory disclosure or mandatory testing, it's mandatory universal precautions, a remedy all medical experts agree makes the most sense.
Universal precautions require treating all patients and all workers and all blood as potential carriers the AIDS virus and erecting real barriers to its transmission, building protective practices into every health provider's everyday routine.
Universal precautions include strict standards for medical devices and for handling blood, use of protective gloves, facial shields, non-permeable gowns and intensive training of health-care professionals as well as support workers.
Universal precautions also provide protection from other bloodborne diseases such as hepatitis B, which, incidentally, kills more than 200 health-care workers every year.
The Federal Centers for Disease Control in 1985 made universal precautions the core of its guidelines. But those guidelines don't carry the force of law and so for five long years our union has been trying to persuade the Occupational Health and Safety Administration to issue a new bloodborne disease standard mandating universal precautions in all medical facilities, including private physician and dentist offices.
Frustrated and angry when the Helms amendments passed, we initiated discussions that persuaded Sens. Ted Kennedy and Bob Dole to introduce another amendment, this one making universal precautions the law of the land if OSHA doesn't act by Dec. 1. The Senate passed our amendment 99-1.
In the next few weeks, Congress will be compelled to adopt the measures proposed by Dannemeyer and Helms or follow the approach sponsored by Kennedy and Dole.
Our fervent hope is that Congress will decide in favor of universal precautions, the only sane way to cope with what is becoming an insane reaction against the victims of AIDS and the people who lovingly and courageously care for them.
(John J. Sweeney is president of the 975,000-member Service Employees International Union and chair of the AFL-CIO's health-care committee.)