Intrepid lesbian reporter
Karen Ocamb has a special report in the latest edition of
IN LA Magazine on
the fight over what HIV testing procedures should look like in California that
Mad Professah blogged about earlier this week.
In the article "Assembly Passes Controversial HIV Testing Bill" Ocamb quotes
Mad Professah Ron Buckmire.
The coalition [to Amend AB 682], Buckmire wrote, “would like to amend the bill to ensure that patients receive an information sheet about HIV testing [as is provided for cancer screening], that the provider record in the medical chart whether the patient consented to or declined the test and document delivery of the information sheet, that HIV-positive test results are communicated in person, that non-discrimination protections be put in place to prevent HIV testing to screen out people with HIV/AIDS from routine health care services and that the impact of AB 682 be studied to see if it increases voluntary testing without diminishing patient’s autonomy, privacy and access to health care.”
The response from proponents of the bill was curious (and obnoxious). After quoting the odious
Michael Weinstein, head of AIDS Healthcare Foundation, as claiming that the actions of the City of West Hollywood passing a resolution opposing AB 682 and supporting the proposed amendments were "sad" and would "sacrifice" lives. Gee, that's really raising the level of public policy debate! Cute and cuddly he is not.
A lobbyist for AHF was given the last word in the article, which he used to reveal some curious beliefs about HIV testing as well as a cavalier attitude about California public health policy.
“I can only think that [the City Council] misunderstands the intent of the bill. The objective of AB 682 is to remove barriers to health-care providers giving HIV tests to their patients—the only exception being our continued belief that HIV testing should be voluntary, so we’ve included a provision that maintains the patient’s right to decline the offer of a test [emphasis added]," said AHF Public Policy Coordinator Joey Terrill, who is working on the bill.
"Nearly 40,000 Californians are unaware that they are HIV-positive,” says Terrill. “The two biggest barriers to testing are: first, requiring a signature before testing, and second, the requirement of a provider to obtain informed consent. AB 682 removes the requirement of a signature and lessens the burden for obtaining consent. No more, no less. AB 682 does not remove the requirement of obtaining consent nor does it in any way affect laws regarding confidentiality."
Gee, so a Public Policy Coordinator for the largest AIDS service organization in California (and the world) has a "continued belief" that a patient has a right to decline an HIV test? Well, isn't that special. So, if in the future AHF reconsiders this belief ("that HIV testing
should be voluntary") does that mean that they would be supporting mandatory HIV testing for all Californians? Because if a patient does not have a right to refuse the offer of an HIV test, how is that not mandatory testing? Also, if there is no documentation anywhere of either acceptance or refusal of an offer of an HIV test and an HIV test occurs what redress does that person who was tested have? That is the crux of the Coalition to Amend AB 682's position on the Full Employment Act for HIV Discrimination Lawyers that the current version of Assemblymember Berg's bill represents. How is a doctor having to make a notation in a medical chart that an HIV test was offered (along with a simple information sheet about the test) and what the patient's response was constitute "a psychological barrier" to testing? A barrier to the doctor or a barrier to the patient? Whose interests should California law be protecting here? Getting an HIV test can be a life-changing decision and should be a "teachable moment" for HIV prevention, at least that has been the position of AIDS educators for the last 20 years.
Note, the Coalition has not stated a position that requires that a patient give a signature before getting an HIV test, so this is simply a straw man being raised by Mr. Terrill. We believe more people should be tested for HIV, but we can not support legislation that "opens the door for coercive testing of all Californians." And neither does the CDC! The latest research shows that the way to reac the 40,000 Californians who are unaware of their HIV status is through targeted testing, not reckless universal testing with diminished patient's rights.
That Mr. Terrill says that AB 682 "lessens the burden for obtaining consent[,] No more, no less" is simply laughable. 1) There is no requirement for documentation of consent, so as any lawyer will tell you, if there's no documentation, it didn't happen. 2) AB 682 doesn't just lessen consent, it eliminates
informed consent, which is a longstanding principle in California Health law that is not clear can even be reduced, let alone eliminated due to California appellate court rulings in this area. 3) Somehow Illinois and New York state have managed to start with bills as ill-thought out and frankly dangerous as California's but Illinois' law is one the Coalition to Amend AB 682 would probably endorse and New York's is substantially better than the bill pending before the California State Senate. Hopefully intelligent legislators with longtime experience and political savvy like
Gloria Romero,
Sheila Kuehl and
Carole Migden will be able to fix this legislation before it becomes the law of the land.
Stay Tuned. Comments welcome.
