The chief of Lawrence Memorial Hospital's medical staff said Friday he was pleased with the guidelines adopted this week by the American Medical Assn. concerning AIDS testing for physicians and medical health workers.
However, the official, Dr. Donald Hatton, an internist, said it will probably be some time before local hospital officials put together their own guidelines for LMH's medical personnel.
"The Centers for Disease Control have not been much in the forefront about telling institutions nor the state how to write their regulations on testing," Hatton said. "So I think it's going to be helpful for some body or organization to give us some guidelines."
The AMA approved the testing of physicians and health care workers for the AIDS virus and proposed easing informed-consent procedures so more patients could be tested for the virus.
The measures were among a package of resolutions adopted by the association at its annual meeting in Chicago to set forth the responsibilities of physicians and patients in the transmission of AIDS.
THE RESOLUTIONS were adopted in the wake of the finding that a Florida dentist, Dr. David J. Acer, apparently passed on the virus to his patients.
The AMA rejected the idea of mandatory testing as unwieldy and too expensive.
But it strongly asserted that doctors have a duty to ``do no harm'' and, if infected, must either cease performing invasive procedures or disclose their condition to their patients.
Hatton said mandatory testing would be difficult to enforce.
"I would think that the policy of voluntary testing is going to be a relatively easy one to deal with, certainly one easier to deal with than mandatory testing," he said.
Hatton said the general feeling in the medical community is that voluntary testing is favored for those people at risk.
"I think the assumption is that's what we have at the present time," he said. "There certainly is no mandatory testing from regulatory agencies, nor no testing required by the hospital to join the staff."
HATTON said there are a few situations where there is mandatory testing now, such as in the state's prison population.
"All the rest is voluntary, with counseling of the individual before and after the testing," he said. "There are other situations where testing has been done as a matter of routine in certain circumstances."
He said such circumstances might occur when a health care worker is accidentally stuck by a needle or an instrument during an operation. "If the individual can be identified, the individual is tested to let the health care worker know if he or she is being exposed to the HIV virus," Hatton said.
Another situation that leads to an HIV test "is where a patient is a multiply traumatized situation, where there is blood and body secretions everywhere," Hatton saidl
Hatton said in other cases, he thinks the tests should be performed on a voluntary basis with pre-test and post-test counseling.
HATTON said LMH routinely requires HIV testing for mothers who deliver at the hospital.
There are still many questions surrounding the issue, such as if health care workers are tested, who should have access to the information, he said.
"Those sorts of questions have not been answered, although they at least have been discussed," he said.
He said the hospital's board of trustees and the administration is currently working on a general testing policy for HIV, and a general policy of what the hospital will do if HIV exposure occurs.
Hatton said there are currently about 70 to 75 physicians who are active medical staff members, and more than 100 members, considering courtesy and honorary staff members.
The only record the hospital currently keeps of HIV infection is if a health care worker is exposure by a puncture wound during a surgical procedure, he said.
He said he was not aware of any physician on the staff who may have been infected.
"We have no organized program to deal with it or to find out about it right now," he said.