BOSTON -- As legislators grapple with requests to safeguard patient confidentiality, the limits of confidentiality for HIV and AIDS patients who may threaten the safety of others were debated last week at a hearing held by the Joint Committee on Health Care.
Health-care providers who testified were divided on the merits of the bill requiring HIV testing of patients whose bodily fluids may have come in contact with public health or public safety officials.
While some said the bill encroaches too heavily on the confidentiality of a patient's medical records, others contend the safety of workers who may be at risk of being infected should trump that confidentiality.
The state Department of Public Health has no position on the legislation, which is sponsored by Sen. Michael Morrissey, D-Quincy.
State law protects the confidentiality of HIV test results, but the bill, if passed, would create an exception to that.
Firefighters, police officers, emergency medical technicians, and medical personnel who are bitten, scratched or stabbed with a hypodermic needle while on duty would be able to file a petition through the court system to learn whether they are at risk of contracting the illness.
The hospital or clinic conducting the testing would not be liable for the release of such information.
Sen. Richard T. Moore, D-Uxbridge, who chairs the committee, said supporters of the bill have not been able to overcome one significant obstacle.
"We've had these bills before," he said after the hearing. "They have not moved forward because of the concerns about confidentiality."
Yet those confidentiality protections have not been enough to stop supporters of the bill.
Roberta Wright, a registered nurse, outlined the ordeal that followed an incident where she was accidentally pricked by a needle used on a patient who refused to be tested for HIV, calling it "above and beyond" the duties of being a nurse.
Taking as many as 16 medications to block the disease from entering her system, she said she suffered from many of the side effects of the drugs. Things would have been different if she had known whether the patient was actually HIV-positive.
"I felt like I had no choice," she said of her year spent with the fear that she may have contracted the disease.
Mary Ellen Jepsen, a nurse practitioner who practices in Springfield, however, called on legislators to reject the bill, decrying "the negative message this sends." The actual risk of contracting HIV while caring for infected patients "is negligible," she added.
Another bill heard by the committee would require the state Department of Public Health and Executive Office of Public Safety to develop guidelines for educational and training requirements that must be met by all health-care providers as well as those who counsel AIDS and HIV-positive patients.
The bill, supporters said, will help cut health-care costs, by helping workers diagnose the disease in its early stages.
